title: Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy.
abstract: BACKGROUND Increasing evidence suggests that cancer-associated inflammation is associated with poorer outcomes. The neutrophil-to-lymphocyte ratio (NLR), considered as a systemic inflammation marker, is thought to predict prognoses in colorectal cancer. In this study, we explored the association between the NLR and prognoses following neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC). MATERIAL AND METHODS From February 2002 to December 2012, a group of 202 patients diagnosed with LARC and receiving neoadjuvant CRT followed by radical surgery was included in our retrospective study. The associations between the pre-CRT NLR and clinicopathological characteristics, as well as the predictive value of pre-CRT NLR against survival outcomes, were analyzed. RESULTS The average NLR was 2.7±1.5 (median 2.4, range 0.6-12.8). There were 63 (31.2%) patients with NLR ≥3.0, and 139 (68.8%) patients with NLR <3.0. Correlation analyses showed that no clinicopathological characteristics except age were associated with NLR. We did not find an association between NLR and survival outcomes. In multivariate Cox model analyses, the R1/R2 resection, lymph node ratio ≥0.1, and perineural/lymphovascular invasion were independently associated with worse disease-free survival and overall survival. CONCLUSIONS In our cohort, the NLR did not correlate with survival outcomes in LARC patients undergoing neoadjuvant CRT. The prognostic value of NLR should be validated in large-scale prospective studies.
authors.affiliation: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).
authors.forename: Jinwen
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).|Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, Zhejiang, China (mainland).
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.affiliation: Department of Diagnostic Radiology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).
authors.forename: Lingnan
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Colorectal Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).
authors.forename: Haixing
authors.initials: H
authors.lastname: Ju
authors.affiliation: Department of Colorectal Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).
authors.forename: Yongtian
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Department of Colorectal Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).
authors.forename: Yuping
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).|Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, Zhejiang, China (mainland).
authors.forename: Jialin
authors.initials: J
authors.lastname: Luo
authors.affiliation: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).|Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, Zhejiang, China (mainland).
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).|Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, Zhejiang, China (mainland).
authors.forename: Ning
authors.initials: N
authors.lastname: Zhou
authors.affiliation: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).|Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, Zhejiang, China (mainland).
authors.forename: Ke
authors.initials: K
authors.lastname: Lu
authors.affiliation: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).|Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, Zhejiang, China (mainland).
authors.forename: Na
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Department of Colorectal Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).
authors.forename: Dechuan
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China (mainland).|Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, Zhejiangq, China (mainland).
authors.forename: Luying
authors.initials: L
authors.lastname: Liu
mesh_terms: D000368:Aged; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000097:blood* / Q000473:pathology / Q000628:therapy*; D012307:Risk Factors; D016019:Survival Analysis