title: A pre-operative elevated neutrophil: lymphocyte ratio does not predict survival from oesophageal cancer resection.
abstract: BACKGROUND
  Elevated pre-operative neutrophil: lymphocyte ratio (NLR) has been identified as a predictor of survival in patients with hepatocellular and colorectal cancer. The aim of this study was to examine the prognostic value of an elevated preoperative NLR following resection for oesophageal cancer.
  
  
  METHODS
  Patients who underwent resection for oesophageal carcinoma from June 1997 to September 2007 were identified from a local cancer database. Data on demographics, conventional prognostic markers, laboratory analyses including blood count results, and histopathology were collected and analysed.
  
  
  RESULTS
  A total of 294 patients were identified with a median age at diagnosis of 65.2 (IQR 59-72) years. The median pre-operative time of blood sample collection was three days (IQR 1-8). The median neutrophil count was 64.2 x 10-9/litre, median lymphocyte count 23.9 x 10-9/litre, whilst the NLR was 2.69 (IQR 1.95-4.02). NLR did not prove to be a significant predictor of number of involved lymph nodes (Cox regression, p = 0.754), disease recurrence (p = 0.288) or death (Cox regression, p = 0.374). Furthermore, survival time was not significantly different between patients with high (>or= 3.5) or low (< 3.5) NLR (p = 0.49).
  
  
  CONCLUSIONS
  Preoperative NLR does not appear to offer useful predictive ability for outcome, disease-free and overall survival following oesophageal cancer resection.
authors.affiliation: Royal Derby Hospital, Uttoxeter Road, Derby DE22 3NE, UK. farhan.rashid@nottingham.ac.uk
authors.forename: Farhan
authors.initials: F
authors.lastname: Rashid
authors.forename: Naseem
authors.initials: N
authors.lastname: Waraich
authors.forename: Imran
authors.initials: I
authors.lastname: Bhatti
authors.forename: Shopan
authors.initials: S
authors.lastname: Saha
authors.forename: Raheela N
authors.initials: RN
authors.lastname: Khan
authors.forename: Javed
authors.initials: J
authors.lastname: Ahmed
authors.forename: Paul C
authors.initials: PC
authors.lastname: Leeder
authors.forename: Mike
authors.initials: M
authors.lastname: Larvin
authors.forename: Syed Y
authors.initials: SY
authors.lastname: Iftikhar
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome