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Dowling GP, Daly GR, Hegarty A, Hembrecht S, Bracken A, Toomey S, Hennessy BT, Hill ADK. Predictive value of pretreatment circulating inflammatory response markers in the neoadjuvant treatment of breast cancer: meta-analysis. Br J Surg 2024; 111:znae132. [PMID: 38801441 PMCID: PMC11129713 DOI: 10.1093/bjs/znae132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/21/2024] [Accepted: 05/05/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Systemic inflammatory response markers have been found to have a prognostic role in several cancers, but their value in predicting the response to neoadjuvant chemotherapy in breast cancer is uncertain. A systematic review and meta-analysis of the literature was carried out to investigate this. METHODS A systematic search of electronic databases was conducted to identify studies that explored the predictive value of circulating systemic inflammatory response markers in patients with breast cancer before commencing neoadjuvant therapy. A meta-analysis was undertaken for each inflammatory marker where three or more studies reported pCR rates in relation to the inflammatory marker. Outcome data are reported as ORs and 95% confidence intervals. RESULTS A total of 49 studies were included, of which 42 were suitable for meta-analysis. A lower pretreatment neutrophil-to-lymphocyte ratio was associated with an increased pCR rate (pooled OR 1.66 (95% c.i. 1.32 to 2.09); P < 0.001). A lower white cell count (OR 1.96 (95% c.i. 1.29 to 2.97); P = 0.002) and a lower monocyte count (OR 3.20 (95% c.i. 1.71 to 5.97); P < 0.001) were also associated with a pCR. A higher lymphocyte count was associated with an increased pCR rate (OR 0.44 (95% c.i. 0.30 to 0.64); P < 0.001). CONCLUSION The present study found the pretreatment neutrophil-to-lymphocyte ratio, white cell count, lymphocyte count, and monocyte count of value in the prediction of a pCR in the neoadjuvant treatment of breast cancer. Further research is required to determine their value in specific breast cancer subtypes and to establish optimal cut-off values, before their adoption in clinical practice.
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Affiliation(s)
- Gavin P Dowling
- Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Medical Oncology Lab, Department of Molecular Medicine, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Gordon R Daly
- Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Aisling Hegarty
- Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Sandra Hembrecht
- Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Aisling Bracken
- Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Sinead Toomey
- Medical Oncology Lab, Department of Molecular Medicine, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Bryan T Hennessy
- Medical Oncology Lab, Department of Molecular Medicine, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Arnold D K Hill
- Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
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Menni AE, Tzikos G, Fyntanidou B, Ioannidis A, Loukipoudi L, Grosomanidis V, Chorti A, Shrewsbury A, Stavrou G, Kotzampassi K. The Effect of Probiotics on the Prognostication of the Neutrophil-to-Lymphocyte Ratio in Severe Multi-Trauma Patients. J Pers Med 2024; 14:419. [PMID: 38673046 PMCID: PMC11051514 DOI: 10.3390/jpm14040419] [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: 02/21/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The ratio of neutrophils to lymphocytes [NLR] is one of the most accepted prognostic indices and demonstrates a positive correlation with the severity of a disease. Given that probiotics exerted immunomodulatory properties and thus positively affected lymphocytopenia induction in severely ill patients, we performed a post hoc analysis in the ProVAP protocol to investigate whether probiotics affected the prognostication of NLR in respect to ventilator-associated pneumonia in multi-trauma patients. This cohort mandatorily involved severe traumatic brain injury patients. METHODS The white blood cell data of all patients, after being retrieved for the days 0 and 7, were statistically assessed in respect to neutrophils, lymphocytes and NLR among the 4 sub-groups of the study: placebo/no-VAP, placebo/VAP, probiotics/no-VAP, and probiotics/VAP. RESULTS Lymphopenia was dominant in placebo sub-groups, while an increased level of lymphocytes was prominent in probiotics sub-groups. This resulted in an increase [p = 0.018] in the NLR value in the probiotics/VAP group in relation to the probiotics/no-VAP cohort; this was an increase of half the value of the placebo/VAP [p < 0.001], while the NLR value in placebo/no-VAP group increased almost four-fold in relation to probiotics/no-VAP [p < 0.001]. Additionally, the ROC curve for probiotic-treated patients revealed a NLR7 cut-off value of 7.20 as a prognostic factor of VAP (AUC: 78.6%, p = 0.015, 95% CI: 62.6-94.5%), having a high specificity of 90.2% and a sensitivity of 42.9%. CONCLUSIONS NLR may considered a credible prognostic biomarker in multi-trauma patients since it can evaluate the immunomodulatory benefits of probiotic treatment. However, the results of the present post hoc analysis should be interpreted meticulously until further evaluation, since they may be basically species- or strain-specific.
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Affiliation(s)
- Alexandra-Eleftheria Menni
- Department of Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece (G.T.); (A.I.); (A.C.); (A.S.)
| | - Georgios Tzikos
- Department of Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece (G.T.); (A.I.); (A.C.); (A.S.)
| | - Barbara Fyntanidou
- Department of Emergency Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Aristeidis Ioannidis
- Department of Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece (G.T.); (A.I.); (A.C.); (A.S.)
| | - Lamprini Loukipoudi
- Department of Anesthesia & Intensive Care, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (L.L.); (V.G.)
| | - Vasilis Grosomanidis
- Department of Anesthesia & Intensive Care, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (L.L.); (V.G.)
| | - Angeliki Chorti
- Department of Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece (G.T.); (A.I.); (A.C.); (A.S.)
| | - Anne Shrewsbury
- Department of Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece (G.T.); (A.I.); (A.C.); (A.S.)
| | - George Stavrou
- Department of General Surgery, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK;
| | - Katerina Kotzampassi
- Department of Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece (G.T.); (A.I.); (A.C.); (A.S.)
