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Lo CM, Lu HI, Wang YM, Chen YH, Chen Y, Chen LC, Li SH. Preoperative neutrophil-to-lymphocyte ratio after chemoradiotherapy for esophageal squamous cell carcinoma associates with postoperative pulmonary complications following radical esophagectomy. Perioper Med (Lond) 2024; 13:65. [PMID: 38956623 PMCID: PMC11218404 DOI: 10.1186/s13741-024-00431-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/26/2024] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVES Esophagectomy after chemoradiotherapy is associated with an increased risk of surgical complications. The significance of preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio after chemoradiotherapy in predicting pulmonary complications following radical esophagectomy in esophageal squamous cell carcinoma patients receiving preoperative chemoradiotherapy remains unknown. We aimed to investigate the utility of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in predicting the pulmonary complications of esophagectomy after preoperative chemoradiotherapy. METHODS We retrospectively reviewed 111 consecutive patients with stage III esophageal squamous cell carcinoma who received preoperative chemoradiotherapy followed by esophagectomy between January 2009 and December 2017. Laboratory data were collected before the operation and surgical outcomes and complications were recorded. We calculated neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and correlated them with the clinical parameters, postoperative complications, overall survival, and disease-free survival. RESULTS Postoperative complications were observed in 75 (68%) patients, including 32 (29%) with pulmonary complications. The preoperative neutrophil-to-lymphocyte ratio of ≥ 3 (P = 0.008), clinical T4 classification (P = 0.007), and advanced stage IIIC (P = 0.012) were significantly associated with pulmonary complications. Pulmonary complication rates were 15% and 38% in patients with preoperative neutrophil-to-lymphocyte ratio of < 3 and ≥ 3, respectively. Preoperative neutrophil-to-lymphocyte ratio was not associated with the oncological stratification such as pathological T classification, pathological N classification, and pathological AJCC stage. The 3-year overall survival rates were 70% and 34% in patients with preoperative neutrophil-to-lymphocyte ratio of < 3 and ≥ 3, respectively (P = 0.0026). The 3-year disease-free survival rates were 57% and 29% in patients with preoperative neutrophil-to-lymphocyte ratio of < 3 and ≥ 3, respectively (P = 0.0055). The preoperative neutrophil-to-lymphocyte ratio of ≥ 3 was independently associated with more pulmonary complications, inferior overall survival, and worse disease-free survival. CONCLUSIONS Elevated preoperative neutrophil-to-lymphocyte ratio after chemoradiotherapy is independently associated with higher pulmonary complication rate following radical esophagectomy and poor prognosis in patients with esophageal squamous cell carcinoma receiving preoperative chemoradiotherapy. Preoperative neutrophil-to-lymphocyte ratio is routinely available in clinical practice and our findings suggest it can be used as a predictor for pulmonary complications after esophagectomy in patients with esophageal squamous cell carcinoma receiving preoperative chemoradiotherapy.
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Affiliation(s)
- Chien-Ming Lo
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hung-I Lu
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Ming Wang
- Deaprtment of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yen-Hao Chen
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu Chen
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Li-Chun Chen
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shau-Hsuan Li
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
- , No.123, Dapi Rd., Niaosong Dist., Kaohsiung City, 833, Taiwan.
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Yang Y, Liang Q, Chen Y, Cao Y, Zhuo Q, Liu B, Wang S. Aldehyde dehydrogenase 2 gene rs671 G>A polymorphism is associated with an increased risk of digestive tract cancer. J Int Med Res 2023; 51:3000605231206257. [PMID: 37871625 PMCID: PMC10594971 DOI: 10.1177/03000605231206257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 09/21/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE Acetaldehyde can accumulate in cells and form acetaldehyde-DNA adducts that result in digestive tract cancer development. Acetaldehyde dehydrogenase 2 (ALDH2) enzymatic activity is involved in this process. Here, we aimed to analyze the relationship between an ALDH2 gene polymorphism and the digestive tract cancer risk in the Hakka population in China. METHODS This was a retrospective study, with the ALDH2 rs671 genotype and medical record information collected from all subjects. The relationships between these factors, including various blood cell parameters, and digestive tract cancer susceptibility were analyzed. RESULTS Overall, 307 cancer patients and 317 controls were included. The cancer patients had significantly higher percentages with a history of smoking and drinking alcohol, as well as an increased platelet to lymphocyte ratio and lower lymphocyte to monocyte ratio, compared with the controls. The ALDH2 rs671 genotype and allele distributions were significantly different between the cancer patients and controls. Logistic regression analysis showed that the ALDH2 G/A genotype (G/A vs. G/G) and A/A genotype (A/A vs. G/G) in the co-dominant mode were risk factors for digestive tract cancer susceptibility. CONCLUSIONS ALDH2 rs671 G/A or A/A genotype carriers may have an increased risk of developing digestive tract cancers among the Hakka people.
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Affiliation(s)
- Yang Yang
- Department of Gastroenterology, Meizhou People's Hospital, Meizhou, China
| | - Qun Liang
- Department of Gastroenterology, Meizhou People's Hospital, Meizhou, China
| | - Yijin Chen
- Department of Gastroenterology, Meizhou People's Hospital, Meizhou, China
| | - Yu Cao
- Department of Gastrointestinal Surgery, Meizhou People's Hospital, Meizhou, China
| | - Qingqing Zhuo
- Department of Gastroenterology, Meizhou People's Hospital, Meizhou, China
| | - Boying Liu
- Department of Gastroenterology, Meizhou People's Hospital, Meizhou, China
| | - Shengbing Wang
- Department of Gastroenterology, Meizhou People's Hospital, Meizhou, China
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Caram LJ, Calderon F, Masino E, Ardiles V, Mauro E, Haddad L, Pekolj J, Vicens J, Gadano A, de Santibañes E, de Santibañes M. Do changes in inflammatory markers predict hepatocellular carcinoma recurrence and survival after liver transplantation? Ann Hepatobiliary Pancreat Surg 2022; 26:40-46. [PMID: 34980682 PMCID: PMC8901987 DOI: 10.14701/ahbps.21-094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/02/2021] [Accepted: 09/21/2021] [Indexed: 12/24/2022] Open
Abstract
Backgrounds/Aims The role of inflammation in malignant cell proliferation has been well described. High values of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers of systemic inflammation have shown associations with unfavorable long-term outcomes. The purpose of this study was to determine values of NLR and PLR evaluated prior to and after surgery and their associations with mortality and recurrence rates of liver transplant patients with hepatocellular carcinoma (HCC). Methods A total of 105 patients with HCC who underwent orthotopic liver transplantation (OLT) were retrospectively reviewed. NLR and PLR values were obtained from complete blood counts prior to and after surgery. Overall survival (OS) and recurrence-free survival (RFS) in relation with delta NLR and PLR were estimated. Results Serum alpha-fetoprotein levels > 100 ng/mL (p = 0.014) and lymphovascular emboli in the specimen (p = 0.048) were identified to be significant predictors of RFS. Child-Pugh score (p = 0.016) was found to be an independent factor associated with poorer OS. An increasing delta PLR was associated with worse RFS, although it showed no significant association with OS. Conclusions The analysis of PLR as a continuous variable may predict recurrence outcomes in patients undergoing OLT for HCC. It is more representative than isolated values.
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Affiliation(s)
- Lucas José Caram
- Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Francisco Calderon
- Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Esteban Masino
- Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Victoria Ardiles
- Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Ezequiel Mauro
- Department of Internal Medicine and Hepatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Leila Haddad
- Department of Internal Medicine and Hepatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Juan Pekolj
- Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Jimena Vicens
- Department of Internal Medicine and Statistics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Adrian Gadano
- Department of Internal Medicine and Hepatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Eduardo de Santibañes
- Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Martín de Santibañes
- Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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The Clinical Impacts of Neutrophil to Lymphocyte Ratio for Esophageal Cancer Patients Who Receive Curative Treatment. Indian J Surg 2022. [DOI: 10.1007/s12262-021-02830-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Kumarasamy C, Tiwary V, Sunil K, Suresh D, Shetty S, Muthukaliannan GK, Baxi S, Jayaraj R. Prognostic Utility of Platelet-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio and Monocyte-Lymphocyte Ratio in Head and Neck Cancers: A Detailed PRISMA Compliant Systematic Review and Meta-Analysis. Cancers (Basel) 2021; 13:cancers13164166. [PMID: 34439320 PMCID: PMC8393748 DOI: 10.3390/cancers13164166] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/14/2021] [Accepted: 08/16/2021] [Indexed: 01/19/2023] Open
Abstract
Simple Summary Inflammation plays a major role in cancer development and progression and has the potential to be used as a prognostic marker in cancer. Previous studies have attempted to evaluate PLR, NLR and MLR as indicators of inflammation/prognostic markers in cancer, but there is no common consensus on its application in clinical practice. The aim of this systematic review and meta-analysis (a) assess the prognostic efficacy of all three prognostic markers in comparison to each other and, (b) investigate the prognostic potential of these three markers in HNC. The study followed PRISMA guidelines, with literature being collated from multiple bibliographic databases. Preliminary and secondary screening were carried out using stringent inclusion/exclusion criteria. Abstract Inflammation plays a major role in cancer development and progression and has the potential to be used as a prognostic marker in cancer. Previous studies have attempted to evaluate Platelet-to-lymphocyte ratio (PLR), neutrophil–lymphocyte ratio (NLR) or monocyte–lymphocyte ratio (MLR) as indicators of inflammation/prognostic markers in cancer, but there is no common consensus on their application in clinical practice. The aim of this systematic review and meta-analysis is to (a) assess the prognostic efficacy of all three prognostic markers in comparison to each other and (b) investigate the prognostic potential of these three markers in HNC. The study followed PRISMA guidelines, with the literature being collated from multiple bibliographic databases. Preliminary and secondary screening were carried out using stringent inclusion/exclusion criteria. Meta-analysis was carried out on selected studies using CMA software and HR as the pooled effect size metric. A total of 49 studies were included in the study. The pooled HR values of PLR, NLR and MLR indicated that they were significantly correlated with poorer OS. The pooled effect estimates for PLR, NLR and MLR were 1.461 (95% CI 1.329–1.674), 1.639 (95% CI 1.429–1.880) and 1.002 (95% CI 0.720–1.396), respectively. Significant between-study heterogeneity was observed in the meta-analysis of all three. The results of this study suggest that PLR, NLR and MLR ratios can be powerful prognostic markers in head and neck cancers that can guide treatment. Further evidence from large-scale clinical studies on patient cohorts are required before they can be incorporated as a part of the clinical method. PROSPERO Registration ID: CRD42019121008
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Affiliation(s)
- Chellan Kumarasamy
- School of Health and Medical Sciences, Curtin University, Perth, WA 6102, Australia;
| | - Vaibhav Tiwary
- School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, India; (V.T.); (G.K.M.)
| | - Krishnan Sunil
- Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL 32224, USA;
| | - Deepa Suresh
- Division of Endocrinology, Department of Internal Medicine, Mayo Clinic Florida, Jacksonville, FL 32224, USA;
| | - Sameep Shetty
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, A Constituent of MAHE, Manipal 576104, India;
| | | | - Siddhartha Baxi
- Radiation Oncology, Genesiscare Gold Coast, John Flynn Hospital, 42 Inland Drive, Tugun, QLD 4224, Australia;
| | - Rama Jayaraj
- Northern Territory Institute of Research and Training, Darwin, NT 0909, Australia
- Correspondence:
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Micaela R, Lucas C, Franco C, Federico C, Agustín D, David S. Dynamic perioperative variation of neutrophil-to-lymphocyte ratio as an independent prognosis factor following lobectomy for NSCLC. Updates Surg 2021; 73:1567-1574. [PMID: 33387167 DOI: 10.1007/s13304-020-00936-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/19/2020] [Indexed: 10/22/2022]
Abstract
Inflammation plays a key role in malignant tumor progression. The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation and, as such, high isolated pretreatment NLR has been shown to be associated with worse long-term outcomes. The aim of the present study is to evaluate the prognostic value of pre- and post-operative NLR in relation to mortality and recurrence rates in patients undergoing lung lobectomy for NSCLC. A single-center retrospective analysis of 534 lobectomies was performed between 2009 and 2018. NLR was measured in two opportunities: 1 month prior to surgery and 1-4 months after. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS). Secondary outcomes were variables associated with mortality and recurrence. The study sample included 264 lobectomies. Independent predictors of OS were ASA 3/4 (p = 0.041) and open surgical approach (p = 0.042). Adjuvant chemotherapy (p = 0.002) and pathological N 1/2-stage (p = 0.0015) were associated with RFS. Delta NLR correlated with OS (p = 0.042) and RFS (p < 0.001). Patients were divided into three delta NLR categories: delta NLR < 0, delta NLR 0-0.5 and delta NLR > 0.5. Increasing delta NLR was significantly associated with worse OS (p < 0.001) and RFS (p < 0.001). Dynamic behaviour of NLR assessed through delta NLR is a useful tool that potentially allows predicting mortality and recurrence outcomes in patients undergoing lung lobectomy for NSCLC and may be more informative than static baseline values.
