Giuseppe Portale1, Francesco Cavallin2, Alessandro Valdegamberi3, Flavio Frigo3, Valentino Fiscon3. 1. Department of General Surgery, Azienda ULSS 6, Cittadella, Via Casa di Ricovero, 40, 35013, Cittadella, Padova, Italy. portale@surgery.usc.edu. 2. Independent statistician, Solagna, Italy. 3. Department of General Surgery, Azienda ULSS 6, Cittadella, Via Casa di Ricovero, 40, 35013, Cittadella, Padova, Italy.
Abstract
BACKGROUND: Actual predictors of survival and recurrence for rectal cancer patients undergoing curative resection mostly come from pathological data of surgical specimen. Recently, novel blood biomarkers have been proposed as useful tools in cancer patient management, but few and conflicting data have been reported in rectal cancer. We evaluated the prognostic relevance of preoperative platelet-to-lymphocyte (P/L) ratio and neutrophil-to-lymphocyte (N/L) ratio on survival and recurrence in patients undergoing laparoscopic curative resection for rectal cancer. METHODS: All consecutive patients who referred for primary rectal disease to the Department of General Surgery in Cittadella (Italy) from June 2005 to September 2015 were retrospectively evaluated. Patients with metastatic disease at surgery were excluded. P/L and N/L ratios were calculated. For patients undergoing neoadjuvant chemo-radiotherapy, pre-treatment data were considered. Follow-up data were updated at December 2016. RESULTS: One hundred fifty-two patients were included in the study, 49 (32%) received neoadjuvant chemo-radiotherapy. Both P/L and N/L ratios showed poor discriminative performance on 5-year OS and DFS. Time-dependent ROC curves showed no improvements in discriminative performance of P/L and N/L ratios when considering different time endpoints. Multivariable analysis identified CEA-rather than P/L or N/L ratios-as independent predictor of OS and DFS, adjusting for age, tumor stage, and postoperative morbidity. CONCLUSION: Neither P/L nor N/L ratios were associated with survival after rectal cancer surgery. Further studies on large series might provide insights on the role of these inexpensive blood biomarkers in rectal cancer.
BACKGROUND: Actual predictors of survival and recurrence for rectal cancerpatients undergoing curative resection mostly come from pathological data of surgical specimen. Recently, novel blood biomarkers have been proposed as useful tools in cancerpatient management, but few and conflicting data have been reported in rectal cancer. We evaluated the prognostic relevance of preoperative platelet-to-lymphocyte (P/L) ratio and neutrophil-to-lymphocyte (N/L) ratio on survival and recurrence in patients undergoing laparoscopic curative resection for rectal cancer. METHODS: All consecutive patients who referred for primary rectal disease to the Department of General Surgery in Cittadella (Italy) from June 2005 to September 2015 were retrospectively evaluated. Patients with metastatic disease at surgery were excluded. P/L and N/L ratios were calculated. For patients undergoing neoadjuvant chemo-radiotherapy, pre-treatment data were considered. Follow-up data were updated at December 2016. RESULTS: One hundred fifty-two patients were included in the study, 49 (32%) received neoadjuvant chemo-radiotherapy. Both P/L and N/L ratios showed poor discriminative performance on 5-year OS and DFS. Time-dependent ROC curves showed no improvements in discriminative performance of P/L and N/L ratios when considering different time endpoints. Multivariable analysis identified CEA-rather than P/L or N/L ratios-as independent predictor of OS and DFS, adjusting for age, tumor stage, and postoperative morbidity. CONCLUSION: Neither P/L nor N/L ratios were associated with survival after rectal cancer surgery. Further studies on large series might provide insights on the role of these inexpensive blood biomarkers in rectal cancer.
Authors: E Kapiteijn; C A Marijnen; I D Nagtegaal; H Putter; W H Steup; T Wiggers; H J Rutten; L Pahlman; B Glimelius; J H van Krieken; J W Leer; C J van de Velde Journal: N Engl J Med Date: 2001-08-30 Impact factor: 91.245
Authors: Anne J Breugom; Marloes Swets; Jean-François Bosset; Laurence Collette; Aldo Sainato; Luca Cionini; Rob Glynne-Jones; Nicholas Counsell; Esther Bastiaannet; Colette B M van den Broek; Gerrit-Jan Liefers; Hein Putter; Cornelis J H van de Velde Journal: Lancet Oncol Date: 2015-01-12 Impact factor: 41.316
Authors: M Kusters; C A M Marijnen; C J H van de Velde; H J T Rutten; M J Lahaye; J H Kim; R G H Beets-Tan; G L Beets Journal: Eur J Surg Oncol Date: 2010-01-21 Impact factor: 4.424
Authors: Cornelis J A Punt; Marc Buyse; Claus-Henning Köhne; Peter Hohenberger; Roberto Labianca; Hans J Schmoll; Lars Påhlman; Alberto Sobrero; Jean-Yves Douillard Journal: J Natl Cancer Inst Date: 2007-06-27 Impact factor: 13.506
Authors: Georgia M Carroll; Grace L Burns; Joel A Petit; Marjorie M Walker; Andrea Mathe; Stephen R Smith; Simon Keely; Peter G Pockney Journal: Surg Open Sci Date: 2020-01-23