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Liu X, Teng L, Dai J, Shao H, Chen R, Li H, Li J, Zou H. Effect of Intraoperative Opioid Dose on Perioperative Neutrophil-to-Lymphocyte Ratio and Lymphocyte-to-Monocyte Ratio in Glioma. J Inflamm Res 2024; 17:2159-2167. [PMID: 38617385 PMCID: PMC11016269 DOI: 10.2147/jir.s451455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/26/2024] [Indexed: 04/16/2024] Open
Abstract
Background The neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) are inflammatory biomarkers. Until now, it is unknown the impact of opioid dosage on perioperative immunity in glioma patients. The aim of this study was to explore the effect of intraoperative opioid dosage on perioperative immune perturbations using NLR and LMR as inflammatory biomarkers and evaluate the correlation between inflammatory biomarkers and pathological grade of glioma. Methods The study included 208 patients with primary glioma who underwent glioma resection from February 2012 to November 2019 at Harbin Medical University Cancer Hospital. Complete blood count (CBC) was collected at 3 time points: one week before surgery, and 24 hours and one week after surgery. Patients were divided into high-dose and low-dose groups, based on the median value of intraoperative opioid dose. The relationships between perioperative NLR, LMR and intraoperative opioid dosage were analyzed using repeated measurement analysis of variance (ANOVA). Correlations between preoperative various factors and pathological grade were analyzed by Spearman analysis. Receiver operating characteristic (ROC) curves were performed to assess the predictive performance of the NLR and LMR for pathological grade. Results The NLR (P=0.020) and lower LMR (P=0.037) were statistically significant different between high-dose and low-dose groups one week after surgery. The area under the curve (AUC) of the NLR to identify poor diagnosis was 0.685, which was superior to the LMR (AUC: 0.607) and indicated a correlation between the NLR with pathological grade. The preoperative NLR (P=0.000), LMR (P=0.009), age (P=0.000) and tumor size (P=0.001) exhibited a significant correlation with the pathological grade of glioma. Conclusion Intraoperative opioids in the high-dose group were associated with higher NLR and lower LMR in postoperative glioma patients. The preoperative NLR and LMR demonstrated predictive value for distinguishing between high-grade and low-grade gliomas.
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Affiliation(s)
- Xuejiao Liu
- Department of Pain Medicine, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China
| | - Lei Teng
- Department of Pain Medicine, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China
| | - Junzhu Dai
- Department of Pain Medicine, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China
| | - Hongxue Shao
- Department of Pain Medicine, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China
| | - Rui Chen
- Department of Pain Medicine, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China
| | - Haixiang Li
- Department of Pain Medicine, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China
| | - Jing Li
- Department of Pain Medicine, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China
| | - Huichao Zou
- Department of Pain Medicine, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China
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Guo G, Hu X, Gao T, Zhou H, Li B, Zhou C, Yu B, Wang G. Potential impact of platelet-to-lymphocyte ratio on prognosis in patients with colorectal cancer: A systematic review and meta-analysis. Front Surg 2023; 10:1139503. [PMID: 37051571 PMCID: PMC10083474 DOI: 10.3389/fsurg.2023.1139503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/06/2023] [Indexed: 03/29/2023] Open
Abstract
BackgroundNumerous studies have confirmed that inflammation promotes the occurrence, development and prognosis of colorectal cancer (CRC).ObjectiveThis study focuses on the potentially prognostic value of the platelet-to-lymphocyte ratio (PLR) in CRC patients.Data SourcesThis study was registered at PROSPERO (ID: CRD42020219215). Relative studies were searched on PubMed, Cochrane Library, Embase, Web of Science, and clinical trial databases by two back-to-back reviewers. Study Selection and Intervention: Studies were screened according to the predetermined inclusion and exclusion criteria, comparing prognosis differences between low PLR levels and high PLR levels for CRC patients. Main Outcome Measures: Studies were integrated and compared to analyze the value of PLR in predicting overall survival (OS), progression-free survival (PFS), cancer-specific survival (CSS), disease-free survival (DFS) and recurrence-free survival (RFS) of CRC. Results: Outcomes were compared using Review Manager (version 5.4) software from Cochrane Collaboration. A total of 27 literary works, including 13,330 patients, were incorporated into our study. The final results showed that higher PLR levels had worse OS (hazard ratio [HR] = 1.40, 95% confidence interval [CI] = 1.21–1.62, P < 0.00001), DFS (HR = 1.44, 95% CI = 1.09–1.90, P = 0.01) and RFS (HR = 1.48, 95% CI = 1.13–1.94, P = 0.005) than lower PLR levels, respectively. However, there was no evidence of significance for PFS (HR = 1.14, 95% CI = 0.84–1.54, P = 0.40) and CSS (HR = 1.16, 95% CI = 0.88–1.53, P = 0.28) in the final meta-analysis.LimitationsOur study has the following limitations. First of all, we only included literature published in English, which means that some publication bias may be inevitable. In addition, our study used aggregate data, not individual data; furthermore, we did not define the exact cut-off value representing the PLR level.ConclusionAn elevated PLR seems to be an adverse prognostic factor affecting survival outcomes in patients with CRC. Meanwhile, more prospective studies are required to confirm our conclusion.PROSPERO ID: CRD42020219215.
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Affiliation(s)
- Ganlin Guo
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuhua Hu
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tianyi Gao
- The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Huixian Zhou
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Baokun Li
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chaoxi Zhou
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bin Yu
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guiying Wang
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Correspondence: Guiying Wang
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Colloca G, Venturino A, Guarneri D. Neutrophil-to-lymphocyte ratio predict survival of patients with rectal cancer receiving neo-adjuvant chemoradiation followed by radical resection: a meta-analysis. Expert Rev Anticancer Ther 2023; 23:421-429. [PMID: 36970998 DOI: 10.1080/14737140.2023.2194635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
BACKGROUND Neutrophil-to-lymphocyte ratio is suggested as a prognostic and predictive factor for patients with rectal cancer. The purpose of the current meta-analysis is to evaluate the relationship between neutrophil-lymphocyte ratio (NLR) and the outcome of patients, with rectal cancer receiving chemoradiation and surgery. METHODS A systematic review on two databases and a selection of studies were done. Thereafter, two meta-analyses were performed, evaluating the relationship of baseline NLR with overall survival (OS) and disease-free survival (DFS). RESULTS Thirty-one retrospective studies were selected. Twenty-six studies have documented a significant relationship of NLR to OS (HR 2.05, CI 1.66-2.53), whereas 23 studies have reported a weaker but significant relationship of NLR to DFS (HR 1.78, CI 1.49-2.12). Among the moderator variables, a possible effect for age and sex on the relationship of NLR with DFS is suggested. CONCLUSIONS Baseline NLR >3 is a simple and reproducible prognostic factor, with a more consistent effect in the elderly. It could be a reliable variable to support clinicians in defining personalized treatment strategies, even though a standardization of the cutoff and a better characterization among microsatellite unstable rectal tumors are necessary.
