title: Prognostic significance of preoperative inflammatory response biomarkers in patients undergoing curative thoracoscopic esophagectomy for esophageal squamous cell carcinoma.
abstract: BACKGROUND
  Recent studies have revealed significant relationships between the lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) and survival in various cancers. The purpose of this study was to confirm whether the LMR, NLR, and PLR have prognostic values, independent of clinicopathological criteria, in patients undergoing curative resection for esophageal cancer.
  
  
  METHODS
  The LMR, NLR and PLR were calculated in 147 consecutive patients who underwent curative esophagectomy between January 2006 and December 2014. Receiver operating characteristics (ROC) curve analysis was conducted to identify the optimal cutoff values of each biomarkers.
  
  
  RESULTS
  In multivariate analysis for cancer-specific survival (CSS), pTNM stage (p < 0.0001) and low LMR (p = 0.0081) were selected as independent prognostic factor. Similarly, pTNM stage(p < 0.0001) and low LMR (p = 0.0225) were found to be independent prognostic factor for overall survival (OS). There was no significant relationship between LMR, NLR and PLR and survival in patients with stage I or II, however, significant relationships between LMR and CSS or OS were observed in patients with stage III esophageal cancer.
  
  
  CONCLUSIONS
  LMR can be used as a novel predictor of postoperative CSS and OS in patients with esophageal cancer and that it may be useful in identifying patients with a poor prognosis even after radical esophagectomy.
authors.affiliation: Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan. Electronic address: norinorihirahara@yahoo.co.jp.
authors.forename: N
authors.initials: N
authors.lastname: Hirahara
authors.affiliation: Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Matsubara
authors.affiliation: Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan.
authors.forename: D
authors.initials: D
authors.lastname: Kawahara
authors.affiliation: Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nakada
authors.affiliation: Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Ishibashi
authors.affiliation: Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Tajima
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000276:immunology*; D001772:Blood Cell Count; D002294:Carcinoma, Squamous Cell / Q000276:immunology* / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000276:immunology* / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013906:Thoracoscopy
chemical_list: D014408:Biomarkers, Tumor
keywords: Esophageal cancer; Lymphocyte to monocyte ratio (LMR); Neutrophil to lymphocyte ratio (NLR); Platelet lymphocyte ratio (PLR); Prognostic predictor