title: Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios can Predict Treatment Response to Neoadjuvant Therapy in Esophageal Cancer.
abstract: We hypothesized that serum neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios may predict pathologic complete response to neoadjuvant chemoradiotherapy in esophageal cancer patients. The ability to predict favorable treatment response to therapy may aid in determining optimal treatment regimens.
  
  
  
  A retrospective review of a prospective esophageal disease registry was conducted. Neutrophil-to-lymphocyte ratio was defined as the pre-chemoradiotherapy serum neutrophil count divided by lymphocyte count. Platelet-to-lymphocyte ratio was similarly defined. Logistic regression was applied to analyze these ratios and their effect on pathologic complete response. A Cox proportional-hazards model was used to analyze survival.
  
  
  
  Sixty patients were included. Elevated neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were both negative predictors of pathologic complete response (odds ratio: 0.62; 95% confidence interval: 0.37-0.89, P = 0.037 and odds ratio: 0.91; 95% confidence interval: 0.82-0.98, P = 0.028, respectively). Only platelet-to-lymphocyte ratio was predictive of decreased overall survival (hazard ratio: 1.05, 95% confidence interval: 0.94-1.16, P = 0.40).
  
  
  
  Elevated neutrophil and platelet-to-lymphocyte ratios were significant predictors of a poor treatment response to neoadjuvant therapy. Only elevated platelet-to-lymphocyte ratio was predictive of worse overall survival. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios may offer a simple serum test to assess the likelihood of a pathologic complete response after neoadjuvant therapy in esophageal cancer.
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Oregon Health and Science University, 3181 Sam Jackson Park Rd, Portland, OR, 97239, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: McLaren
authors.affiliation: Department of General Surgery, Kaiser Permanente, Sunnyside, Portland, OR, USA.
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Bronson
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Oregon Health and Science University, 3181 Sam Jackson Park Rd, Portland, OR, 97239, USA.
authors.forename: Kyle D
authors.initials: KD
authors.lastname: Hart
authors.affiliation: Division of Medical Oncology, Department of Medicine, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Gina M
authors.initials: GM
authors.lastname: Vaccaro
authors.affiliation: Department of Pathology, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Ken M
authors.initials: KM
authors.lastname: Gatter
authors.affiliation: Department of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Thomas
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Oregon Health and Science University, 3181 Sam Jackson Park Rd, Portland, OR, 97239, USA.
authors.forename: John G
authors.initials: JG
authors.lastname: Hunter
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Oregon Health and Science University, 3181 Sam Jackson Park Rd, Portland, OR, 97239, USA. dolanj@ohsu.edu.
authors.forename: James P
authors.initials: JP
authors.lastname: Dolan
mesh_terms: D000368:Aged; D001792:Blood Platelets; D059186:Chemoradiotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000097:blood* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009504:Neutrophils; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Esophageal cancer; Neutrophil-to-lymphocyte ratio; Oesophageal cancer; Pathologic complete response; Platelet-to-lymphocyte ratio