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Li Y, Xu T, Wang X, Jia X, Ren M, Wang X. The prognostic utility of preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with colorectal liver metastasis: a systematic review and meta-analysis. Cancer Cell Int 2023; 23:39. [PMID: 36855112 PMCID: PMC9976405 DOI: 10.1186/s12935-023-02876-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/17/2023] [Indexed: 03/02/2023] Open
Abstract
The neutrophil-to-lymphocyte ratio is used to reflect body's inflammatory status with prognostic value in different cancers. We aimed to investigate the influence of preoperative NLR in the prognosis of CRLM patients receiving surgery using meta-analysis. Data in Cochrane Library, PubMed, Embase, and Web of Science databases created before October 2022 were recruited. Meta-analysis was carried out with RevMan 5.3 and Stata16 software, and the primary outcome indicators included overall survival (OS), and secondary outcome indicators included disease-free survival (DFS) and relapse-free survival (RFS). The pooled risk ratio (HR) and 95% confidence interval (CI) for each outcome indicator were determined using random-effects models or fixed-effects models. The pooled odds ratio (OR) and corresponding 95% confidence intervals (CI) for NLR and clinicopathological characteristics were determined with a fixed-effects model. 18 papers published between 2008 and 2022 (3184 patients in total) were included. The pooled analysis found that high preoperative NLR was correlated with poor OS (multivariate HR = 1.83, 95% CI = 1.61-2.08, p < 0.01), DFS (multivariate HR = 1.78, 95% CI = 1.16-2.71, p < 0.01) and RFS (multivariate HR = 1.46, 95% CI = 1.15-1.85, p < 0.01), but NLR was not related to clinicopathological features of CRLM patients correlation. In conclusion, NLR is an independent risk factor for poor prognosis in patients with CRLM. More large-scale clinical researches are required in the future to demonstrate the inclusion of preoperative NLR as a prognostic indicator for CRLM patients to guide postoperative adjuvant chemotherapy.
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Affiliation(s)
- Yanqing Li
- grid.462400.40000 0001 0144 9297Graduate School of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, 014000 China
| | - Tianxiang Xu
- grid.440229.90000 0004 1757 7789Abdominal Tumor Surgery, Center of Tumor, Inner Mongolia People’s Hospital, Hohhot, 010017 China
| | - Xin Wang
- grid.462400.40000 0001 0144 9297Graduate School of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, 014000 China
| | - Xiangdong Jia
- grid.440229.90000 0004 1757 7789Abdominal Tumor Surgery, Center of Tumor, Inner Mongolia People’s Hospital, Hohhot, 010017 China
| | - Meng Ren
- grid.440229.90000 0004 1757 7789Abdominal Tumor Surgery, Center of Tumor, Inner Mongolia People’s Hospital, Hohhot, 010017 China
| | - Xiaoxia Wang
- Intensive Care Unit, Inner Mongolia People's Hospital, Hohhot, 010017, China.
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Zhang Y, Wang LJ, Li QY, Yuan Z, Zhang DC, Xu H, Yang L, Gu XH, Xu ZK. Prognostic value of preoperative immune-nutritional scoring systems in remnant gastric cancer patients undergoing surgery. World J Gastrointest Surg 2023; 15:211-221. [PMID: 36896300 PMCID: PMC9988643 DOI: 10.4240/wjgs.v15.i2.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 12/14/2022] [Accepted: 01/01/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Remnant gastric cancer (GC) is defined as GC that occurs five years or more after gastrectomy. Systematically evaluating the preoperative immune and nutritional status of patients and analyzing its prognostic impact on postoperative remnant gastric cancer (RGC) patients are crucial. A simple scoring system that combines multiple immune or nutritional indicators to identify nutritional or immune status before surgery is necessary.
AIM To evaluate the value of preoperative immune-nutritional scoring systems in predicting the prognosis of patients with RGC.
METHODS The clinical data of 54 patients with RGC were collected and analyzed retrospectively. Prognostic nutritional index (PNI), controlled nutritional status (CONUT), and Naples prognostic score (NPS) were calculated by preoperative blood indicators, including absolute lymphocyte count, lymphocyte to monocyte ratio, neutrophil to lymphocyte ratio, serum albumin, and serum total cholesterol. Patients with RGC were divided into groups according to the immune-nutritional risk. The relationship between the three preoperative immune-nutritional scores and clinical characteristics was analyzed. Cox regression and Kaplan–Meier analysis was performed to analyze the difference in overall survival (OS) rate between various immune-nutritional score groups.
RESULTS The median age of this cohort was 70.5 years (ranging from 39 to 87 years). No significant correlation was found between most pathological features and immune-nutritional status (P > 0.05). Patients with a PNI score < 45, CONUT score or NPS score ≥ 3 were considered to be at high immune-nutritional risk. The areas under the receiver operating characteristic curves of PNI, CONUT, and NPS systems for predicting postoperative survival were 0.611 [95% confidence interval (CI): 0.460–0.763; P = 0.161], 0.635 (95%CI: 0.485–0.784; P = 0.090), and 0.707 (95%CI: 0.566–0.848; P = 0.009), respectively. Cox regression analysis showed that the three immune-nutritional scoring systems were significantly correlated with OS (PNI: P = 0.002; CONUT: P = 0.039; NPS: P < 0.001). Survival analysis revealed a significant difference in OS between different immune-nutritional groups (PNI: 75 mo vs 42 mo, P = 0.001; CONUT: 69 mo vs 48 mo, P = 0.033; NPS: 77 mo vs 40 mo, P < 0.001).
CONCLUSION These preoperative immune-nutritional scores are reliable multidimensional prognostic scoring systems for predicting the prognosis of patients with RGC, in which the NPS system has relatively effective predictive performance.
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Affiliation(s)
- Yan Zhang
- Department of Gastrointestinal Surgery, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical University, Suzhou 215000, Jiangsu Province, China
| | - Lin-Jun Wang
- Department of General Surgery, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing 210003, Jiangsu Province, China
| | - Qin-Ya Li
- Department of General Surgery, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing 210003, Jiangsu Province, China
| | - Zhen Yuan
- Department of Gastrointestinal Surgery, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical University, Suzhou 215000, Jiangsu Province, China
| | - Dian-Cai Zhang
- Department of General Surgery, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing 210003, Jiangsu Province, China
| | - Hao Xu
- Department of General Surgery, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing 210003, Jiangsu Province, China
| | - Li Yang
- Department of General Surgery, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing 210003, Jiangsu Province, China
| | - Xin-Hua Gu
- Department of Gastrointestinal Surgery, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical University, Suzhou 215000, Jiangsu Province, China
| | - Ze-Kuan Xu
- Department of General Surgery, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing 210003, Jiangsu Province, China
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Salazar-Valdivia FE, Valdez-Cornejo VA, Ulloque-Badaracco JR, Hernandez-Bustamante EA, Alarcón-Braga EA, Mosquera-Rojas MD, Garrido-Matta DP, Herrera-Añazco P, Benites-Zapata VA, Hernandez AV. Systemic Immune-Inflammation Index and Mortality in Testicular Cancer: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2023; 13:diagnostics13050843. [PMID: 36899987 PMCID: PMC10000460 DOI: 10.3390/diagnostics13050843] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 02/25/2023] Open
Abstract
The systemic immune-inflammation index (SIII) is a marker studied in multiple types of urologic cancer. This systematic review evaluates the association between SIII values with overall survival (OS) and progression-free survival (PFS) in testicular cancer. We searched observational studies in five databases. The quantitative synthesis was performed using a random-effects model. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). The only measure of the effect was the hazard ratio (HR). A sensitivity analysis was performed according to the risk of bias in the studies. There were 833 participants in a total of 6 cohorts. We found that high SIII values were associated with worse OS (HR = 3.28; 95% CI 1.3-8.9; p < 0.001; I2 = 78) and PFS (HR = 3.9; 95% CI 2.53-6.02; p < 0.001; I2 = 0). No indication of small study effects was found in the association between SIII values and OS (p = 0.5301). High SIII values were associated with worse OS and PFS. However, further primary studies are suggested to enhance the effect of this marker in different outcomes of testicular cancer patients.