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Affiliation(s)
- Raices Micaela
- Department of General Surgery, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina
| | - Caram Lucas
- Department of General Surgery, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina
| | - Corvatta Franco
- Department of General Surgery, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina.
| | - Cayol Federico
- Department of Oncology, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina
| | - Dietrich Agustín
- Department of Thoracic Surgery and Pulmonary Transplantation, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina
| | - Smith David
- Department of Thoracic Surgery and Pulmonary Transplantation, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina
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Clinicopathological and prognostic significance of platelet-lymphocyte ratio (PLR) in gastric cancer: an updated meta-analysis. World J Surg Oncol 2020; 18:191. [PMID: 32731872 PMCID: PMC7391520 DOI: 10.1186/s12957-020-01952-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 07/07/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Pre-treatment PLR (platelet-lymphocyte ratio) was reported to be associated with the prognosis in gastric cancer (GC), but the results remain inconclusive. This meta-analysis aimed to investigate the prognostic potential of the pre-treatment PLR in gastric cancer. METHODS We performed a systematic literature search in PubMed, Embase, and the Cochrane Library to identify eligible publications. The hazard ratio (HR)/odds ratio (OR) and its 95% confidence (CI) of survival outcomes and clinicopathological parameters were calculated. RESULTS A total of 49 studies (51 cohorts), collecting data from 28,929 GC patients, were included in the final analysis. The pooled results demonstrated that the elevated pre-treatment PLR was significantly associated with poor overall survival (OS) (HR 1.37, 95% CI 1.26-1.49, p < 0.001; I2 = 79.90%, Ph < 0.001) and disease-free survival (DFS) (HR 1.52, 95% CI 1.22-1.90, p < 0.001, I2 = 88.6%, Ph < 0.001). Furthermore, the patients with the elevated PLR had a higher risk of lymph node metastasis (OR = 1.17, 95% CI 1.02-1.33, p = 0.023), serosal invasion (T3+T4) (OR = 1.34, 95% CI 1.10-1.64, p = 0.003), and increased advanced stage (III+IV) (OR = 1.20, 95% CI 1.06-1.37, p = 0.004). CONCLUSIONS An elevated pre-treatment PLR was a prognostic factor for poor OS and DFS and associated with poor clinicopathological parameters in GC patients.
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Hu J, Chen D, Wu S, Chen Y, Li R, Miao H, Wen Z. Prognostic significance of neutrophil-to-lymphocyte ratio in middle thoracic esophageal squamous cell carcinoma patients undergoing radical esophagectomy. J Thorac Dis 2020; 12:363-374. [PMID: 32274102 PMCID: PMC7139068 DOI: 10.21037/jtd.2020.01.31] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background It is widely accepted that the pretreatment neutrophil-to-lymphocyte ratio (NLR) is an independent predictor of prognosis in multiple malignancies, including esophageal squamous cell carcinoma (ESCC). However, its predictive value in middle thoracic esophageal carcinoma is still unclear. Therefore, the purpose of this study was to investigate the preoperative serum levels of NLR in middle thoracic esophageal carcinoma patients to clarify their clinical significance as predictors of prognosis. Methods This study investigated 556 patients with middle thoracic ESCC treated by esophagectomy from January 2010 to December 2012. The prognostic impact of serum NLR level was analyzed. A receiver operating characteristic (ROC) curve was used to identify the NLR for predicting survival. Correlation between the NLR and clinicopathological characteristics was analyzed by χ2 test. Prognostic influence was calculated by using the Kaplan-Meier method and the difference was compared by log-rank test. Cox regression analysis was performed to evaluate the significant prognostic factors. Results The cutoff value for the NLR was 2.43 ng/mL, the area under the curve was 0.553 (95% CI: 0.504–0.601; P=0.035), and the sensitivity and specificity were 53.3% and 58.7% respectively. It is demonstrated that preoperative NLR (P=0.003), T stage (P<0.001), N stage (P<0.001), surgical approach (P=0.004), and gender (P=0.008) were independent prognostic factors in middle thoracic ESCC by univariate analysis. Multivariate analysis showed that preoperative NLR (P=0.036), T stage (P=0.004), N stage (P<0.001), surgical approach (P=0.002), and age (P=0.019) were independent prognostic factors for survival. Conclusions Pretreatment NLR >2.43 ng/mL could serve as an indicator of poor prognosis in middle thoracic ESCC patients after surgical treatment.
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Affiliation(s)
- Jia Hu
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Dongni Chen
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Shaoyong Wu
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Youfang Chen
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Rongzhen Li
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Huikai Miao
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Zhesheng Wen
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
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Liu XB, Gao ZY, Zhang QH, Pandey S, Gao B, Yang F, Tong Q, Li SB. Preoperative Neutrophil Lymphocyte Ratio Can Be Used as a Predictor of Prognosis in Patients With Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta Analysis. Front Oncol 2020; 10:178. [PMID: 32154173 PMCID: PMC7046751 DOI: 10.3389/fonc.2020.00178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 02/03/2020] [Indexed: 01/19/2023] Open
Abstract
Objective: Neutrophil lymphocyte ratio (NLR), Lymphocyte mononuclear cell ratio (LMR), and Platelet lymphocyte ratio (PLR) can be used as various prognostic factors for malignant tumors, but the value of prognosis for patients with adenocarcinoma of the esophagogastric junction (AEG) has not been determined. This study used meta-analysis to assess the value of these indicators in the evaluation of AEG prognosis. Methods: Relevant literatures on the prognostic relationship between NLR, LMR, PLR, and AEG was retrieved from PubMed, Web of Science, Embase, Cochrane Library, Cochrane Central Register of Controlled Trials, Wanfang data, and Chinese National Knowledge Infrastructure. The search time from database establishment to June 30, 2019. The language is limited to English and Chinese. Data was analyzed using Stata 15.0 software. Result: Six retrospective studies were included, five of them involved NLR and six of them involved PLR. No LMR literature that adequately satisfied the conditions was retrieved. Increased NLR was significantly associated with a significant reduction in overall survival (OS), cancer-specific survival (CSS), or disease specific survival (DSS) in patients with AEG [hazard ratio (HR) = 1.545, 95% CI: 1.096-2.179, P < 0.05]. Subgroup analysis showed that NLR had significant value in the prognosis of both Chinese and Non-Chinese patients (P = 0.009 vs. P = 0.000). NLR had significant prognostic value for ≥3 and <3 groups (P = 0.022 vs. P = 0.000). NLR has a significant prognostic value for samples ≥500 and <500 (P = 0.000 vs. P = 0.022). NLR and OS/CSS/DSS single factor meta-regression showed that regional NLR cut-off values and sample size may be the source of heterogeneity in AEG patients (all P < 0.05). There was no significant association between elevated PLR and OS in patients with AEG (HR = 1.117, 95% CI: 0.960-1.300, P > 0.05). PLR had no significant prognostic value for both Chinese and UK patients (P = 0.282 vs. P = 0.429). PLR had no significant prognostic value for ≥150 group and <150 group (P = 0.141 and P = 0.724). No significant prognostic value was found in either the 300 group and <300 group (P = 0.282 vs. P = 0.429). Conclusion: Preoperative NLR rise was an adverse prognostic indicator of AEG. High-risk patients should be treated promptly. The results showed that PLR was not recommended as a prognostic indicator of AEG.
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Affiliation(s)
- Xiao-Bo Liu
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Zi-Ye Gao
- Department of Oncology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Qing-Hui Zhang
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Sandeep Pandey
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan, China.,Post Graduate Department, Hubei University of Medicine, Shiyan, China
| | - Bo Gao
- Department of Laboratory Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Fan Yang
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Qiang Tong
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Sheng-Bao Li
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
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Szor DJ, Dias AR, Pereira MA, Ramos MFKP, Zilberstein B, Cecconello I, Ribeiro U. Neutrophil-lymphocyte ratio change after curative gastrectomy for gastric cancer: a subgroup analysis. EINSTEIN-SAO PAULO 2020; 18:eAO4860. [PMID: 31778466 PMCID: PMC6896601 DOI: 10.31744/einstein_journal/2020ao4860] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 06/07/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To evaluate the impact of neutrophil-lymphocyte ratio change after curative surgery for gastric cancer. METHODS A retrospective analysis of patients with gastric cancer who underwent curative surgery between 2009 and 2017 was performed. A cutoff value was established for the neutrophil-lymphocyte ratio in the pre- and postoperative periods, according to the median value, and four subgroups were formed (low-low/low-high/high-low/high-high). Clinical-pathological and survival data were analyzed and related to these subgroups. RESULTS A total of 325 patients were included in the study. The cutoff values of the neutrophil-lymphocyte ratio were 2.14 and 1.8 for the pre and postoperative periods, respectively. In patients with stages I and II, the high-high subgroup presented worse overall survival (p=0.016) and disease-free survival (p=0.001). Complications were higher in the low-high subgroup of patients. CONCLUSION The neutrophil-lymphocyte ratio is a low cost, efficient and reproducible marker. The prognosis individualization can be performed according to the identification of subgroups at a higher risk of complications and worse prognosis.
