BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) predict for survival in cancer patients. In patients receiving multimodality therapy, the effect of therapy on the NLR and PLR is not well understood. We evaluated changes in NLR and PLR among locally advanced esophageal cancer patients who received trimodality therapy. METHODS: We performed a retrospective analysis of nonmetastatic patients with esophageal cancer who received neoadjuvant chemoradiation therapy (CRT) followed by esophagectomy at our institution between March 2000 and April 2012. NLR and PLR values were obtained for the following time points (TPs): (I) at diagnosis before CRT; (II) after CRT but prior to surgery; and (III) after surgery. We evaluated changes in NLR and PLR using the difference and ratio between TPs. Overall survival (OS) was evaluated by Kaplan-Meier analysis. Univariate and multivariate Cox regression models were applied to evaluate the independent prognostic significance of NLR and PLR. RESULTS: This IRB-approved study included the records of 83 consecutive patients with stage II-IV esophageal cancer. The median age was 60 years, and median follow-up was 29.3 months. Patients were treated to a median prescription dose of 50.4 Gy (range, 50.4-56.4 Gy) in 28-33 fractions. Median NLR and PLR were 3.3 and 157.2, 12 and 645, and 11.5 and 391.7 at TPs 1, 2, and 3, respectively. On multivariate analysis, superior OS was associated with PLR ≥250 at TP3 (P=0.03), PLR decrease ≥609.2 between TP2 and TP3 (P=0.02), and PLR ratio (TP3/TP1) ≥1.08 (P=0.03). Inferior progression-free survival (PFS) was associated with NLR ≥36 at TP2 (P=0.0008), NLR increase ≥28.3 between TP1 and TP2 (P=0.0005), and PLR ratio (TP2/TP3) ≥0.38 (P=0.1). Pathologic complete response (PCR) was less likely for adenocarcinoma (AC) histology (P=0.03), NLR ≥10.6 at TP2 (P=0.04), and NLR increase ≥4.6 from TP1 to TP2 (P=0.03). CONCLUSIONS: To our knowledge, this is the first study to examine NLR and PLR values at various time intervals throughout treatment and demonstrate a correlation between OS, PFS, and PCR in patients undergoing trimodality therapy for esophageal cancer.
BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) predict for survival in cancerpatients. In patients receiving multimodality therapy, the effect of therapy on the NLR and PLR is not well understood. We evaluated changes in NLR and PLR among locally advanced esophageal cancerpatients who received trimodality therapy. METHODS: We performed a retrospective analysis of nonmetastatic patients with esophageal cancer who received neoadjuvant chemoradiation therapy (CRT) followed by esophagectomy at our institution between March 2000 and April 2012. NLR and PLR values were obtained for the following time points (TPs): (I) at diagnosis before CRT; (II) after CRT but prior to surgery; and (III) after surgery. We evaluated changes in NLR and PLR using the difference and ratio between TPs. Overall survival (OS) was evaluated by Kaplan-Meier analysis. Univariate and multivariate Cox regression models were applied to evaluate the independent prognostic significance of NLR and PLR. RESULTS: This IRB-approved study included the records of 83 consecutive patients with stage II-IV esophageal cancer. The median age was 60 years, and median follow-up was 29.3 months. Patients were treated to a median prescription dose of 50.4 Gy (range, 50.4-56.4 Gy) in 28-33 fractions. Median NLR and PLR were 3.3 and 157.2, 12 and 645, and 11.5 and 391.7 at TPs 1, 2, and 3, respectively. On multivariate analysis, superior OS was associated with PLR ≥250 at TP3 (P=0.03), PLR decrease ≥609.2 between TP2 and TP3 (P=0.02), and PLR ratio (TP3/TP1) ≥1.08 (P=0.03). Inferior progression-free survival (PFS) was associated with NLR ≥36 at TP2 (P=0.0008), NLR increase ≥28.3 between TP1 and TP2 (P=0.0005), and PLR ratio (TP2/TP3) ≥0.38 (P=0.1). Pathologic complete response (PCR) was less likely for adenocarcinoma (AC) histology (P=0.03), NLR ≥10.6 at TP2 (P=0.04), and NLR increase ≥4.6 from TP1 to TP2 (P=0.03). CONCLUSIONS: To our knowledge, this is the first study to examine NLR and PLR values at various time intervals throughout treatment and demonstrate a correlation between OS, PFS, and PCR in patients undergoing trimodality therapy for esophageal cancer.
Entities:
Keywords:
Neutrophil-to-lymphocyte ratio (NLR); changes; esophageal cancer; platelet-to-lymphocyte ratio (PLR)
Authors: Mehmet Aliustaoglu; Ahmet Bilici; Bala Basak Oven Ustaalioglu; Volkan Konya; Murat Gucun; Mesut Seker; Mahmut Gumus Journal: Med Oncol Date: 2009-10-22 Impact factor: 3.064
Authors: D H Boggs; C Tarabolous; C G Morris; A Hanna; W Burrows; N Horiba; M Suntharalingam Journal: Dis Esophagus Date: 2014-05-26 Impact factor: 3.429
Authors: Falguni Parikh; Dorothée Duluc; Naoko Imai; Amelia Clark; Krzys Misiukiewicz; Marcello Bonomi; Vishal Gupta; Alexis Patsias; Michael Parides; Elizabeth G Demicco; David Y Zhang; Seunghee Kim-Schulze; Johnny Kao; Sacha Gnjatic; Sangkon Oh; Marshall R Posner; Andrew G Sikora Journal: Cancer Res Date: 2014-10-15 Impact factor: 12.701
Authors: P Lissoni; F Brivio; L Fumagalli; G Messina; V Ghezzi; L Frontini; L Giani; M Vaghi; A Ardizzoia; G S Gardani Journal: Int J Biol Markers Date: 2004 Apr-Jun Impact factor: 2.659
Authors: Mudit Chowdhary; Jeffrey M Switchenko; Robert H Press; Jaymin Jhaveri; Zachary S Buchwald; Philip A Blumenfeld; Gaurav Marwaha; Aidnag Diaz; Dian Wang; Ross A Abrams; Jeffrey J Olson; Hui-Kuo G Shu; Walter J Curran; Kirtesh R Patel Journal: J Neurooncol Date: 2018-05-30 Impact factor: 4.130
Authors: James Tankel; Alexander Calderone; Jose Luis Ramirez Garcia-Luna; Carmen L Mueller; Sarah Najmeh; Jonathan Spicer; David Mulder; Lorenzo Ferri; Jonathan Cools-Lartigue Journal: Ann Surg Oncol Date: 2022-04-04 Impact factor: 5.344
Authors: Alexander J Lin; Margery Gang; Yuan James Rao; Jian Campian; Mackenzie Daly; Hiram Gay; Peter Oppelt; Ryan S Jackson; Jason Rich; Randal Paniello; Jose Zevallos; Dennis Hallahan; Douglas Adkins; Wade Thorstad Journal: JAMA Otolaryngol Head Neck Surg Date: 2019-05-01 Impact factor: 6.223
Authors: Antoine Schernberg; Laurence Moureau-Zabotto; Eleonor Rivin Del Campo; Alexandre Escande; Michel Ducreux; France Nguyen; Diane Goere; Cyrus Chargari; Eric Deutsch Journal: Oncotarget Date: 2017-02-14