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Affiliation(s)
- Farley E. Salazar-Valdivia
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
| | - Valeria A. Valdez-Cornejo
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
| | | | - Enrique A. Hernandez-Bustamante
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo 13011, Peru
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15012, Peru
| | - Esteban A. Alarcón-Braga
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
| | - Melany D. Mosquera-Rojas
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
| | | | - Percy Herrera-Añazco
- Escuela de Medicina, Universidad Privada San Juan Bautista, Lima 15067, Peru
- Universidad Privada del Norte, Trujillo 13011, Peru
| | - Vicente A. Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 14072, Peru
- Correspondence: ; Tel.: +51-1-3171000
| | - Adrian V. Hernandez
- Unidad de Revisiones Sistemáticas y Meta-análisis, Guías de Práctica Clínica y Evaluaciones de Tecnología Sanitaria, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 15012, Peru
- Health Outcomes, Policy, and Evidence Synthesis Group, University of Connecticut School of Pharmacy, Mansfield, CT 06269, USA
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Portale G, Bartolotta P, Azzolina D, Gregori D, Fiscon V. Prognostic role of platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte, and lymphocyte-to-monocyte ratio in operated rectal cancer patients: systematic review and meta-analysis. Langenbecks Arch Surg 2023; 408:85. [PMID: 36781510 DOI: 10.1007/s00423-023-02786-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/30/2022] [Indexed: 02/15/2023]
Abstract
BACKGROUND Inflammation plays an important role in tumor growth. Novel serum blood biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), have been proposed as useful prognostic indexes in cancer patients. However, their role in rectal cancer is controversial. METHODS A comprehensive literature review was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, and the Cochrane Database of Systematic Reviews through May 2022. The systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Quality was appraised with the Methodological Index for Non-Randomized Studies (MINORS) tool. Aim of the study was to summarize available literature on PLR, NLR, and LMR in patients with rectal cancer undergoing resection. RESULTS Forty-seven observational studies (14,205 patients) were included; there were 42 retrospective and 5 prospective cohort studies with an average MINORS score of 14.6 (range: 12-18). Worse overall survival was associated with high NLR (HR 1.81; 95%CI 1.52-2.15; p < 0.001), high PLR (HR 1.24; 95%CI 1.06-1.46; p = 0.009), and low LMR (HR 0.67; 95%CI 0.49-0.91; p = 0.01). High NLR and low LMR were also associated with disease-free-survival (HR 1.68; 95%CI 1.35-2.08; p < 0.001 and HR 0.71; 95%CI 0.58-0.87; p < 0.001, respectively). CONCLUSIONS NLR, PLR, and LMR are independent clinical predictors for overall survival in patients with rectal cancer treated with curative surgery. NLR and LMR are also good predictors for disease free survival. These biomarkers, which are readily available, appear optimal prognostic indexes and may help clinicians predict the prognosis of rectal cancer and develop individualized treatment strategies.
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Affiliation(s)
- Giuseppe Portale
- Department of General Surgery, Azienda Euganea ULSS 6, Via Casa Di Ricovero 40, 35013, Cittadella, Padua, Italy.
| | - Patrizia Bartolotta
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35121, Padua, Italy
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35121, Padua, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35121, Padua, Italy
| | - Valentino Fiscon
- Department of General Surgery, Azienda Euganea ULSS 6, Via Casa Di Ricovero 40, 35013, Cittadella, Padua, Italy
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Cao W, Yu H, Zhu S, Lei X, Li T, Ren F, Zhou N, Tang Q, Zu L, Xu S. Clinical significance of preoperative neutrophil‐lymphocyte ratio and platelet‐lymphocyte ratio in the prognosis of resected early‐stage patients with non‐small cell lung cancer: A meta‐analysis. Cancer Med 2022; 12:7065-7076. [PMID: 36480232 PMCID: PMC10067053 DOI: 10.1002/cam4.5505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/06/2022] [Accepted: 11/20/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Poor prognosis is linked to peripheral blood levels of preoperative platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) in many advanced cancers. Nevertheless, whether the correlation exists in resected early-stage cases with non-small cell lung cancer (NSCLC) stays controversial. Consequently, we performed a meta-analysis to explore the preoperative NLR and PLR's prognostic significance in early-stage patients with NSCLC undergoing curative surgery. METHODS Relevant studies that validated the link between preoperative NLR or PLR and survival results were found via the proceeding databases: PubMed, Embase, Cochrane Library, and Web of Science. The merged 95% confidence interval (CI) and hazard ratio (HR) was employed to validate the link between the NLR or PLR's index and overall survival (OS) and disease-free survival (DFS) in resected NSCLC cases. We used sensitivity and subgroup analyses to assess the studies' heterogeneity. RESULTS An overall of 21 studies were attributed to the meta-analysis. The findings indicated that great preoperative NLR was considerably correlated with poor DFS (HR = 1.58, 95% CI: 1.37-1.82, p < 0.001) and poor OS (HR = 1.51, 95% CI: 1.33-1.72, p < 0.001), respectively. Subgroup analyses were in line with the pooled findings. In aspect of PLR, raised PLR was indicative of inferior DFS (HR = 1.28, 95% CI: 1.04-1.58, p = 0.021) and OS (HR = 1.37, 95% CI: 1.18-1.60, p < 0.001). In the subgroup analyses between PLR and DFS, only subgroups with a sample size <300 (HR = 1.67, 95% CI: 1.15-2.43, p = 0.008) and TNM staging of mixed (I-II) (HR = 1.47, 95% CI: 1.04-2.07, p = 0.028) showed that the link between high PLR and poor DFS was significant. CONCLUSIONS Preoperative elevated NLR and PLR may act as prognostic biomarkers in resected early-stage NSCLC cases and are therefore valuable for guiding postoperative adjuvant treatment.