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Affiliation(s)
- Daniel José Szor
- Universidade de São PauloFaculdade de MedicinaInstituto do Câncer do Estado de São PauloSão PauloSPBrazilInstituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
- Corresponding author: Daniel José Szor Avenida Dr. Enéas Carvalho de Aguiar, 255 Cerqueira César Zip code: 05403-000 – São Paulo, SP, Brazil Phone: (55 11) 3289-5222 E-mail:
| | - André Roncon Dias
- Universidade de São PauloFaculdade de MedicinaInstituto do Câncer do Estado de São PauloSão PauloSPBrazilInstituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Marina Alessandra Pereira
- Universidade de São PauloFaculdade de MedicinaInstituto do Câncer do Estado de São PauloSão PauloSPBrazilInstituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Marcus Fernando Kodama Pertille Ramos
- Universidade de São PauloFaculdade de MedicinaInstituto do Câncer do Estado de São PauloSão PauloSPBrazilInstituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Bruno Zilberstein
- Universidade de São PauloFaculdade de MedicinaInstituto do Câncer do Estado de São PauloSão PauloSPBrazilInstituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Ivan Cecconello
- Universidade de São PauloFaculdade de MedicinaInstituto do Câncer do Estado de São PauloSão PauloSPBrazilInstituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Ulysses Ribeiro
- Universidade de São PauloFaculdade de MedicinaInstituto do Câncer do Estado de São PauloSão PauloSPBrazilInstituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
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11
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Liu CT, Hong CQ, Huang XC, Li EM, Xu YW, Peng YH. Blood-based Markers in the Prognostic Prediction of Esophagogastric Junction Cancer. J Cancer 2020; 11:4332-4342. [PMID: 32489452 PMCID: PMC7255356 DOI: 10.7150/jca.44545] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/13/2020] [Indexed: 02/05/2023] Open
Abstract
Esophagogastric junction cancer poses a great threat to human beings both in western countries and East Asia, especially in China and Japan, and its incidence has increased during recent decades. The 5-year survival rate of esophagogastric junction cancer is quite poor compared with that of other gastric cancer sites. Until now, the traditional TNM staging system has been widely used in clinical practice for prognosis. However, the TNM system is based on pathology after surgical resection or radiology using CT and MRI, not on blood markers. Evidently, some research has been reported concentrated on the prognostic value of blood-based markers with the character of non-invasive and non-radioactive in EJA. Hematologic, biochemical and coagulation parameters could be obtained from clinical data and utilized to analyze their prognostic values. Tumor-associated antigens, microRNAs and circulating tumor cells have also been reported in EJC prognosis. In this article, we review research focused on blood-based markers to evaluate their prognostic value in esophagogastric junction cancer, especially its main subtype adenocarcinoma.
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Affiliation(s)
- Can-Tong Liu
- Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Chao-Qun Hong
- Department of Oncological Laboratory Research, the Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xu-Chun Huang
- Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
| | - En-Min Li
- Department of Biochemistry and Molecular Biology, Shantou University Medical College, Shantou, Guangdong, China
| | - Yi-Wei Xu
- Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
- ✉ Corresponding authors: Yu-Hui Peng, Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou 515041, Guangdong, China. E-mail: ; Telephone: +86-137-1591-2739; Fax: +86-754-8856-0352. Also correspondence to Yi-Wei Xu,
| | - Yu-Hui Peng
- Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
- ✉ Corresponding authors: Yu-Hui Peng, Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou 515041, Guangdong, China. E-mail: ; Telephone: +86-137-1591-2739; Fax: +86-754-8856-0352. Also correspondence to Yi-Wei Xu,
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12
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Prognostic Value of the Systemic Inflammation Response Index in Patients with Adenocarcinoma of the Oesophagogastric Junction: A Propensity Score-Matched Analysis. DISEASE MARKERS 2019; 2019:4659048. [PMID: 31781301 PMCID: PMC6875417 DOI: 10.1155/2019/4659048] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/06/2019] [Accepted: 10/10/2019] [Indexed: 01/19/2023]
Abstract
Systemic inflammation is closely related to the occurrence and development of tumours. Based on preoperative neutrophil, monocyte, and lymphocyte counts, a new systemic inflammation response index (SIRI) was established, and the predictive ability of the SIRI for the survival of patients with adenocarcinoma of the oesophagogastric junction (AEG) was evaluated by propensity score matching (PSM) analysis. A total of 302 AEG patients undergoing radical surgery were studied. Univariate and multivariate analyses were performed using Cox proportional hazards regression models. Time-dependent receiver operating characteristic (ROC) curves were used to compare the predictive capabilities of the SIRI. PSM was implemented to balance the baseline characteristics. The results showed that the SIRI, PLR, NLR, and MLR were associated with overall survival (OS) in AEG patients based on the Kaplan-Meier survival analysis. Multivariate analysis demonstrated that the SIRI was an independent prognostic factor. The AUC for the SIRI was significantly greater than that for the NLR, PLR, and MLR in predicting the 3- and 5-year OS of AEG patients. In PSM analysis, the SIRI remained an independent prognostic indicator of OS in AEG patients. The SIRI is a novel, simple, and inexpensive prognostic predictor for AEG. The prognostic value of the SIRI is superior to that of the PLR, NLR, and MLR. The SIRI can be used to distinguish the prognosis of AEG patients with different TNM stages and can be an important supplement to TNM staging.
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13
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Li KJ, Xia XF, Su M, Zhang H, Chen WH, Zou CL. Predictive value of lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) in patients with oesophageal cancer undergoing concurrent chemoradiotherapy. BMC Cancer 2019; 19:1004. [PMID: 31655563 PMCID: PMC6815405 DOI: 10.1186/s12885-019-6157-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 09/13/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The survival rate of patients with advanced oesophageal cancer is very low and can vary significantly, even among patients with the same TNM stage. It is important to look for indicators that are economical and readily available to predict overall survival. The aim of this study was to determine whether lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) could be potential predictors of survival in patients with advanced oesophageal squamous cell carcinoma (ESCC) undergoing concurrent chemoradiotherapy. METHODS Differences in survival among 204 patients with advanced oesophageal cancer who underwent concurrent chemoradiotherapy were collected and analysed. Univariate and multivariate COX regression analyses were used to investigate the association between blood inflammatory markers and patient survival before treatment. RESULTS Univariate COX regression analyses showed that a history of alcohol use, neutrophil count, LMR, NLR, tumour length, and N stage were significantly associated with the survival of tumour patients receiving concurrent chemoradiotherapy. Multivariate COX regression analysis showed that NLR and LMR were predictors of outcome in tumour patients receiving chemoradiotherapy. According to receiver operating characteristic (ROC) curve analysis, the AUC of LMR and NLR was 0.734 and 0.749, and the best cutoff point for LMR and NLR was 3.03 and 2.64, respectively. CONCLUSIONS LMR and NLR can be used to predict the survival of patients with advanced oesophageal cancer receiving concurrent chemoradiotherapy, thereby providing clinicians with suggestions for further treatment options.
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Affiliation(s)
- Ke-Jie Li
- Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
| | - Xiao-Fang Xia
- Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
| | - Meng Su
- Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, WenZhou, China
| | - Hui Zhang
- Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
| | - Wen-Hao Chen
- Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
| | - Chang-Lin Zou
- Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, WenZhou, China
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14
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Pirozzolo G, Gisbertz SS, Castoro C, van Berge Henegouwen MI, Scarpa M. Neutrophil-to-lymphocyte ratio as prognostic marker in esophageal cancer: a systematic review and meta-analysis. J Thorac Dis 2019; 11:3136-3145. [PMID: 31463142 DOI: 10.21037/jtd.2019.07.30] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A high preoperative neutrophil-lymphocyte ratio (NLR) has been shown in several studies as a predictor of worse survival in many solid neoplasms, including esophageal cancer, but its impact remains unclear. The goal of this systematic review was to gain all the evidence about NLR in order to analyse its potential in predicting survival in esophageal cancer. Therefore, we conducted a systematic literature search of all relevant studies reporting data on NLR as prognostic marker in esophageal cancer patients. We considered overall survival (OS) as primary outcome, disease-free survival (DFS) and progression-free survival (PFS) as secondary outcomes. We included studies with a directly or indirectly available hazard ratio (HR), furthermore we used both fixed effect model and random effect model depending on heterogeneity. We included a total of 20 studies, published between 2011 and 2017, consisting of 6,457 patients. The NLR cut-off value ranges from 1.7 to 5. The HR for OS of all included studies was 1.60. The HR for DFS and PFS was 1.75 and 1.66 respectively. The survival sub-analysis about tumor characteristics, treatment modality, blood sample timing also confirmed NLR prognostic relevance with statistically significant results. The meta-analysis showed that high preoperative NLR is associated with worse survival in esophageal cancer, as shown in several solid tumors, but its use in the clinical practice is still underestimated. High-quality studies are needed to assess the most effective cut-off in survival prognostication and NLR relevance on postoperative complications.
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Affiliation(s)
| | - Suzanne S Gisbertz
- General Surgery Department, AMC-Academic Medical Center, Amsterdam, The Netherlands
| | - Carlo Castoro
- Esophago-gastric Surgery Department, Humanitas Research Hospital, Rozzano, Italy
| | | | - Marco Scarpa
- General Surgery Department, Padua Hospital, Padua, Italy
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15
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Fuentes HE, Oramas DM, Paz LH, Wang Y, Andrade XA, Tafur AJ. Venous Thromboembolism Is an Independent Predictor of Mortality Among Patients with Gastric Cancer. J Gastrointest Cancer 2019. [PMID: 28634671 DOI: 10.1007/s12029-017-9981-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Venous thromboembolism (VTE) is an independent predictor of death among patients with cancer. Patients with gastric cancer (GC) are at higher risk for VTE when compared to other solid tumors, and if one considers its prevalence, GC may be responsible for one of the highest incidences of cancer-associated thrombosis. The impact of VTE on mortality is not well defined among patients with GC. AIM The aim of this study is to measure the impact of VTE as independent predictor of GC mortality. METHODS Chart review of patients with GC treated in the Department of Oncology at John Stroger Hospital between the years of 2010 and 2015. VTE events were objectively confirmed with imaging in all cases. Active GC was defined as biopsy-proven metastatic disease or on active chemotherapy. Along with cancer-specific data, we abstracted risk assessments tools, non-GC-specific, validated for VTE and mortality prediction cancer, including the Khorana score (KRS), platelet lymphocyte ratio (PLR), and neutrophil lymphocyte ratio (NLR). Continuous variables are expressed by the median as appropriate according to normality. Categorical variables are expressed as percentages. SPSS version 22 was used and chi-square, Mann-Whitney U, Kaplan-Meier curve, and Cox proportional hazard with forward modeling were applied. RESULTS We included 112 patients in the analysis. The patients were predominantly men (66%), 58-year-old, with adenocarcinoma (84%) and advanced disease (59%). The median follow-up was 21.3 months (IQR 8.9-42.4). Cumulative incidence of VTE at 1 year was 9%. The median time from diagnosis to VTE occurrence was 59 days (IQR 36 to 258). Patients with VTE had worse OS when compared to the non-VTE group (medians 11.87 vs 29.97 months, p = 0.02). Patients stratified as high risk by the PLR had worse OS (medians 22.6 vs 42.77 months, p = 0.02). There was no statistical difference in OS among patients stratified as high risk by the KRS (medians 23.7 vs 42.5, p = 0.16) and NLR (medians 24.1 vs 42.7 months, p = 0.21). In multivariate analysis, the independent predictors of mortality were VTE (hazard ratio (HR), 2.9; 95% CI, 1.4 to 6.6; p < 0.01), adenocarcinoma (HR, 3.1; 95% CI, 1.1 to 9.0; p = 0.03), advanced disease (HR, 2.8; 95% CI, 1.4 to 5.8; p < 0.01), and PLR (HR, 2.2; 95% CI, 1.3 to 3.8; p < 0.01). CONCLUSION VTE is associated with worse survival among patients with GC along with adenocarcinoma, advanced disease, and PLR. Moreover, these findings were independent of other cancer- and treatment-specific variables. Although potentially predictive in other cancer types, NLR and KRS were not associated with worse survival in this cohort.
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Affiliation(s)
- Harry E Fuentes
- Department of Internal Medicine, John Stroger Jr. Hospital, 1900 West Polk Street, Chicago, IL, 60612, USA.
| | - D M Oramas
- Department of Pathology, University of Illinois at Chicago, Chicago, IL, USA
| | - L H Paz
- Department of Internal Medicine, John Stroger Jr. Hospital, 1900 West Polk Street, Chicago, IL, 60612, USA
| | - Y Wang
- Department of Internal Medicine, John Stroger Jr. Hospital, 1900 West Polk Street, Chicago, IL, 60612, USA
| | - X A Andrade
- Department of Internal Medicine, John Stroger Jr. Hospital, 1900 West Polk Street, Chicago, IL, 60612, USA
| | - A J Tafur
- Cardiology - Vascular Medicine, NorthShore University HealthSystem, Evanston, IL, USA
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16
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Zhang X, Jiang Y, Wang Y, Wang Z, Zhao L, Xue X, Sang S, Zhang L. Prognostic role of neutrophil-lymphocyte ratio in esophageal cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e13585. [PMID: 30544482 PMCID: PMC6310576 DOI: 10.1097/md.0000000000013585] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The prognostic role of neutrophil-to-lymphocyte ratio (NLR) in esophageal cancer (EC) remains controversial. METHODS The aim of this study was to evaluate the association between NLR and oncologic outcome of EC patients through a meta-analysis. A systematic search was performed in PubMed, Web of Science and Embase for relevant studies. Meta-analysis was performed using hazard ratio (HR) and95% confidence interval (CI) as effect measures. RESULTS Finally, 33 articles with 11,039patients were included in our study. The synthesized results indicated that the elevated NLR was negatively related to overall survival (OS) (HR = 1.39, 95% CI: 1.23-1.54). When the patients were stratified according to country, pathological type, treatment strategies, sample size, and different HR estimate method, high NLR was also significantly correlated with poor OS. Similarly, elevated NLR was also associated with shorter disease-free survival (DFS), progress-free survival (PFS), relapse-free survival (RFS), and cancer-specific survival (CSS). CONCLUSION The elevated pretreatment NLR is associated with poor oncological outcomes in patients with EC. NLR may be a significant predictive biomarker in EC. Further large-cohort studies are needed to confirm these findings.
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Affiliation(s)
| | | | - Yang Wang
- Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan
| | | | - Linping Zhao
- Department of Thoracic Surgery, Shouguang City People's Hospital, Shouguang
| | - Xianbiao Xue
- Department of Thoracic Surgery, Juye County People's Hospital, Juye
| | - Shaowei Sang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, People's Republic of China
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17
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Diagnosis and survival values of neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in esophageal cancer. Clin Chim Acta 2018; 488:150-158. [PMID: 30389457 DOI: 10.1016/j.cca.2018.10.042] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 10/07/2018] [Accepted: 10/29/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Recent studies have borne out claims that inflammation has a vital role in the development and progression of many diseases, including cancers. It has been reported that neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) could act as independent prognostic factors for several malignant tumors. We evaluated the diagnosis and prognosis values of preoperative inflammatory indicators, including NLR and RDW in esophageal cancer (EC). METHODS We retrospectively analyzed the clinical data of 354 EC patients and 220 early esophageal cancer (EEC) undergoing potentially curative esophagectomy in Shandong Provincial Hospital Affiliated to Shandong University and chose 201 age and sex-matched healthy volunteers as the control group. We compared the clinicopathological features, survival curves and prognosis of the EC patients between the high and low groups according to the cutoff values of NLR and RDW. RESULTS Significant higher preoperative NLR and RDW values were detected in patients with EEC and EC compared to the healthy controls (P < .001). A high RDW was significantly associated with an older age (P < .05). NLR and RDW values after surgery in EC group were significantly higher than those before surgery (P < .001 and P < .001, respectively). For EEC group, a higher RDW value showed a significantly worse overall survival (OS) and disease-free survival (DFS) (P = .040 and P = .013, respectively). For EC group, an increased NLR indicated a significantly association with poor overall survival (OS) (P = .004) and DFS (P = .001). Preoperative NLR can act as an independent prognostic indicator for EC. CONCLUSION The preoperative NLR and RDW are convenient, practical easily measured biomarkers of clinical diagnosis and prognostic assessment of patients with EC. Furthermore, NLR was more effective than RDW acting as an independent prognostic biomarker for EC.
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18
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Hirahara N, Tajima Y, Fujii Y, Hyakudomi R, Yamamoto T, Ishitobi K, Taniura T, Kawabata Y. Prognostic significance of red cell distribution width in esophageal squamous cell carcinoma. J Surg Res 2018; 230:53-60. [PMID: 30100040 DOI: 10.1016/j.jss.2018.04.051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 04/11/2018] [Accepted: 04/19/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Red cell distribution width (RDW) is routinely assessed as part of the complete blood count (CBC) to gather information on the heterogeneity in the size of circulating erythrocytes. RDW is a more sensitive screening marker for anemia, inflammation, and nutritional deficiencies. The purpose of this study was to explore the prognostic value of RDW in esophageal squamous cell carcinoma (ESCC) patients. METHODS We conducted a retrospective study of data from 148 ESCC consecutive patients who underwent potentially curative esophagectomy and analyzed the correlation of RDW with various clinicopathological factors. RESULTS Multivariate analyses identified a high RDW (HR, 2.061; P = 0.0286) as a significant risk factor for cancer-specific survival (CSS). Kaplan-Meier analysis and the log-rank test demonstrated that patients with a high RDW had a significantly worse prognosis in terms of CSS than those with a low RDW (P = 0.0011). In multivariate analysis, there was no significant relationship between RDW and CSS in pathological tumor node metastasis stage I or II patients. However, a high RDW (HR, 2.386; P = 0.0471) was confirmed to be an independent worse prognostic factor for CSS in pathological tumor node metastasis stage III cancer patients. Kaplan-Meier analysis and the log-rank test showed a significant relationship between RDW and CSS in patients with pathological tumor node metastasis stage III (P = 0.0175). CONCLUSIONS The RDW was a significant and independent predictor of poor survival in ESCC patients after curative esophagectomy. RDW may aid clinicians in detecting signs of recurrence very early and effectively customize treatment regimens. RDW is thus a convenient, cost-effective, and readily available biomarker to predict survival in ESCC.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Yusuke Fujii
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Kazunari Ishitobi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Takahito Taniura
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Yasunari Kawabata
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
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19
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Weng W, Chen X, Gong S, Guo L, Zhang X. Preoperative neutrophil–lymphocyte ratio correlated with glioma grading and glioblastoma survival. Neurol Res 2018; 40:917-922. [PMID: 30074469 DOI: 10.1080/01616412.2018.1497271] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Weiji Weng
- Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xu Chen
- Department of Neurosurgery, Shangrao People’s Hospital, Shangrao, China
| | - Shaohui Gong
- Department of Neurosurgery, Shangrao People’s Hospital, Shangrao, China
| | - Liemei Guo
- Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaohua Zhang
- Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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20
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Athanasiou A, Spartalis M, Spartalis E. Platelets-to-lymphocyte ratio and esophageal cancer. J Thorac Dis 2018; 10:E650-E651. [PMID: 30233905 DOI: 10.21037/jtd.2018.07.41] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Antonios Athanasiou
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Michael Spartalis
- Laboratory of Experimental Surgery and Surgical Research, University of Athens, Medical School, Athens, Greece
| | - Eleftherios Spartalis
- Laboratory of Experimental Surgery and Surgical Research, University of Athens, Medical School, Athens, Greece
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21
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Wang Y, Qu X, Kam NW, Wang K, Shen H, Liu Q, Du J. An inflammation-related nomogram for predicting the survival of patients with non-small cell lung cancer after pulmonary lobectomy. BMC Cancer 2018; 18:692. [PMID: 29940884 PMCID: PMC6019648 DOI: 10.1186/s12885-018-4513-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 05/16/2018] [Indexed: 11/20/2022] Open
Abstract
Background Emerging inflammatory response biomarkers are developed to predict the survival of patients with cancer, the aim of our study is to establish an inflammation-related nomogram based on the classical predictive biomarkers to predict the survivals of patients with non-small cell lung cancer (NSCLC). Methods Nine hundred and fifty-two NSCLC patients with lung cancer surgery performed were enrolled into this study. The cutoffs of inflammatory response biomarkers were determined by Receiver operating curve (ROC). Univariate and multivariate analysis were conducted to select independent prognostic factors to develop the nomogram. Results The median follow-up time was 40.0 months (range, 1 to 92 months). The neutrophil to lymphocyte ratio (cut-off: 3.10, HR:1.648, P = 0.045) was selected to establish the nomogram which could predict the 5-year OS probability. The C-index of nomogram was 0.72 and the 5-year OS calibration curve displayed an optimal agreement between the actual observed outcomes and the predictive results. Conclusions Neutrophil to lymphocyte ratio was shown to be a valuable biomarker for predicting survival of patients with NSCLC. The addition of neutrophil to lymphocyte ratio could improve the accuracy and predictability of the nomogram in order to provide reference for clinicians to assess patient outcomes.
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Affiliation(s)
- Ying Wang
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, People's Republic of China.,Department of Clinical Oncology, The University of Hong Kong, Laboratory block, 21 Sassoon, Pokfulam, Hong Kong, People's Republic of China
| | - Xiao Qu
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, People's Republic of China
| | - Ngar-Woon Kam
- Department of Clinical Oncology, The University of Hong Kong, Laboratory block, 21 Sassoon, Pokfulam, Hong Kong, People's Republic of China
| | - Kai Wang
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, People's Republic of China
| | - Hongchang Shen
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, People's Republic of China
| | - Qi Liu
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, People's Republic of China.
| | - Jiajun Du
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, People's Republic of China. .,Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, People's Republic of China.
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22
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Urabe M, Yamashita H, Uemura Y, Tanabe A, Yagi K, Aikou S, Seto Y. Non-linear association between long-term outcome and preoperative neutrophil-to-lymphocyte ratio in patients undergoing curative resection for gastric cancer: a retrospective analysis of 1335 cases in a tetrachotomous manner. Jpn J Clin Oncol 2018; 48:343-349. [PMID: 29420755 DOI: 10.1093/jjco/hyy005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 01/17/2018] [Indexed: 12/18/2022] Open
Abstract
Objective Although the prognostic utility of the pretreatment neutrophil-to-lymphocyte ratio (NLR) has been widely reported for gastric cancer and several other malignancies, the optimal patient stratification methodologies for such analyses have yet to be established. We aimed to examine the predictive value of preoperative NLR in patients with operable gastric cancer, and to elucidate whether or not the relationship between long-term outcome and pretreatment NLR is monotonically linear. Methods Preoperative data from 1335 patients who underwent curative surgery for gastric cancer were retrospectively evaluated. Patients were divided into four groups (Q1-Q4) according to preoperative NLR (1.59, 2.11 and 2.96). Survival time was calculated applying the Cox proportional hazard model to both univariate and multivariate estimates. Results On univariate Cox regression analysis, preoperative NLR was significantly associated with overall survival (OS) and relapse-free survival (RFS). On subsequent multivariate analysis, preoperative NLR, as a tetrachotomous variable, was independently associated with OS and RFS (P = 0.028, 0.023, respectively). When comparing Q1 with Q3 or Q4 in multivariate analysis, there were no significant prognostic differences in OS (P = 0.23, 0.37, respectively) and RFS (P = 0.26, 0.46, respectively). The Q2 group showed significantly longer RFS than the Q1 group (hazard ratio 0.69, 95% confidence interval 0.48-0.99, P = 0.048). Conclusions Although preoperative NLR was significantly associated with long-term outcome in gastric cancer patients, the association was not linear.
