title: Pre-operative Neutrophils/Lymphocyte Ratio in Rectal Cancer Patients with Preoperative Chemoradiotherapy.
abstract: BACKGROUND
  Several studies have reported that an elevation in neutrophils/lymphocyte ratio (NLR) is correlated with poor survival in patients with colorectal cancer, but in rectal cancer (RC), it has been reported only in a few studies. It is necessary to separate colon cancer and rectal cancer to clarify the prognostic significance of NLR, especially in patients who received chemoradiotherapy.
  
  
  METHODS
  It is a comparative, observational retrospective study of a cohort of 175 patients. We grouped the patients into two based on their NLR (0-3 vs. > 3) to correlate with disease-specific survival (DSS) and pathologic complete response (pCR).
  
  
  RESULTS
  The average NLR was 2.65 + 1.32 (range 0.58-6.89), and 144 (82.3%) patients had an NLR of 0-3. The median follow-up was 33.53 months. There were no differences in pCR between the two groups. The 5-year DSS was 78.8%. NLR did not correlate with survival. Mesorectal quality, pT3-4 tumors, lymph node metastasis, lymphovascular invasion, perineural invasion, positive margins and recurrence were statistically significant predictors of increased mortality in univariate analysis. In multivariate analysis, only overall recurrence correlated with poor survival. The analysis of the association of NLR with outcomes with different cut points (2.0, 2.5, 4 and 5) did not show differences in DSS and pCR.
  
  
  CONCLUSIONS
  In our cohort, the NLR did not serve as a prognostic marker in patients with locally advanced rectal cancer and who received chemoradiotherapy and did not correlate with pCR as well.
authors.affiliation: Departament of Gastrointestinal Pathology, Instituto Nacional de Cancerología, Mexico City, Mexico.
authors.forename: Leonardo S
authors.initials: LS
authors.lastname: Lino-Silva
authors.affiliation: Surgical Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico.
authors.forename: Rosa A
authors.initials: RA
authors.lastname: Salcedo-Hernández
authors.affiliation: Translational Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico.
authors.forename: Erika B
authors.initials: EB
authors.lastname: Ruiz-García
authors.affiliation: Surgical Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico.
authors.forename: Leticia
authors.initials: L
authors.lastname: García-Pérez
authors.affiliation: Surgical Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Herrera-Gómez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009504:Neutrophils; D012004:Rectal Neoplasms / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015996:Survival Rate; D055815:Young Adult
keywords: cancer; colorectal; lymphocyte; neutrophils; rectal; survival