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Affiliation(s)
- Weibo Cao
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Haochuan Yu
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Shuai Zhu
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Xi Lei
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Tong Li
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Fan Ren
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Ning Zhou
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Quanying Tang
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Lingling Zu
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Song Xu
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
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Yi L, Qiang J, Yichen P, Chunna Y, Yi Z, Xun K, Jianwei Z, Rixing B, Wenmao Y, Xiaomin W, Parker L, Wenbin L. Identification of a 5-gene-based signature to predict prognosis and correlate immunomodulators for rectal cancer. Transl Oncol 2022; 26:101529. [PMID: 36130456 PMCID: PMC9493070 DOI: 10.1016/j.tranon.2022.101529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/11/2022] [Accepted: 09/01/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Specific tumor markers have yet to be identified in rectal cancer. This study aims to identify a novel genetic signature in rectal cancer to provide clues for survival and immunotherapy. METHODS DEGs were obtained from two GEO datasets of rectal cancer. By using data from TCGA and GSE133057, two cohorts of rectal cancer were applied to establish and evaluate the signature. A nomogram was constructed for training and validation. We integrated the risk-score with clinicopathological features and assessed its interplay with immune cells and molecules. Finally, our study performed functional annotations, gene-targeted miRNAs, and single-cell analysis. RESULTS A total of 468 DEGs were identified, and a signature consisting of 5 genes (CLIC5, ENTPD8, PACSIN3, HGD, and GNG7) was selected to calculate the risk-score. The model exhibited high performance in time-dependent ROC and a nomogram. Further results showed that overall survival was significantly worse in the high-risk group. As an independent prognostic factor, the risk-score was associated with vascular invasion. There was a dramatic difference in nonregulatory CD4+ and CD8+ T cells between the high and low-risk groups, and the 5 genes were correlated with immune inhibitors. There was a considerable difference in autophagy, immune, cell cycle, infection, and apoptosis-associated terms and pathways in GO and KEGG. The functional states of differentiation, apoptosis, and quiescence were closely related to the 5-gene signature in single-cell analysis. CONCLUSION Our results suggest that the signature could serve as a novel prognostic biomarker in rectal cancer, which might benefit decision-making regarding immunotherapy.
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Affiliation(s)
- Lin Yi
- Department of General Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neuro-oncology, Cancer Center, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ji Qiang
- Department of Neuro-oncology, Cancer Center, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Peng Yichen
- Department of Neuro-oncology, Cancer Center, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yu Chunna
- Department of Neuro-oncology, Cancer Center, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zheng Yi
- Department of Neuro-oncology, Cancer Center, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Kang Xun
- Department of Neuro-oncology, Cancer Center, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zheng Jianwei
- Department of General Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Bai Rixing
- Department of General Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yan Wenmao
- Department of General Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wang Xiaomin
- Department of Neuro-oncology, Cancer Center, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
| | - Li Parker
- Clinical Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Wenbin
- Department of Neuro-oncology, Cancer Center, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Müller SD, Both CP, Sponholz C, Voelker MT, Christiansen H, Niggli F, Schmitz A, Weiss M, Thomas J, Stehr SN, Piegeler T. Association between Intraoperative Blood Transfusion, Regional Anesthesia and Outcome after Pediatric Tumor Surgery for Nephroblastoma. Cancers (Basel) 2022; 14:cancers14225585. [PMID: 36428673 PMCID: PMC9688304 DOI: 10.3390/cancers14225585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/04/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Recent data suggest that anesthesiologic interventions-e.g., the choice of the anesthetic regimen or the administration of blood products-might play a major role in determining outcome after tumor surgery. In contrast to adult patients, only limited data are available regarding the potential association of anesthesia and outcome in pediatric cancer patients. METHODS A retrospective multicenter study assessing data from pediatric patients (0-18 years of age) undergoing surgery for nephroblastoma between 2004 and 2018 was conducted at three academic centers in Europe. Overall and recurrence-free survival were the primary outcomes of the study and were evaluated for a potential impact of intraoperative administration of erythrocyte concentrates, the use of regional anesthesia and the choice of the anesthetic regimen. The length of stay on the intensive care unit, the time to hospital discharge after surgery and blood neutrophil-to-lymphocyte ratio were defined as secondary outcomes. RESULTS In total, data from 65 patients were analyzed. Intraoperative administration of erythrocyte concentrates was associated with a reduction in recurrence-free survival (hazard ratio (HR) 7.59, 95% confidence interval (CI) 1.36-42.2, p = 0.004), whereas overall survival (HR 5.37, 95% CI 0.42-68.4, p = 0.124) was not affected. The use of regional anesthesia and the choice of anesthetic used for maintenance of anesthesia did not demonstrate an effect on the primary outcomes. It was, however, associated with fewer ICU transfers, a shortened time to discharge and a decreased postoperative neutrophil-to-lymphocyte ratio. CONCLUSIONS The current study provides the first evidence for a possible association between blood transfusion as well as anesthesiologic interventions and outcome after pediatric cancer surgery.