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Affiliation(s)
- Masayuki Urabe
- Department of Gastrointestinal Surgery, Graduate School of Medicine, the University of Tokyo
| | - Hiroharu Yamashita
- Department of Gastrointestinal Surgery, Graduate School of Medicine, the University of Tokyo
| | - Yukari Uemura
- Biostatistics Division, Clinical Research Support Center, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Asami Tanabe
- Department of Gastrointestinal Surgery, Graduate School of Medicine, the University of Tokyo
| | - Koichi Yagi
- Department of Gastrointestinal Surgery, Graduate School of Medicine, the University of Tokyo
| | - Susumu Aikou
- Department of Gastrointestinal Surgery, Graduate School of Medicine, the University of Tokyo
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, the University of Tokyo
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Zhang X, Wang Y, Zhao L, Sang S, Zhang L. Prognostic value of platelet-to-lymphocyte ratio in oncologic outcomes of esophageal cancer: A systematic review and meta-analysis. Int J Biol Markers 2018; 33:1724600818766889. [PMID: 29683072 DOI: 10.1177/1724600818766889] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The platelet-to-lymphocyte ratio (PLR) is a useful prognostic factor in several cancers. However, the prognostic role of PLR in esophageal cancer remains controversial. The aim of this study is to evaluate the association between PLR and the oncologic outcome of esophageal cancer patients through a meta-analysis. Relevant articles were researched from Embase, PubMed, and Web of Science databases. The meta-analysis was performed using hazard ratio (HR) and 95% confidence intervals (CIs) as effect measures. Finally, 19 articles with 6134 patients were included in our study. The summary results indicated that the elevated PLR was negatively related to overall survival (HR= 1.263; 95% CI 1.094, 1.458). The subgroup analysis revealed that increased PLR was associated with poor overall survival in esophageal cancer patients for Asians (HR=1.252; 95% CI 1.141, 1.373) but not for Caucasians (HR=1.463; 95% CI 0.611, 3.502). When the patients were segregated by pathological type, sample size, and HR estimate method, high PLR was also significantly correlated with poor overall survival. In contrast, elevated PLR was not statistically associated with disease-free survival or cancer-specific survival. High PLR is associated with poor overall survival in patients with esophageal cancer. PLR may be a significant predictive biomarker in patients with esophageal cancer. Further large-cohort studies are needed to confirm these findings.
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Affiliation(s)
- Xiangwei Zhang
- 1 Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China
| | - Yang Wang
- 2 Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China
| | - Linping Zhao
- 3 Department of Thoracic Surgery, Shouguang People's Hospital, Shouguang, People's Republic of China
| | - Shaowei Sang
- 4 Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Lin Zhang
- 1 Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China
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Neutrophil-to-lymphocyte ratio as prognostic indicator in gastrointestinal cancers: a systematic review and meta-analysis. Oncotarget 2018; 8:32171-32189. [PMID: 28418870 PMCID: PMC5458276 DOI: 10.18632/oncotarget.16291] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 02/20/2017] [Indexed: 12/12/2022] Open
Abstract
An accurate, time efficient, and inexpensive prognostic indicator is needed to reduce cost and assist with clinical decision making for cancer management. The neutrophil-to-lymphocyte ratio (NLR), which is derived from common serum testing, has been explored in a variety of cancers. We sought to determine its prognostic value in gastrointestinal cancers and performed a meta-analysis of published studies using the Meta-analysis Of Observational Studies in Epidemiology guidelines. Included were randomized control trials and observational studies that analyzed humans with gastrointestinal cancers that included NLR and hazard ratios (HR) with overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), and/or cancer-specific survival (CSS). We analyzed 144 studies comprising 45,905 patients, two-thirds of which were published after 2014. The mean, median, and mode cutoffs for NLR reporting OS from multivariate models were 3.4, 3.0, 5.0 (±IQR 2.5-5.0), respectively. Overall, NLR greater than the cutoff was associated with a HR for OS of 1.63 (95% CI, 1.53-1.73; P < 0.001). This association was observed in all subgroups based on tumor site, stage, and geographic region. HR for elevated NLR for DFS, PFS, and CSS were 1.70 (95% CI, 1.52-1.91, P < 0.001), 1.64 (95% CI, 1.36-1.97, P < 0.001), and 1.83 (95% CI, 1.50-2.23, P < 0.001), respectively. Available evidence suggests that NLR greater than the cutoff reduces OS, independent of geographic location, gastrointestinal cancer type, or stage of cancer. Furthermore, DFS, PFS, and CSS also have worse outcomes with elevated NLR.
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25
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Huang L, Liu S, Lei Y, Wang K, Xu M, Chen Y, Liu B, Chen Y, Fu Q, Zhang P, Qin K, Cai Y, Fu S, Ge S, Yuan X. Systemic immune-inflammation index, thymidine phosphorylase and survival of localized gastric cancer patients after curative resection. Oncotarget 2018; 7:44185-44193. [PMID: 27283904 PMCID: PMC5190088 DOI: 10.18632/oncotarget.9923] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/16/2016] [Indexed: 12/27/2022] Open
Abstract
Systemic immune-inflammation index (SII), based on lymphocyte (L), neutrophil (N), and platelet (P) counts, was recently developed and reflects comprehensively the balance of host inflammatory and immune status. We explored its prognostic value in localized gastric cancer (GC) after R0 resection and the potential associations with Thymidine phosphorylase (TYMP), which was reported to increase the migration and invasion of gastric cancer cells. A total of 455 GC patients who received D2 gastrectomy were enrolled. Blood samples were obtained within 1 week before surgery to measure SII (SII = P × N/L). TYMP expression was measured on tumor sections by immunohistochemical analysis. Preoperative high SII indicated worse prognosis (HR: 1.799; 95% CI: 1.174-2.757; p = 0.007) in multivariate analysis and was associated with higher pathological TNM stage, deeper local invasion of tumor and lymph node metastasis (all p < 0.001). SII predicted poor overall survival in pathological TNM stage I subgroup also (p < 0.001). Furthermore we found that in high SII group, positive rate of TYMP expression increased (53.7% vs 42.7%, p = 0.046) and TYMP positive patients had higher SII score (median 405.9 vs. 351.9, p = 0.026). SII, as a noninvasive and low cost prognostic marker, may be helpful to identify higher-risk patients after R0 resection, even for stage I GC patients.
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Affiliation(s)
- Liu Huang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Shan Liu
- The Second Clinical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Yu Lei
- The Second Clinical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Kun Wang
- The Second Clinical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Min Xu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Yaobing Chen
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Bo Liu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Yangyang Chen
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Qiang Fu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Peng Zhang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Kai Qin
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Yixin Cai
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Shengling Fu
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Shuwang Ge
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Xianglin Yuan
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
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26
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Guo D, Han A, Jing W, Chen D, Jin F, Li M, Kong L, Yu J. Preoperative to postoperative change in neutrophil-to-lymphocyte ratio predict survival in colorectal cancer patients. Future Oncol 2018; 14:1187-1196. [PMID: 29302993 DOI: 10.2217/fon-2017-0659] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIM To evaluate the prognostic value of preoperative to postoperative neutrophil-to-lymphocyte ratio changes (ΔNLR) in patients undergoing surgical resection for colorectal cancer. PATIENTS & METHODS Data of 135 such patients managed at the Shandong Cancer Hospital and Institute were retrospectively analyzed. Clinicopathologic factors, overall survival (OS) and disease-free survival (DFS) were assessed using Kaplan-Meier curves and Cox regression models. RESULTS In the multivariate analysis, preoperative NLR (p = 0.002) and ΔNLR (p = 0.037) independently predicted OS, but preoperative NLR (p = 0.141) and ΔNLR (p = 0.297) were not significant prognosticators for DFS. CONCLUSION Our results demonstrated the prognostic value of the ΔNLR in predicting OS in patients undergoing surgical resection for colorectal cancer. However, ΔNLR could not predict DFS.
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Affiliation(s)
- Dong Guo
- Weifang Medical University, Weifang, PR China.,Department of Radiotherapy, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, PR China
| | - Anqin Han
- Department of Radiotherapy, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, PR China
| | - Wang Jing
- Department of Radiotherapy, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, PR China.,Department of Radiotherapy, the First Affiliated Hospital to Zhengzhou University, Zhengzhou, PR China
| | - Dawei Chen
- Department of Radiotherapy, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, PR China
| | - Feng Jin
- Department of Radiotherapy, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, PR China
| | | | - Li Kong
- Department of Radiotherapy, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, PR China
| | - Jinming Yu
- Department of Radiotherapy, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, PR China
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27
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Han F, Shang X, Wan F, Liu Z, Tian W, Wang D, Liu Y, Wang Y, Zhang B, Ju Y. Clinical value of the preoperative neutrophil-to-lymphocyte ratio and red blood cell distribution width in patients with colorectal carcinoma. Oncol Lett 2017; 15:3339-3349. [PMID: 29435077 DOI: 10.3892/ol.2017.7697] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 09/09/2017] [Indexed: 12/13/2022] Open
Abstract
The aim of the present study was to investigate the clinical value of the preoperative neutrophil-to-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in the peripheral blood of colorectal carcinoma (CRC) patients. Clinical data obtained from 240 patients with CRC undergoing radical surgical resection in Shandong Provincial Hospital Affiliated to Shandong University (Jinan, Shandong, China) between January 2011 and April 2015 were retrospectively analyzed. Data were also collected from 110 patients with colon polyps and 48 healthy volunteers to serve as controls for comparative analysis. The clinicopathological characteristics of the patients in the low and high NLR and RDW groups were compared. The NLR and RDW values were compared prior to and following surgery. Kaplan-Meier analyses and Cox regression modeling were performed to predict overall survival (OS) and disease-free survival (DFS). The NLR and RDW levels in the CRC patients were markedly higher than those in the colon polyp patients and the healthy controls. The optimum NLR and RDW cutoff points for CRC were 2.06 and 13.45%, respectively. Significant differences were detected in tumor location, diameter, degree of differentiation, tumor depth, carcinoembryonic antigen and carbohydrate antigen 199 when comparing the high and low NLR groups (P<0.05). A high RDW was significantly associated with distant metastasis and older age in CRC patients. No significant difference was detected in the NLR and RDW levels of CRC patients prior to and following surgery (P>0.05). CRC patients with an increased RDW had significantly worse OS and DFS rates, particularly those with metastatic CRC (P<0.05). Patients with a high NLR exhibited a reduced DFS time in CRC (P=0.053), although this difference was not significant, and a significantly worse DFS time in metastatic CRC (P=0.047). In conclusion, it is convenient to use preoperative NLR and RDW to predict prognosis following surgery for patients with CRC.
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Affiliation(s)
- Fuyan Han
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Xuming Shang
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Furong Wan
- Department of Laboratory Medicine, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong 250014, P.R. China
| | - Zhanfeng Liu
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Wenjun Tian
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Dan Wang
- Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Yiqing Liu
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Yong Wang
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Bingchang Zhang
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Ying Ju
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
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The role of the systemic inflammatory response in predicting outcomes in patients with operable cancer: Systematic review and meta-analysis. Sci Rep 2017; 7:16717. [PMID: 29196718 PMCID: PMC5711862 DOI: 10.1038/s41598-017-16955-5] [Citation(s) in RCA: 198] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 11/17/2017] [Indexed: 02/06/2023] Open
Abstract
Cancer remains a leading causes of death worldwide and an elevated systemic inflammatory response (SIR) is associated with reduced survival in patients with operable cancer. This review aims to examine the evidence for the role of systemic inflammation based prognostic scores in patients with operable cancers. A wide-ranging literature review using targeted medical subject headings for human studies in English was carried out in the MEDLINE, EMBASE, and CDSR databases until the end of 2016. The SIR has independent prognostic value, across tumour types and geographical locations. In particular neutrophil lymphocyte ratio (NLR) (n = 158), platelet lymphocyte ratio (PLR) (n = 68), lymphocyte monocyte ratio (LMR) (n = 21) and Glasgow Prognostic Score/ modified Glasgow Prognostic Score (GPS/mGPS) (n = 60) were consistently validated. On meta-analysis there was a significant relationship between elevated NLR and overall survival (OS) (p < 0.00001)/ cancer specific survival (CSS) (p < 0.00001), between elevated LMR and OS (p < 0.00001)/CSS (p < 0.00001), and elevated PLR and OS (p < 0.00001)/CSS (p = 0.005). There was also a significant relationship between elevated GPS/mGPS and OS (p < 0.00001)/CSS (p < 0.00001). These results consolidate the prognostic value of the NLR, PLR, LMR and GPS/mGPS in patients with resectable cancers. This is particularly true for the NLR/GPS/mGPS which should form part of the routine preoperative and postoperative workup.
