title: Leukocytosis and neutrophilia predict outcome in locally advanced esophageal cancer treated with definitive chemoradiation.
abstract: OBJECTIVE
  To investigate the prognostic value of leukocyte and neutrophil count as biomarkers in patients with locally advanced esophageal squamous cell carcinoma (SCC) undergoing exclusive chemoradiation.
  
  
  RESULTS
  A total of 126 patients were identified. Respectively, 33% and 35% displayed baseline leukocytosis and neutrophilia. Estimated 3-year OS and PFS from chemoradiation completion were 31% and 25%, respectively. In univariate analysis, both leukocytosis and neutrophilia were associated with worse OS, PFS, and LRC (p < 0.01). In multivariate analysis, leukocytosis remained an independent risk factor associated with poorer OS, PFS and LRC (p < 0.05), independently from tumor stage and length, with higher prognostic value for OS compared with patients' performance status (PS).
  
  
  METHODS
  Bi-institutional clinical records from consecutive non-operable patients treated between 2003 and 2015 with definitive chemoradiation for locally advanced esophageal carcinoma were reviewed. Leukocytosis and neutrophilia were defined as a leukocyte or neutrophil count over 10 G/L and 7 G/L, respectively. These parameters were studied for their potential correlation with overall survival (OS), progression free survival (PFS), locoregional control (LRC) and distant metastases control (DMC).
  
  
  CONCLUSIONS
  Leukocytosis and neutrophilia were independent prognostic factors of poor OS, PFS, and LRC in this bi-institutional series of locally advanced esophageal SCC treated with definitive chemoradiation. Although prospective confirmation is warranted, it is suggested that the leukocyte and neutrophil count parameters might be clinically relevant biomarkers to be considered for further clinical investigations.
authors.affiliation: Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Schernberg
authors.affiliation: Radiation Oncology Department, Institut Paoli-Calmettes, Marseille, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Moureau-Zabotto
authors.affiliation: Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Eleonor
authors.initials: E
authors.lastname: Rivin Del Campo
authors.affiliation: Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Escande
authors.affiliation: Université Paris Sud, Université Paris Saclay, Faculté de médecine du Kremlin-Bicetre, Le Kremlin-Bicetre, France.|Department of Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Ducreux
authors.affiliation: Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: France
authors.initials: F
authors.lastname: Nguyen
authors.affiliation: Department of Surgery, Gustave Roussy, Université Paris-Saclay, Villejuif, France.
authors.forename: Diane
authors.initials: D
authors.lastname: Goere
authors.affiliation: Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France.|INSERM1030, Gustave Roussy Cancer Campus, Villejuif France.|French Military Health Services Academy, Ecole du Val-de-Grâce, Paris, France.|Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge, France.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.affiliation: Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France.|Université Paris Sud, Université Paris Saclay, Faculté de médecine du Kremlin-Bicetre, Le Kremlin-Bicetre, France.|INSERM1030, Gustave Roussy Cancer Campus, Villejuif France.
authors.forename: Eric
authors.initials: E
authors.lastname: Deutsch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D005260:Female; D006801:Humans; D007964:Leukocytosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult
keywords: biomarker; concurrent chemoradiation; esophageal cancer; leukocytosis; prognostic factor