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Affiliation(s)
- Sarah D. Müller
- Department of Anesthesiology and Intensive Care, University Hospital Leipzig, 04275 Leipzig, Germany
| | - Christian P. Both
- Department of Anesthesia, University Children’s Hospital Zurich, 8032 Zurich, Switzerland
| | - Christoph Sponholz
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Jena, 07740 Jena, Germany
| | - Maria Theresa Voelker
- Department of Anesthesiology and Intensive Care, University Hospital Leipzig, 04275 Leipzig, Germany
| | - Holger Christiansen
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, 04103 Leipzig, Germany
| | - Felix Niggli
- Department of Pediatric Oncology, University Children’s Hospital Zurich, 8032 Zurich, Switzerland
| | - Achim Schmitz
- Department of Anesthesia, University Children’s Hospital Zurich, 8032 Zurich, Switzerland
| | - Markus Weiss
- Department of Anesthesia, University Children’s Hospital Zurich, 8032 Zurich, Switzerland
| | - Jörg Thomas
- Department of Anesthesia, University Children’s Hospital Zurich, 8032 Zurich, Switzerland
| | - Sebastian N. Stehr
- Department of Anesthesiology and Intensive Care, University Hospital Leipzig, 04275 Leipzig, Germany
| | - Tobias Piegeler
- Department of Anesthesiology and Intensive Care, University Hospital Leipzig, 04275 Leipzig, Germany
- EuroPeriscope: The ESA-IC Onco-Anaesthesiology Research Group
- Correspondence: ; Tel.: +49-341-97-17700; Fax: +49-341-97-17709
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Mu J, Wu Y, Jiang C, Cai L, Li D, Cao J. Progress in Applicability of Scoring Systems Based on Nutritional and Inflammatory Parameters for Ovarian Cancer. Front Nutr 2022; 9:809091. [PMID: 35464000 PMCID: PMC9024308 DOI: 10.3389/fnut.2022.809091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/10/2022] [Indexed: 01/04/2023] Open
Abstract
Ovarian cancer is a malignancy that seriously endangers women’s health; its case fatality rate ranks first among the gynecological malignancies. The status of nutrition of ovarian cancer patients is related to their prognoses. Thus, it is important to evaluate, monitor, and improve the nutritional status of ovarian cancer patients during their treatment. Currently, there are several tools for examining malnutrition and nutritional assessment, including NRI (nutrition risk index), PG-SGA (patient-generated subjective global assessment), and NRS 2002 (nutritional risk screening 2002). In addition to malnutrition risk examination and related assessment tools, the evaluation of muscle mass, C-reactive protein, lymphocytes, and other inflammation status indicators, such as neutrophils to lymphocytes ratio, lymphocyte-to-monocyte ratio, and C-reactive protein-albumin ratio, is of great importance. The nutritional status of ovarian cancer patients undergoing surgery affects their postoperative complications and survival rates. Accurate evaluation of perioperative nutrition in ovarian cancer patients is crucial in clinical settings. An intelligent nutritional diagnosis can be developed based on the results of its systematic and comprehensive assessment, which would lay a foundation for the implementation of personalized and precise nutritional therapy.
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Affiliation(s)
- Juan Mu
- Department of Nutrition, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Yue Wu
- Department of Gynecology, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Jiang
- Department of Gynecology, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Linjuan Cai
- Department of Gynecology, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Dake Li
- Department of Gynecology, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Dake Li,
| | - Jian Cao
- Department of Gynecology, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
- Jian Cao,
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An SH, Kim IY. Can pretreatment platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios predict long-term oncologic outcomes after preoperative chemoradiation followed by surgery for locally advanced rectal cancer? Ann Coloproctol 2022; 38:253-261. [PMID: 35249276 PMCID: PMC9263313 DOI: 10.3393/ac.2021.00633.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/06/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose Systemic inflammation is associated with various malignancies, including colorectal cancer, as possible prognostic predictors. We aimed to evaluate the correlation of pretreatment the platelet-to-lymphocyte (PLR) and the neutrophil-to-lymphocyte (NLR) ratio with long-term oncologic outcomes and pathologic complete response (pCR) in locally ad vanced rectal cancer patients who received neoadjuvant concurrent chemoradiotherapy (CRT) followed by curative resection. Methods Between October 1996 and December 2015, 168 rectal cancer patients treated with preoperative CRT followed by surgery were enrolled. The set cut-off/mean PLR and NLR were 170 and 2.8. We analyzed the relationship between PLR, NLR, and the 5-year overall survival (OS), disease-free survival (DFS), and pCR rate. Results The 5-year OS rates were 75.9% and 59.8% in the highand low-PLR groups. The 5-year DFS rates were 62.9% and 50.8% in the high- and low-PLR groups, with no significant difference. In addition, the 5-year OS rates were 75.7% and 58.4%, and the 5-year DFS rates were 62.5% and 50.0% in the high- and low-NLR groups, respectively, both without any significant difference. Multivariate analysis showed only pretreatment PLR as an independent prognostic factor for OS (hazard ratio, 1.850; 95% confidence interval, 1.041–3.287; P=0.036), and both serologic markers were not independent prognostic factors for 5-year DFS. Conclusion Neither PLR nor NLR was associated with 5-year DFS nor pCR to neoadjuvant CRT. Only pretreatment PLR can be used in predicting OS in locally advanced rectal cancer patients who received neoadjuvant CRT followed by curative resection.
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Affiliation(s)
- Sang Hyun An
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ik Yong Kim
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
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15
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Lee SJ, Kim K, Park HJ. Meta-Analysis on the Neutrophil-Lymphocyte Ratio in Rectal Cancer Treated With Preoperative Chemoradiotherapy: Prognostic Value of Pre- and Post-Chemoradiotherapy Neutrophil-Lymphocyte Ratio. Front Oncol 2022; 12:778607. [PMID: 35223468 PMCID: PMC8873579 DOI: 10.3389/fonc.2022.778607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/21/2022] [Indexed: 12/16/2022] Open
Abstract
Background To evaluate the prognostic value of neutrophil-lymphocyte ratio (NLR) in rectal cancer patients treated with preoperative chemoradiotherapy (CRT) and curative surgery. Methods A comprehensive search of the EMBASE and PubMed databases was performed to screen studies that compared treatment outcomes according to the pre-CRT and/or post-CRT NLR in patients receiving preoperative CRT and curative surgery for locally advanced rectal cancer. Hazard ratios (HRs) for disease-free survival (DFS) and/or overall survival (OS) were extracted, and a random-effects model was used for pooled analysis. Results Totally, 22 retrospective studies comprising 6316 patients were included. Preoperative CRT was administered with concurrent chemotherapy (mostly fluoropyrimidine-based regimens). The elevated pre-CRT NLR was significantly associated with an increased risk of recurrence (HR, 1.54; 95% confidence interval [CI], 1.31-1.81) and death (HR, 2.14; 95% CI, 1.61-2.84). Post-CRT NLR was reported in only 3 of 22 studies, and the correlation was not statistically significant for recurrence (HR, 1.44; 95% CI, 0.86-2.41) or death (HR, 2.38; 95% CI, 0.94-6.07). Conclusions Elevated pre-CRT NRL, but not post-CRT NRL, is associated with inferior DFS and OS. Further studies are needed to confirm the prognostic value of NLR in rectal cancer patients receiving preoperative CRT.