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29
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Zhao QT, Zhang XP, Zhang H, Duan GC. Prognostic role of platelet to lymphocyte ratio in esophageal cancer: A meta-analysis. Oncotarget 2017; 8:112085-112093. [PMID: 29340113 PMCID: PMC5762381 DOI: 10.18632/oncotarget.22557] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/28/2017] [Indexed: 12/13/2022] Open
Abstract
Purpose The prognostic role of inflammation index like platelet to lymphocyte ratio (PLR) in esophageal cancer remains controversial. We evaluated the prognostic significance of PLR in esophageal cancer patients. Methods We searched databases to identify relevant literatures. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. A meta-analysis was performed to evaluate the prognostic value of PLR in patients with esophageal cancer. Results A total of 6,699 patients from 16 studies (17 cohorts) were finally enrolled in the meta-analysis. The results demonstrate that the elevated PLR predicted poorer overall survival (OS) (HR: 1.389, 95% CI: 1.161-1.663) and disease-free survival (DFS) (HR: 1.404, 95% CI: 1.169-1.687) and cancer-specific survival (CSS) (HR: 1.686, 95% CI: 1.146-2.480) in patients with esophageal cancer. Subgroup analysis revealed that the elevated PLR was also associated with poor OS in esophageal cancer treated by surgery (HR: 1.492, 95%CI: 1.149-1.938, P<0.05) and mixed treatment (HR: 1.222, 95%CI: 1.009-1.479, P<0.05). In addition, PLR Cut-off value≤160 (HR: 1.484, 95%CI: 1.088-2.024, P<0.05) and PLR Cut-off value>160 (HR: 1.391, 95%CI: 1.161-1.666, P<0.05). Conclusion This meta-analysis result suggested that PLR might be a significant predicative biomarker of poor prognosis for esophageal cancer patients.
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Affiliation(s)
- Qing-Tao Zhao
- Department of Thoracic Surgery, Hebei General Hospital, Shijiazhuang 050051, Hebei, PR China
| | - Xiao-Peng Zhang
- Department of Thoracic Surgery, Hebei General Hospital, Shijiazhuang 050051, Hebei, PR China
| | - Hua Zhang
- Department of Thoracic Surgery, Hebei General Hospital, Shijiazhuang 050051, Hebei, PR China
| | - Guo-Chen Duan
- Department of Thoracic Surgery, Hebei General Hospital, Shijiazhuang 050051, Hebei, PR China
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30
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Kubo H, Murayama Y, Arita T, Kuriu Y, Nakanishi M, Otsuji E. The Prognostic Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Colorectal Cancer. World J Surg 2017; 40:2796-2802. [PMID: 27307087 DOI: 10.1007/s00268-016-3595-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) has been reported in several cancers included colorectal cancer; however, it is not clear if there is an association between NLR and cancer-specific survival in colorectal cancer. And the optimal cut-off value is controversial. This study was designed to assess the prognostic value of preoperative NLR in colorectal cancer patients. METHODS Total 823 consecutive patients who underwent surgery for all stages of colorectal cancer in our hospital between January 2006 and December 2011 were included in the study. Preoperative NLR was calculated from their hospital records. RESULTS Using the receiver-operating characteristic curve, we found that the optimal preoperative NLR cut-off value that was strongly associated with cancer-specific survival was 2.1. Using this value, 505 patients were identified as having high NLR (≥2.1) and 397 patients were identified as having low NLR (<2.1). High NLR was associated with preoperative serum albumin values <4.0 g/dl (p < 0.001), positive preoperative serum C-reactive protein (CRP; p < 0.001), preoperative carcinoembryonic antigen (CEA) values ≥5.0 ng/dl (p = 0.003), and stage progression (p = 0.002). Cox proportional hazard analyses identified preoperative high NLR as an independent poor prognostic factor (p = 0.020, HR 1.66 (95 % CI: 1.08-2.63)). When comparing stage of disease, preoperative high-NLR patients with Stage III disease (p = 0.024) and Stage IV disease (p = 0.036) had significantly poorer prognoses. CONCLUSIONS In this study, we have demonstrated that preoperative NLR ≥2.1 was a prognostic indicator for cancer-specific survival of colorectal cancer patients.
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Affiliation(s)
- Hidemasa Kubo
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yasutoshi Murayama
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Tomohiro Arita
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshiaki Kuriu
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masayoshi Nakanishi
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
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31
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Zhang JW, Huang L, Xu AM. Preoperative monocyte-lymphocyte and neutrophil-lymphocyte but not platelet-lymphocyte ratios are predictive of clinical outcomes in resected patients with non-metastatic Siewert type II/III adenocarcinoma of esophagogastric junction: a prospective cohort study (the AMONP corhort). Oncotarget 2017; 8:57516-57527. [PMID: 28915691 PMCID: PMC5593663 DOI: 10.18632/oncotarget.15497] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/07/2017] [Indexed: 12/26/2022] Open
Abstract
AIMS To propectively reveal the clinicopathological and prognostic significances of monocyte-lymphocyte ratio (MLR), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in resected patients with non-metastatic Siewert type II/III adenocarcinoma of esophagogastric junction (AEG). METHODS A total of 611 patients diagnosed with Siewert type II/III AEG and undergoing surgery between 2006 and 2011 were prospectively followed-up until April 2016. Associations between preoperative peripheral MLR, NLR, and PLR and clinicopathological parameters were quantified using the multivariate Logistic regression model with adjustment. The correlation between the 3 ratios and cancer-specific survival (CSS) was investigated using the univariate and adjusted multivariate Cox regression models with stratifications. The periodical survival rates for the low- and high-level arms were obtained using the Kaplan-Meier method. RESULTS We set the medians (0.223, 2.22, and 124.4) as the cut-off values of preoperative MLR, NLR, and PLR, respectively. MLR was higher in male patients and those > 63 years; PLR was higher in patients with type II tumors. The (marginally-)significantly inverse ratio-CSS association was detected in male patients, those ≤ 63 years, those with type III tumors, and those with pTNM stage III tumors for MLR, and in female patients, those > 63 years, those with type III tumors, those with vessel invasion, and those with stage III tumors for NLR, but was generally negative concerning PLR. The association majorly existed in type III and pTNM stage III tumors. CONCLUSION MLR and NLR might be prognostic factors for patients with non-metastatic Siewert type II/III AEG, while PLR had limited significance.
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Affiliation(s)
- Jia-Wei Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lei Huang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A-Man Xu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
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32
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Wang Y, Liu JF. A retrospective study on the prognostic value of preoperative neutrophil/lymphocyte ratio in patients with primary small-cell carcinoma of the esophagus. Onco Targets Ther 2017; 10:2453-2459. [PMID: 28503068 PMCID: PMC5426465 DOI: 10.2147/ott.s115637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION There is increasing evidence that systemic inflammation influences the prognosis in patients with malignant tumors. The aim of this research was to investigate the prognostic value of neutrophil/lymphocyte ratio (NLR) in patients with primary small-cell carcinoma of the esophagus. METHODS This study retrospectively analyzed 129 patients with primary small-cell carcinoma of the esophagus who underwent esophagectomy in The Fourth Hospital of Hebei Medical University between January 2008 and December 2010. NLRs were calculated by using the following formula: peripheral neutrophil count/lymphocyte count (109/L). Correlations of NLR with other clinicopathologic data and prognosis were analyzed. The survival rate was calculated by Kaplan-Meier analysis. The differences between groups were compared by using the log-rank test. Cox regression was used to analyze the factors that may affect the survival of the patients. RESULTS The survival rate was found to be related to tumor stage, tumor location, nodal metastasis, TNM stage, histology, adjuvant therapy, and NLR (all P<0.05). High-NLR group had significantly poorer survival than low-NLR group (1-, 3-, and 5-year survival rates: 46.6% vs 57.1%, 21.9% vs 50.0%, and 5.5% vs 23.2%, respectively, P=0.002). NLR was identified as an independent prognostic factor for patients with primary small-cell carcinoma of the esophagus. CONCLUSION NLR is a valuable clinical marker in preoperative estimation as well as prognosis prediction for patients with primary small-cell carcinoma of the esophagus.
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Affiliation(s)
- Yan Wang
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jun Feng Liu
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Kijima T, Arigami T, Uchikado Y, Uenosono Y, Kita Y, Owaki T, Mori S, Kurahara H, Kijima Y, Okumura H, Maemura K, Ishigami S, Natsugoe S. Combined fibrinogen and neutrophil-lymphocyte ratio as a prognostic marker of advanced esophageal squamous cell carcinoma. Cancer Sci 2017; 108:193-199. [PMID: 27889946 PMCID: PMC5329150 DOI: 10.1111/cas.13127] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 10/18/2016] [Accepted: 11/23/2016] [Indexed: 12/27/2022] Open
Abstract
Patients with advanced esophageal squamous cell carcinoma (ESCC) is received chemoradiotherapy or chemotherapy for clinical management. However, it is difficult to predict tumor response and prognosis using blood markers before starting treatments. The purpose of this study was to investigate the pre‐treatment plasma fibrinogen and neutrophil–lymphocyte ratio (NLR) in patients with advanced ESCC treated with chemoradiotherapy or chemotherapy, and to assess the clinical utility of a combined score using these blood markers, named as the F‐NLR (fibrinogen and NLR) score, as a predictor of tumor response and prognosis. A total of 98 advanced ESCC patients, treated with chemoradiotherapy or chemotherapy, were classified into three groups: F‐NLR score of 2, having both hyperfibrinogenemia (>400 mg/dL) and high NLR (>3.0), score of 1, one of these hematological abnormalities, and score of 0, having neither hyperfibrinogenemia nor high NLR. Fibrinogen and NLR were significantly higher in the progressive disease (PD) group than the non‐PD group (P = 0.0419, and P = 0.0001, respectively). A significantly higher F‐NLR score was found in the PD group than the non‐PD group (P = 0.0140). Overall survival was significantly lower in patients with an F‐NLR score of 2 than in those with an F‐NLR score of 0 or 1 (P < 0.0001). Multivariate analysis showed that the F‐NLR score was one of the independent prognostic factors (P = 0.0081). Our study demonstrates that the F‐NLR score is promising as a predictive marker for therapeutic effects and prognosis in patients with advanced ESCC.
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Affiliation(s)
- Takashi Kijima
- Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takaaki Arigami
- Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Molecular Frontier Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yasuto Uchikado
- Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yoshikazu Uenosono
- Molecular Frontier Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yoshiaki Kita
- Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tetsuhiro Owaki
- Education Center for Doctors in Remote Islands and Rural Areas, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shinichiro Mori
- Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroshi Kurahara
- Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuko Kijima
- Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroshi Okumura
- Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kosei Maemura
- Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Sumiya Ishigami
- Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shoji Natsugoe
- Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Molecular Frontier Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Jagadesham VP, Lagarde SM, Immanuel A, Griffin SM. Systemic inflammatory markers and outcome in patients with locally advanced adenocarcinoma of the oesophagus and gastro-oesophageal junction. Br J Surg 2017; 104:401-407. [DOI: 10.1002/bjs.10425] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/09/2016] [Accepted: 10/07/2016] [Indexed: 01/09/2023]
Abstract
Abstract
Background
Raised levels of systemic inflammatory markers are associated with poor survival in patients with cancer. The aim of this study was to assess the prognostic value of markers of systemic inflammation in patients with adenocarcinoma of the oesophagus or gastro-oesophageal junction.
