Hao Liu1, Hao Wang2, Jianhua Wu3, Yiming Wang2, Liying Zhao2, Guoxin Li4, Meijuan Zhou5. 1. Department of Radiation Medicine, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China; Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China. 2. Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China. 3. Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China. 4. Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China. Electronic address: gzliguoxin@163.com. 5. Department of Radiation Medicine, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China. Electronic address: fyzmj@163.com.
Abstract
BACKGROUND AND PURPOSE: Neoadjuvant chemoradiation (nCRT) could reduce tumor infiltrating lymphocytes. We examined absolute lymphocyte count (ALC) nadir during nCRT, pathologic response and prognosis for locally advanced rectal cancer (LARC). MATERIALS AND METHODS: 102 patients with LARC (cT3-4N0, or node-positive) treated between 2010 and 2015 with nCRT followed by complete resection were analyzed. The ALC value was obtained prior to, weekly during the treatment, and one month after nCRT. Associations of ALC nadir with immune cells' infiltrations, pathologic response and survival were analyzed. RESULTS: Twenty-four (23.5%) and 60 (58.9%) patients achieved pathologic complete response and partial response respectively. Response rate was higher in high ALC nadir group than low nadir group (89.7% vs. 67.6%, p = 0.006). Compared to low ALC nadir group, increased tumor infiltrates of CD4+ (4% vs. 17.5%, p < 0.001), CD8+ (8% vs.30%, p < 0.001) T cells and CD68+ macrophages (6% vs. 25%, p < 0.001) were observed in high ALC nadir group. High ALC nadir [OR = 4.32 (95% CI, 1.22-15.26), p = 0.023] and well differentiation [OR = 10.53 (1.87-59.36), p = 0.008] were associated with pathologic response. Patients with high ALC nadir yielded better DFS [HR = 0.36 (0.16-0.81), p = 0.010] and OS [HR = 0.24 (0.08-0.69), p = 0.004]. CONCLUSIONS: Higher ALC nadir during nCRT is associated with a higher rate of pathologic response and better survival for LARC patients, suggesting that ALC may be a potential stratification strategy for LARC patients.
BACKGROUND AND PURPOSE: Neoadjuvant chemoradiation (nCRT) could reduce tumor infiltrating lymphocytes. We examined absolute lymphocyte count (ALC) nadir during nCRT, pathologic response and prognosis for locally advanced rectal cancer (LARC). MATERIALS AND METHODS: 102 patients with LARC (cT3-4N0, or node-positive) treated between 2010 and 2015 with nCRT followed by complete resection were analyzed. The ALC value was obtained prior to, weekly during the treatment, and one month after nCRT. Associations of ALCnadir with immune cells' infiltrations, pathologic response and survival were analyzed. RESULTS: Twenty-four (23.5%) and 60 (58.9%) patients achieved pathologic complete response and partial response respectively. Response rate was higher in high ALCnadir group than low nadir group (89.7% vs. 67.6%, p = 0.006). Compared to low ALCnadir group, increased tumor infiltrates of CD4+ (4% vs. 17.5%, p < 0.001), CD8+ (8% vs.30%, p < 0.001) T cells and CD68+ macrophages (6% vs. 25%, p < 0.001) were observed in high ALCnadir group. High ALCnadir [OR = 4.32 (95% CI, 1.22-15.26), p = 0.023] and well differentiation [OR = 10.53 (1.87-59.36), p = 0.008] were associated with pathologic response. Patients with high ALCnadir yielded better DFS [HR = 0.36 (0.16-0.81), p = 0.010] and OS [HR = 0.24 (0.08-0.69), p = 0.004]. CONCLUSIONS: Higher ALCnadir during nCRT is associated with a higher rate of pathologic response and better survival for LARC patients, suggesting that ALC may be a potential stratification strategy for LARC patients.
Authors: Gyu Sang Yoo; Jeong Il Yu; Sungkoo Cho; Youngyih Han; Yoonjin Oh; Do Hoon Lim; Hee Rim Nam; Ji-Won Lee; Ki-Woong Sung; Hyung Jin Shin Journal: Cancer Res Treat Date: 2021-10-15 Impact factor: 5.036
Authors: Brian De; Sweet Ping Ng; Amy Y Liu; Santiago Avila; Randa Tao; Emma B Holliday; Zachary Brownlee; Ahmed Kaseb; Sunyoung Lee; Kanwal Raghav; Jean-Nicolas Vauthey; Bruce D Minsky; Joseph M Herman; Prajnan Das; Grace L Smith; Cullen M Taniguchi; Sunil Krishnan; Christopher H Crane; Clemens Grassberger; Theodore S Hong; Steven H Lin; Albert C Koong; Radhe Mohan; Eugene J Koay Journal: J Hepatocell Carcinoma Date: 2021-03-03