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Affiliation(s)
- Soo Jin Lee
- Department of Nuclear Medicine, Hanyang University Medical Center, Seoul, South Korea
| | - Kyubo Kim
- Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Hae Jin Park
- Department of Radiation Oncology, Hanyang University College of Medicine, Seoul, South Korea
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Hamid HKS, Emile SH, Davis GN. Prognostic Significance of Lymphocyte-to-Monocyte and Platelet-to-Lymphocyte Ratio in Rectal Cancer: A Systematic Review, Meta-analysis, and Meta-regression. Dis Colon Rectum 2022; 65:178-187. [PMID: 34775400 DOI: 10.1097/dcr.0000000000002291] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The low lymphocyte-to-monocyte ratio and high platelet-to-lymphocyte ratio have been reported to be poor prognostic indicators in various solid tumors, but the prognostic significance in rectal cancer remains controversial. OBJECTIVES We sought to determine the prognostic value of the lymphocyte-to-monocyte ratio and the platelet-to-lymphocyte ratio following curative-intent surgery for rectal cancer. DATA SOURCES Following PRISMA guidelines (PROSPERO, ID: CRD42020190880), PubMed and Embase databases were searched through January 2021 including 3 other registered medical databases. STUDY SELECTION Studies evaluating the impact of pretreatment lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio on overall or disease-free survival in patients undergoing curative rectal cancer resection were selected. MAIN OUTCOMES MEASURES The main outcome measures were overall and disease-free survival. RESULTS A total of 23 studies (6683 patients) were included; lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio were evaluated in 14 and 16 studies. A low lymphocyte-to-monocyte ratio was associated with poorer overall survival (HR, 1.57; 95% CI, 1.29-1.90; p < 0.001) and disease-free survival (HR, 1.29; 95% CI, 1.13-1.46; p < 0.001). However, when the analysis was limited to patients treated with surgery alone or to those with stage I to III tumors, lymphocyte-to-monocyte ratio was not a predictor of overall survival and disease-free survival. The platelet-to-lymphocyte ratio did not predict for overall or disease-free survival, regardless of the treatment modality, studied population, tumor stage, or cutoff value. Finally, a low lymphocyte-to-monocyte ratio, but not a high platelet-to-lymphocyte ratio, was inversely correlated with complete pathologic response rate. LIMITATIONS The retrospective nature of most included studies was a limitation. CONCLUSIONS Pretreatment lymphocyte-to-monocyte ratio, but not platelet-to-lymphocyte ratio, correlates with tumor response to neoadjuvant chemoradiotherapy and poorer prognosis after curative-intent surgery for rectal cancer, and it potentially represents a simple and reliable biomarker that could help optimize individualized clinical decision-making in high-risk patients. REGISTRATION https://www.crd.york.ac.uk/prospero/; ID: CRD42020190880.
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Affiliation(s)
- Hytham K S Hamid
- Department of Surgery, East Kent Hospitals University NHS Foundation Trust, Ashford, United Kingdom
| | - Sameh H Emile
- Colorectal Surgery Unit, Department of General Surgery, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
| | - George N Davis
- Department of Surgery, Dorset County Hospital NHS Foundation Trust, Dorchester, United Kingdom
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Zhu Y, Jin X, Xu L, Han P, Lin S, Lu Z. Establishment and validation of prognosis model for patients with cerebral contusion. BMC Neurol 2021; 21:463. [PMID: 34844563 PMCID: PMC8628400 DOI: 10.1186/s12883-021-02482-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background And Objective Cerebral Contusion (CC) is one of the most serious injury types in patients with traumatic brain injury (TBI). In this study, the baseline data, imaging features and laboratory examinations of patients with CC were summarized and analyzed to develop and validate a prediction model of nomogram to evaluate the clinical outcomes of patients. Methods A total of 426 patients with cerebral contusion (CC) admitted to the People’s Hospital of Qinghai Province and Affiliated Hospital of Qingdao University from January 2018 to January 2021 were included in this study, We randomly divided the cohort into a training cohort (n = 284) and a validation cohort (n = 142) with a ratio of 2:1.At Least absolute shrinkage and selection operator (Lasso) regression were used for screening high-risk factors affecting patient prognosis and development of the predictive model. The identification ability and clinical application value of the prediction model were analyzed through the analysis of receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA). Results Twelve independent prognostic factors, including age, Glasgow Coma Score (GCS), Basal cistern status, Midline shift (MLS), Third ventricle status, intracranial pressure (ICP) and CT grade of cerebral edema,etc., were selected by Lasso regression analysis and included in the nomogram. The model showed good predictive performance, with a C index of (0.87, 95% CI, 0.026–0.952) in the training cohort and (0.93, 95% CI, 0.032–0.965) in the validation cohort. Clinical decision curve analysis (DCA) also showed that the model brought high clinical benefits to patients. Conclusion This study established a high accuracy of nomogram model to predict the prognosis of patients with CC, its low cost, easy to promote, is especially applicable in the acute environment, at the same time, CSF-glucose/lactate ratio(C-G/L), volume of contusion, and mean CT values of edema zone, which were included for the first time in this study, were independent predictors of poor prognosis in patients with CC. However, this model still has some limitations and deficiencies, which require large sample and multi-center prospective studies to verify and improve our results. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02482-4.
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Affiliation(s)
- Yufeng Zhu
- Department of Graduate School, Qinghai University, Xining, 810016, Qinghai, China
| | - Xiaoqing Jin
- Department of Neurosurgery, Qinghai Provincial People's Hospital, Xining, 810007, Qinghai, China
| | - Lulu Xu
- Department of Geriatric Medicine, the Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China
| | - Pei Han
- Department of Neurosurgery, Qinghai Provincial People's Hospital, Xining, 810007, Qinghai, China
| | - Shengwu Lin
- Department of Graduate School, Qinghai University, Xining, 810016, Qinghai, China
| | - Zhongsheng Lu
- Department of Neurosurgery, Qinghai Provincial People's Hospital, Xining, 810007, Qinghai, China.
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Valero C, Adilbay D, Fitzgerald CWR, Yuan A, Mimica X, Gupta P, Wong RJ, Shah JP, Patel SG, Cohen MA, Ganly I. Predictors of distant metastases in sinonasal and skull base cancer patients treated with surgery. Oral Oncol 2021; 122:105575. [PMID: 34689008 DOI: 10.1016/j.oraloncology.2021.105575] [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: 08/27/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Sinonasal and skull base tumors comprise a heterogeneous group of malignancies with a significant rate of distant recurrence (DR). The aim of this study was to analyze tumor and host factors, including pretreatment neutrophil-to-lymphocyte ratio (NLR), that predict DR in these patients. MATERIALS AND METHODS We retrospectively reviewed sinonasal tumors and/or tumors involving the skull base treated with surgery between 1973 and 2015 (n = 473). We stratified NLR using the top 5 percentile as cutoff. Factors predictive of outcome were determined by Cox proportional hazards model. RESULTS Most tumors were primary (81%) and 67% had skull base resection. The most common site was the nasal cavity (37%) and the most common histology was squamous cell carcinoma (34%). Most patients presented with advanced primary tumor stage (pT3/T4; 80%) and most had no regional neck disease (pNx/N0; 93%). A total of 104 patients developed DR. The 5-year overall and disease-specific survival for patients who developed DR were 36.4% and 35.8%, compared to 69.0% and 74.9% for patients who did not. Patients with DR had a higher percentage of NLR-high patients compared patients without DR (11% vs 3%, p = .006). In a multivariable analysis, melanoma histology (HR = 5.469, 95% CI 3.171-9.433), pT3/T4 (HR = 2.686, 95% CI 1.150-6.275), pN+ (HR = 6.864, 95% CI 3.450-13.653), and NLR-high (HR = 3.489, 95% CI 1.593-7.639) were independent predictors of DR. CONCLUSION Melanoma histology, pT, pN, and high NLR predict DR, suggesting that both tumor and host factors need to be considered. NLR may act as a surrogate marker of the host́s immune system.