Methods
Data from a consecutive series of patients undergoing transthoracic oesophagectomy following neoadjuvant therapy at a single centre were analysed. Fibrinogen, albumin, C-reactive protein, leucocyte differential and platelet counts were measured before surgery. The upper quartile (75th percentile) was used as a cut-off for dichotomization. Multivariable regression analysis was performed to identify independent prognostic factors.
Results
A series of 199 patients underwent transthoracic oesophagectomy following neoadjuvant therapy. Univariable analysis indicated that reduced median survival was associated with a raised platelet : lymphocyte ratio (158 or above; 25.6 versus 44·4 months for patients with a normal ratio, P = 0·038) and increased fibrinogen levels (4·9 g/l or above; 22·8 versus 59·9 months for those with a normal level, P = 0·005). On multivariable analysis a combination of one or more markers of systemic inflammation was associated with poorer overall survival (hazard ratio 2·12, 95 per cent c.i. 1·20 to 3·74; P = 0·010).
Conclusion
Preoperative markers of systemic inflammation predict poor outcome in patients undergoing curative treatment for locally advanced oesophageal and gastro-oesophageal adenocarcinoma.
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Affiliation(s)
- V P Jagadesham
- Northern Oesophago-Gastric Cancer Unit, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - S M Lagarde
- Northern Oesophago-Gastric Cancer Unit, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
- Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - A Immanuel
- Northern Oesophago-Gastric Cancer Unit, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - S M Griffin
- Northern Oesophago-Gastric Cancer Unit, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
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Xiao Q, Zhang B, Deng X, Wu J, Wang H, Wang Y, Wang W. The Preoperative Neutrophil-To-Lymphocyte Ratio Is a Novel Immune Parameter for the Prognosis of Esophageal Basaloid Squamous Cell Carcinoma. PLoS One 2016; 11:e0168299. [PMID: 27959959 PMCID: PMC5154570 DOI: 10.1371/journal.pone.0168299] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 11/28/2016] [Indexed: 01/22/2023] Open
Abstract
Background The pretreatment neutrophil-to-lymphocyte ratio (NLR) is an independent predictor of prognosis in various malignancies, but its predictive capacity in basaloid squamous cell carcinoma of the esophagus (BSCCE) remains unclear. We aim to determine the value of the inflammation-related factors, including the NLR, neutrophil-to-monocyte ratio (NMR), and albumin levels, in predicting BSCCE prognosis. Methods We retrospectively analyzed the records of 121 patients with pathologically diagnosed BSCCE that underwent a curative esophagectomy from January 2007 to December 2014. Univariate and multivariate analyses were used to identify prognostic factors for overall survival (OS) and recurrence-free survival (RFS). Results The preoperative NLR was correlated with the tumor length and NMR. In OS univariate analyses, a high NLR (>1.77), high NMR (>12.31), and low albumin (≤40.0 g/L) level were significantly associated with a poorer survival in BSCCE. The median OS was significantly greater in low NLR (≤1.77) than in the high NLR (>1.77) patients (51.0 vs. 31.0 months; P = 0.008). In multivariate analyses, only the NLR was an independent prognostic factor for OS (hazard ratio (HR), 2.030; 95% confidence interval (CI), 1.262–3.264; P = 0.003). A high NLR was also an independent predictor of a poorer RFS in BSCCE (HR, 2.222; 95% CI, 1.407–3.508; P = 0.001); the median RFS for low (≤1.77) and high (> 1.77) NLR patients was 44.0 months and 14.0 months, respectively. NLR remained a strong prognostic indicator for OS in stage I/II patients and a preoperative NLR>1.77 was predictive of a poor RFS in both stage I/II and stage III patients. Conclusions We show that the preoperative NLR, a convenient and cost-effective biomarker, may serve as a prognostic indicator for BSCCE patients following curative surgery.
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Affiliation(s)
- Qin Xiao
- Key Laboratory of Translational Radiation Oncology, Hunan Province, Department of Radiation Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Baihua Zhang
- The 2nd Department of Thoracic Surgery, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Xiang Deng
- The 2nd Department of Thoracic Surgery, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Jie Wu
- The 2nd Department of Thoracic Surgery, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Hui Wang
- Key Laboratory of Translational Radiation Oncology, Hunan Province, Department of Radiation Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
- * E-mail:
| | - Yonggang Wang
- Department of Thoracic Surgery, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenxiang Wang
- The 2nd Department of Thoracic Surgery, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
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Neri A, Marrelli D, Voglino C, Di Mare G, Ferrara F, Marini M, Roviello F. Recurrence after surgery in esophago-gastric junction adenocarcinoma: Current management and future perspectives. Surg Oncol 2016; 25:355-363. [PMID: 27916166 DOI: 10.1016/j.suronc.2016.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/10/2016] [Accepted: 08/12/2016] [Indexed: 02/07/2023]
Abstract
Recurrent esophago-gastric junction adenocarcinoma is not a rare event and its correct management is still debated. Many approaches for the treatment of these patients exist, but only few studies compare the different techniques. Most of the studies are retrospectives series and describe the experiences of single institutions in the treatment of recurrent esophageal and esophago-gastric junction cancers. Nowadays surgery is still the main and only curative treatment. Other alternative palliative therapies could be endoscopic stent placement and balloon dilation, photodynamic therapy, thermal tumor ablation (laser photoablation and Argon plasma coagulation), radiation therapy and brachytherapy, and chemotherapy. The aim of this review is to investigate the different rates, patterns and timings of recurrence of this tumor, and to explain the various approaches used for the treatment of recurrent esophago-gastric junction cancer.
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Affiliation(s)
- Alessandro Neri
- Department of Medicine, Surgery and Neurosciences - Unit of General Surgery and Surgical Oncology, University of Siena, Viale Bracci - Policlinico "Le Scotte" 53100, Siena, Italy
| | - Daniele Marrelli
- Department of Medicine, Surgery and Neurosciences - Unit of General Surgery and Surgical Oncology, University of Siena, Viale Bracci - Policlinico "Le Scotte" 53100, Siena, Italy
| | - Costantino Voglino
- Department of Medicine, Surgery and Neurosciences - Unit of General Surgery and Surgical Oncology, University of Siena, Viale Bracci - Policlinico "Le Scotte" 53100, Siena, Italy.
| | - Giulio Di Mare
- Department of Medicine, Surgery and Neurosciences - Unit of General Surgery and Surgical Oncology, University of Siena, Viale Bracci - Policlinico "Le Scotte" 53100, Siena, Italy
| | - Francesco Ferrara
- Department of Medicine, Surgery and Neurosciences - Unit of General Surgery and Surgical Oncology, University of Siena, Viale Bracci - Policlinico "Le Scotte" 53100, Siena, Italy
| | - Mario Marini
- Department of Medicine, Surgery and Neurosciences - Unit of Gastroenterology and Digestive Endoscopy, University of Siena, Viale Bracci - Policlinico "Le Scotte" 53100, Siena, Italy
| | - Franco Roviello
- Department of Medicine, Surgery and Neurosciences - Unit of General Surgery and Surgical Oncology, University of Siena, Viale Bracci - Policlinico "Le Scotte" 53100, Siena, Italy
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Dagistan Y, Dagistan E, Citisli V. Evaluation of simple blood counts as inflammation markers for brain tumor patients. Neurol Neurochir Pol 2016; 50:231-5. [PMID: 27375135 DOI: 10.1016/j.pjnns.2016.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 01/26/2016] [Accepted: 03/07/2016] [Indexed: 10/22/2022]
Abstract
AIMS Hemogram parameters in routine blood panels have been proposed as inflammation markers. These parameters, especially the red cell distribution width (RDW) and mean platelet volume (MPV), were evaluated as surrogate inflammatory markers in brain tumor patients. We aimed to observe RDW and MPV values of tumor patients and compare to those in healthy population. METHODS We recorded white blood cell count, neutrophil count, lymphocyte count, hemoglobin, hematocrit, RDW, platelet count, and MPV of the study group at the time of diagnosis and compared to those of the control subjects. RESULTS The RDW was significantly elevated in study group compared to that of the control subjects (p=0.001). The MPV was significantly lower in study group than that of the control group (p=0.01). CONCLUSION Decreased MPV and increased RDW were both associated with brain tumor. However, prospective studies with larger sample sizes are needed to support the results and expose MPV and RDW variations between metastatic and primary brain tumors.
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Affiliation(s)
- Yasar Dagistan
- Abant Izzet Baysal University Hospital, Department of Neurosurgery, Bolu, Turkey.
| | - Emine Dagistan
- Abant Izzet Baysal University Hospital, Department of Radiology, Bolu, Turkey
| | - Veli Citisli
- Pamukkale University Hospital, Department of Neurosurgery, Denizli, Turkey
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Seo YJ, Park YA, Bong JP, Park DJ, Park SY. Predictive value of neutrophil to lymphocyte ratio in first-time and recurrent idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx 2015; 42:438-42. [DOI: 10.1016/j.anl.2015.04.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/08/2015] [Accepted: 04/27/2015] [Indexed: 12/20/2022]
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Wan GX, Chen P, Cai XJ, Li LJ, Yu XJ, Pan DF, Wang XH, Wang XB, Cao FJ. Elevated red cell distribution width contributes to a poor prognosis in patients with esophageal carcinoma. Clin Chim Acta 2015; 452:199-203. [PMID: 26633854 DOI: 10.1016/j.cca.2015.11.025] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 11/24/2015] [Accepted: 11/24/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND The red cell distribution width (RDW) has also been reported to reliably reflect the inflammation and nutrition status and predict the prognosis across several types of cancer, however, the prognostic value of RDW in esophageal carcinoma has seldom been studied. METHODS A retrospective study was performed to assess the prognostic value of RDW in patients with esophageal carcinoma by the Kaplan-Meier analysis and multivariate Cox regression proportional hazard model. All enrolled patients were divided into high RDW group (≧15%) and low RDW group (<15%) according to the detected RDW values. RESULTS Clinical and laboratory data from a total of 179 patients with esophageal carcinoma were retrieved. With a median follow-up of 21months, the high RDW group exhibited a shorter disease-free survival (DFS) (p<0.001) and an unfavorable overall survival (OS) (p<0.001) in the univariate analysis. The multivariate analysis revealed that elevated RDW at diagnosis was an independent prognostic factor for shorter PFS (p=0.043, HR=1.907, 95% CI=1.020-3.565) and poor OS (p=0.042, HR=1.895, 95% CI=1.023-3.508) after adjustment with other cancer-related prognostic factors. CONCLUSION The present study suggests that elevated preoperative RDW(≧15%) at the diagnosis may independently predict poorer disease-free and overall survival among patients with esophageal carcinoma.
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Affiliation(s)
- Guo-Xing Wan
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Ping Chen
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Xiao-Jun Cai
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Lin-Jun Li
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Xiong-Jie Yu
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Dong-Feng Pan
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Xian-He Wang
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Xuan-Bin Wang
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Feng-Jun Cao
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China.