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Affiliation(s)
- Cristina Valero
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Dauren Adilbay
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Conall W R Fitzgerald
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Avery Yuan
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Ximena Mimica
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Piyush Gupta
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Richard J Wong
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Jatin P Shah
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Snehal G Patel
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Marc A Cohen
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Ian Ganly
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
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Pretreatment Neutrophil-to-Lymphocyte Ratio Associated with Tumor Recurrence and Survival in Patients Achieving a Pathological Complete Response Following Neoadjuvant Chemoradiotherapy for Rectal Cancer. Cancers (Basel) 2021; 13:cancers13184589. [PMID: 34572816 PMCID: PMC8470001 DOI: 10.3390/cancers13184589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/04/2021] [Accepted: 09/09/2021] [Indexed: 01/04/2023] Open
Abstract
Simple Summary Patients with locally advanced rectal cancer who achieve a pathological complete response to neoadjuvant chemoradiotherapy have been associated with excellent long-term prognosis. However, approximately 9% to 12% of patients with a pathological complete response have been reported to experience tumor recurrence and thereby experience poor outcomes. Identifying predictors of recurrence in patients with a pathological complete response is crucial for precise medicine. The neutrophil-to-lymphocyte ratio is a widely available biomarker of systemic inflammation and affects colorectal prognosis. The study aimed to assess the association between neutrophil-to-lymphocyte ratio and oncological outcomes in rectal cancer patients exhibiting a pCR. We found that a pretreatment high neutrophil-to-lymphocyte ratio (≥3.2) was an independent predictor of reduced overall survival and disease-free survival in patients with locally advanced rectal cancer who achieved a pathological complete response to neoadjuvant chemoradiotherapy. Our findings demonstrate that the neutrophil-to-lymphocyte ratio helps identify patients with a pathological complete response who are at high risk of tumor relapse and might facilitate patient selection for precise medicine. Abstract The clinical influence of the neutrophil-to-lymphocyte ratio (NLR) in predicting outcomes in patients with locally advanced rectal cancer (LARC) who achieve a pathological complete response (pCR) to neoadjuvant chemoradiotherapy (NACRT) has seldom been investigated. We retrospectively recruited 102 patients with LARC who achieved a pCR to NACRT and the association of NLR status with survival and tumor recurrence in the patients was analyzed. Thirteen patients (12.7%) developed tumor recurrence. A high NLR (≥3.2) was significantly associated with tumor recurrence (p = 0.039). The 5-year OS rates in patients with a low NLR and patients with a high NLR were 95.1% and 77.7%, respectively (p = 0.014); the 5-year DFS rates in patients with low NLR and patients with a high NLR were 90.6% and 71.3%, respectively (p = 0.031). The Cox proportional hazards model indicated that an NLR of ≥3.2 was an independent poor prognostic factor for DFS (hazard ratio [HR] = 3.12, 95% confidence interval [CI] = 1.06–9.46, p = 0.048) and OS (HR = 6.96, 95% CI = 1.53–35.51, p = 0.013). A pretreatment high NLR (≥3.2) was a promising predictor of reduced OS and DFS in patients with LARC who achieved a pCR to NACRT.
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Nardone V, Boldrini L, Grassi R, Franceschini D, Morelli I, Becherini C, Loi M, Greto D, Desideri I. Radiomics in the Setting of Neoadjuvant Radiotherapy: A New Approach for Tailored Treatment. Cancers (Basel) 2021; 13:cancers13143590. [PMID: 34298803 PMCID: PMC8303203 DOI: 10.3390/cancers13143590] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary This review based on a literature search aims at showing the impact of Texture Analysis in the prediction of response to neoadjuvant radiotherapy and/or chemoradiotherapy. The manuscript explores radiomics approaches in different fields of neoadjuvant radiotherapy, including esophageal cancer, lung cancer, sarcoma and rectal cancer in order to shed a light in the setting of neoadjuvant radiotherapy that can be used to tailor the best subsequent therapeutical strategy. Abstract Introduction: Neoadjuvant radiotherapy is currently used mainly in locally advanced rectal cancer and sarcoma and in a subset of non-small cell lung cancer and esophageal cancer, whereas in other diseases it is under investigation. The evaluation of the efficacy of the induction strategy is made possible by performing imaging investigations before and after the neoadjuvant therapy and is usually challenging. In the last decade, texture analysis (TA) has been developed to help the radiologist to quantify and identify the parameters related to tumor heterogeneity, which cannot be appreciated by the naked eye. The aim of this narrative is to review the impact of TA on the prediction of response to neoadjuvant radiotherapy and or chemoradiotherapy. Materials and Methods: Key references were derived from a PubMed query. Hand searching and ClinicalTrials.gov were also used. Results: This paper contains a narrative report and a critical discussion of radiomics approaches in different fields of neoadjuvant radiotherapy, including esophageal cancer, lung cancer, sarcoma, and rectal cancer. Conclusions: Radiomics can shed a light on the setting of neoadjuvant therapies that can be used to tailor subsequent approaches or even to avoid surgery in the future. At the same, these results need to be validated in prospective and multicenter trials.
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Affiliation(s)
- Valerio Nardone
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (V.N.); (R.G.)
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
| | - Luca Boldrini
- Radiation Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Roberta Grassi
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (V.N.); (R.G.)
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
| | - Davide Franceschini
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Milan, Italy;
| | - Ilaria Morelli
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy;
- Correspondence: ; Tel.: +39-055-7947719
| | - Carlotta Becherini
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy;
| | - Mauro Loi
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, 50139 Florence, Italy; (M.L.); (D.G.); (I.D.)
| | - Daniela Greto
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, 50139 Florence, Italy; (M.L.); (D.G.); (I.D.)
| | - Isacco Desideri
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, 50139 Florence, Italy; (M.L.); (D.G.); (I.D.)
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy
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