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Zhang H, Xia H, Zhang L, Zhang B, Yue D, Wang C. Clinical significance of preoperative neutrophil–lymphocyte vs platelet–lymphocyte ratio in primary operable patients with non–small cell lung cancer. Am J Surg 2015; 210:526-35. [DOI: 10.1016/j.amjsurg.2015.03.022] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 01/24/2015] [Accepted: 03/30/2015] [Indexed: 01/05/2023]
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Shao N, Cai Q. High pretreatment neutrophil-lymphocyte ratio predicts recurrence and poor prognosis for combined small cell lung cancer. Clin Transl Oncol 2015; 17:772-8. [PMID: 26243392 DOI: 10.1007/s12094-015-1289-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/08/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUNDS Compared to pure small cell lung cancer (SCLC), combined small cell lung cancer (C-SCLC) has its own characteristics. High neutrophil to lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have been shown to be related to poor prognosis in several types of tumors. The aim of this study was to explore the prognosis value of NLR and PLR in patients with C-SCLC. METHODS A total of 112 patients diagnosed with C-SCLC between January 2000 and March 2009 were enrolled in the study. The clinicopathological parameters, laboratory analyses, and survival time were collected and analyzed. The correlation between NLR, PLR, and clinicopathological characters was analyzed. Univariate and multivariate analyses were performed to investigate the prognostic significance of these parameters for C-SCLC. RESULTS The pretreatment NLR was elevated in 37.5 % patients (NLR ≥ 4.15; n = 42; H-NLR). NLR was significantly related to disease stage (p = 0.033) and tumor recurrence (p = 0.014). The median overall survival (OS) and progression-free survival (PFS) were significantly worse in the H-NLR group (OS: 22.0 months vs 11.7 months, p = 0.001; PFS: 11.1 vs 6.0 months, p < 0.001). However, PLR at diagnosis was not associated with OS or PFS. Multivariate analyses indicated elevated NLR (HR = 1.6; p = 0.001), disease stage (HR = 1.6; p = 0.001), and performance status (HR = 1.8; p = 0.015) as independent prognostic factors. CONCLUSIONS High pretreatment NLR (≥4.15) is a potential useful indicator for C-SCLC recurrence and predicts a poor long-term prognosis for C-SCLC, which should be considered in defining the prognosis with other well-known prognosticators in C-SCLC patients.
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Affiliation(s)
- N Shao
- Department of Respiratory Medicine, Tianjin Hospital of ITCWM, Nankai Hospital, Changjiang Road, Nankai District, Tianjin, 300100, China.
| | - Q Cai
- Department of Respiratory Medicine, Tianjin Hospital of ITCWM, Nankai Hospital, Changjiang Road, Nankai District, Tianjin, 300100, China
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Choi JE, Villarreal J, Lasala J, Gottumukkala V, Mehran RJ, Rice D, Yu J, Feng L, Cata JP. Perioperative neutrophil:lymphocyte ratio and postoperative NSAID use as predictors of survival after lung cancer surgery: a retrospective study. Cancer Med 2015; 4:825-33. [PMID: 25756351 PMCID: PMC4472205 DOI: 10.1002/cam4.428] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 11/21/2014] [Accepted: 01/11/2015] [Indexed: 12/18/2022] Open
Abstract
The association between neutrophil:lymphocyte ratio (NLR) and poor long-term outcomes in patients with non–small-cell lung cancer (NSCLC) has been demonstrated in numerous studies. The benefit of perioperative administration of anti-inflammatory drugs on these outcomes has not been well established. Our aim in this retrospective study was to investigate the effects of postoperative nonsteroidal anti-inflammatory drug (NSAID) administration and NLR on tumor recurrence and survival in patients' undergoing surgical resection for NSCLC. This retrospective study included perioperative data from 1139 patients who underwent surgical resection for stages I–III NSCLC. Perioperative data such as baseline characteristics, adjuvant or neoadjuvant therapy, pre- and postoperative NLR, and NSAID use (ketorolac, ibuprofen, celecoxib, or in combination) were included. We evaluated the association between preoperative NLR and NSAID use on recurrence-free (RFS) and overall survival (OS). In all, 563 patients received an NSAID as a part of their postoperative management. The majority of patients received ketorolac (n = 374, 67.16%). Ketorolac administration was marginally associated with better OS (P = 0.05) but not with RFS (P = 0.38). Multivariate analysis (n = 1139) showed that preoperative NLR >5 was associated with a reduction in RFS (hazard ratio [HR] = 1.37; 95% confidence interval [CI] = 1.05–1.78; P = 0.02) and OS (HR = 1.69; 95% CI = 1.27–2.23; P = 0.0003). However, after accounting for tumor stage, NLR ≥5 was a predictor of RFS and OS only in patients with stage I NSCLC. To conclude, preoperative NLR was demonstrated to be an independent predictor of RFS and OS in a subset of patients with early stage NSCLC. Ketorolac administration was not found to be an independent predictor of survival.
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Affiliation(s)
- Jae Eun Choi
- University of California, San Diego School of Medicine, California
| | - John Villarreal
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Javier Lasala
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Vijaya Gottumukkala
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Reza J Mehran
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David Rice
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jun Yu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lei Feng
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Juan P Cata
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Outcomes Research Consortium, Cleveland, Ohio
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Zadora P, Dabrowski W, Czarko K, Smolen A, Kotlinska-Hasiec E, Wiorkowski K, Sikora A, Jarosz B, Kura K, Rola R, Trojanowski T. Preoperative neutrophil-lymphocyte count ratio helps predict the grade of glial tumor - a pilot study. Neurol Neurochir Pol 2015; 49:41-4. [PMID: 25666772 DOI: 10.1016/j.pjnns.2014.12.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 12/22/2014] [Accepted: 12/23/2014] [Indexed: 12/28/2022]
Abstract
UNLABELLED Neutrophil-lymphocyte count ratio (NLCR) is a recognized prognostic marker for renal, lung or colorectal carcinomas. The aim of the present study was to determine whether the preoperative value of NLCR might serve as a predictive marker for glial tumors' grading. METHODS The retrospective analysis of NLCR was performed in neurosurgical patients treated for glial brain tumors. The preoperative NLCR was analyzed in accordance with WHO glial tumors' classification, which distinguishes G1, G2, G3 and G4 (glioblastoma) tumors. RESULTS The analysis of NLCR was performed in 424 patients (258 males and 166 females) aged 53 ± 16 years who underwent either an open surgery or stereotactic biopsy for a glial brain tumor. G1 was diagnosed in 22 patients, G2 - in 71 patients, G3 - in 63 patients and G4 - in 268 patients. The highest value of NLCR was noted in G4 patients (5.08 [3.1; 8.7] - median [quartiles 1 and 3, respectively]) and was significantly higher compared to G3 (p<0.01), G2 (p<0.001) and G1 (p<0.01) groups. Moreover, NLCR was significantly higher in group G3 than G2 (p<0.05). ROC curve analysis showed 2.579 as a cut-off point for prediction of glioblastoma. CONCLUSION Preoperative NLCR measurement corresponds with a glial brain tumor grading.
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Affiliation(s)
- Przemyslaw Zadora
- Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Wojciech Dabrowski
- Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland.
| | - Katarzyna Czarko
- Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Agata Smolen
- Department of Epidemiology, Medical University of Lublin, Lublin, Poland
| | - Edyta Kotlinska-Hasiec
- Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Krzysztof Wiorkowski
- Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Agnieszka Sikora
- Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Bozena Jarosz
- Department of Neurosurgery and Paediatric Neurosurgery, Medical University of Lublin, Lublin, Poland
| | - Krzysztof Kura
- Department of Neurosurgery and Paediatric Neurosurgery, Medical University of Lublin, Lublin, Poland
| | - Radosław Rola
- Department of Neurosurgery and Paediatric Neurosurgery, Medical University of Lublin, Lublin, Poland; Department of Physiopathology, Institute of Agricultural Medicine, Lublin, Poland
| | - Tomasz Trojanowski
- Department of Neurosurgery and Paediatric Neurosurgery, Medical University of Lublin, Lublin, Poland
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Dogan M, Eren T, Ozdemir N, Cigirgan CL, Zengin N. The relationship between platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, and survival in metastatic gastric cancer on firstline modified docetaxel and cisplatinum plus 5 Fluorourasil Regimen: A single institute experience. Saudi J Gastroenterol 2015; 21:320-4. [PMID: 26458860 PMCID: PMC4632258 DOI: 10.4103/1319-3767.166207] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIMS The association between platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and survival with response rates were evaluated in metastatic gastric cancer (MGC). PATIENTS AND METHODS MGC patients on firstline modified docetaxel/cisplatinum/5-fluorourasil [mDCF; docetaxel 60 mg/m2 (days 1-5), cisplatin 60 mg/m2 (day 1), 5FU 600 mg/m2 (days 1-5), q3w] were evaluated retrospectively. The cutoff values were 160 for PLR and 2.5 for NLR. Progression-free survival (PFS) and overall survival (OS) were estimated for group I (PLR >160), group II (PLR ≤ 160), group III (NLR ≥ 2.5), group IV (NLR < 2.5), group V (PLR > 160 and NLR ≥ 2.5), group VI (PLR ≤ 160 and NLR <2.5), and group VII [VIIa (PLR > 160 and NLR < 2.5) and VIIb (PLR ≤160 and NLR ≥ 2.5)]. RESULTS One hundred and nine MGC patients were evaluated for basal hematological parameters and survival analysis, retrospectively. Most of the patients were male in their fifties with grade III adenocarcinoma (62.9%) and liver metastasis (46.7%). Patients with PLR > 160 and/or NLR ≥ 2.5 had significantly shorter PFS and OS (P = 0.04, 0.01, 0.019, and P = 0.003, 0.002, 0.000, respectively). CONCLUSION High PLR (> 160) and/or NLR (≥ 2.5) seem to be poor prognostic factors in MGC.
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Affiliation(s)
- Mutlu Dogan
- Department of Medical Oncology, Ankara Numune Training and Research Hospital, Altindag, Ankara, Turkey,Address for correspondence: Dr. Mutlu Dogan, Department of Medical Oncology, Ankara Numune Training and Research Hospital, Altindag - 06100, Ankara, Turkey. E-mail:
| | - Tulay Eren
- Department of Medical Oncology, Ankara Numune Training and Research Hospital, Altindag, Ankara, Turkey
| | - Nuriye Ozdemir
- Department of Medical Oncology, Ankara Numune Training and Research Hospital, Altindag, Ankara, Turkey
| | - Can L. Cigirgan
- Department of Biochemistry, Ankara Numune Training and Research Hospital, Altindag, Ankara, Turkey
| | - Nurullah Zengin
- Department of Medical Oncology, Ankara Numune Training and Research Hospital, Altindag, Ankara, Turkey
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el Aziz LMA. Blood neutrophil-lymphocyte ratio predicts survival in locally advanced cancer stomach treated with neoadjuvant chemotherapy FOLFOX 4. Med Oncol 2014; 31:311. [PMID: 25367855 DOI: 10.1007/s12032-014-0311-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 10/29/2014] [Indexed: 12/13/2022]
Abstract
Accurate predictors of survival for patients with advanced gastric cancer treated with neoadjuvant chemotherapy are currently lacking. In this study, we aimed to evaluate the prognostic significance of the neutrophil-lymphocyte ratio (NLR) in patients with stage III-IV gastric cancer who received neoadjuvant chemotherapy FOLFOX 4 as neoadjuvant chemotherapy. We enrolled 70 patients with stage III-IV cancer stomach in this study. Patients received FOLFOX 4 as neoadjuvant chemotherapy. Blood sample was collected before chemotherapy. The NLR was divided into two groups: high (>3) and low (≤ 3). Univariate analysis on progression-free survival (PFS) and overall survival (OS) was performed using the Kaplan-Meier and log-rank tests, and multivariate analysis was conducted using the Cox proportional hazards regression model. The toxicity was evaluated according to National Cancer Institute Common Toxicity Criteria. The univariate analysis showed that PFS and OS were both worse for patients with high NLR than for those with low NLR before chemotherapy (median PFS 28 and 44 months, respectively, P = 0.001; median OS 30 and 48 months, P = 0.001). Multivariate analysis showed that NLRs before chemotherapy were independent prognostic factors of OS but not for progression-free survival. NLR may serve as a potential biomarker for survival prognosis in patients with stage III-IV gastric cancer receiving neoadjuvant chemotherapy. The FOLFOX 4 demonstrated an acceptable toxicity.
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