Is the neutrophil-lymphocyte ratio (NLR) a predictive and prognostic factor in rectal cancer patients treated with neoadjuvant chemoradiation (nCRT)?

Shin, Ui Sup; You, Y. Nancy; Price, Brandee A.; Rodrı́guez-Bigas, Miguel A.; Skibber, John M.; Maru, Dipen M.; Taggart, Melissa W.; Kopetz, Scott; Eng, Cathy; Minsky, Bruce D.; Das, Prajnan; Krishnan, Sunil; Chang, George J.

doi:10.1200/jco.2016.34.15_suppl.3605

Cited by 5 publications

(6 citation statements)

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“…Additionally, Shen et al (29) reported that there was no significant association between tumor response and NLR to nCRT. It has previously been reported that baseline systemic inflammatory responses could not predict tumor responses in colorectal cancer (32,33). In the present study, there was no significant association between pCR and NLR or PLR during nCRT.…”

Section: Discussioncontrasting

confidence: 69%

Systemic inflammatory indices predict tumor response to neoadjuvant chemoradiotherapy for locally advanced rectal cancer

et al. 2020

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Systemic inflammatory responses are associated with the prognosis of patients with colorectal cancer. However, the value in predicting tumor responses to neoadjuvant chemoradiotherapy (nCRT) remains to be elucidated. The current study aimed to investigate the association between systemic inflammatory indices and pathological complete response (pCR). The training and validation cohorts included 225 and 96 patients with locally advanced rectal cancer. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio were recorded prior to nCRT and radical surgery. Univariate and multivariate analysis were used to investigate the association between systemic inflammatory indices and pCR. Systemic inflammatory indices prior to or following treatment had no significant association with pCR; however, the percentage change in NLR from pre-nCRT to post-nCRT was associated with a poor response, and a percentage change of >21.5% NLR (P=0.006; OR=0.413; 95% CI=0.22–0.773) was a predictor of poor pCR. Therefore, in rectal cancer, the percentage change in NLR from pre- to post-nCRT was found to be a predictor of poor pCR.

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Section: Discussioncontrasting

confidence: 69%

Systemic inflammatory indices predict tumor response to neoadjuvant chemoradiotherapy for locally advanced rectal cancer

et al. 2020

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“…Previous evidence has demonstrated conflicting results regarding the association between pre-NLR and pathologic response to neoCRT in LARC; some studies assigned a predictive role (Braun et al, 2019;Kim et al, 2014;Shin et al, 2016;Zhang et al, 2019); however, others did not (Ergen et al, 2021;Ishikawa et al, 2020;Jeon et al, 2019;Lai et al, 2020;Picardo et al, 2016).…”

Section: Discussionmentioning

confidence: 97%

“…The value of NLR taken before neoCRT (henceforth called pre-NLR) in predicting the pathologic response in LARC is still a matter of debate; several studies assigned a predictive role for it (Braun et al, 2019;Kim et al, 2014;Shin et al, 2016;X Zhang et al, 2019); however, several others did not (Ergen et al, 2021;Ishikawa et al, 2020;Jeon et al, 2019;Lai et al, 2020;Picardo et al, 2016). This discrepancy might originate from the retrospective nature of studies available in the literature with their inherent limitations, such as selection bias and miss to control the effect of confounding factors.…”

Section: Neutrophil-to-lymphocyte Ratio (Nlr) As a Poor Predictive Bi...mentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio (NLR) as a Poor Predictive Biomarker for Pathological Response to Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer: A Prospective Study

Novin

Fadavi

Mortazavi

et al. 2023

Asian Pac J Cancer Prev

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Background:The literature is inconsistent for the role of neutrophil-to-lymphocyte ratio (NLR) obtained before neoadjuvant therapy (pre-NLR) in predicting pathological response to neoadjuvant chemoradiation (neoCRT) in patients with locally advanced rectal cancer (LARC). In the present cohort study, we explored the predictive role of pre-NLR in this setting. Methods: We prospectively included patients with LARC who were candidates for neoCRT at the Shohada-e-Hafte Tir Hospital (Tehran, Iran) between Mar 2018 and Feb 2020. The pre-NLR was obtained through a peripheral blood smear before CRT. We used the AJCC system for evaluating tumor regression grade (TRG). The TRGs were categorized into: response-group 1 (TRG 0-1 vs. 2-3), response-group 2 (TRG 0 vs. 1-3), and responsegroup 3 (TRG 0-2 vs. 3). We applied receiver operating characteristic (ROC) analysis to assess the predictive value of pre-NLR. Results: Of the 86 screened patients with rectal cancer, 30 patients who fulfilled the inclusion criteria were included in the study. In total, 63.3% were responsive, and 23.3% had complete pathologic response. Pre-NLR could not predict the pathologic response in response-group 1 (area under the ROC curve [AUC]: 0.45, 95%CI 0.23-0.66) and response-group 2 (AUC: 0.36, 95%CI 0.13-0.59). Nevertheless, it had a poor predictive value in response-group 3 (AUC: 0.55, CI%95 0.33-0.75) with an optimal NLR cutoff value of 2.94. Conclusions: Pre-NLR could not predict the pathological response to neoCRT in our cohort of patients with LARC.

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“…NLR re ected the balance between antitumor and pro-tumor activities of the host's immune system, and the shin study showed that NLR could be used as one of the indicators of poor prognosis [19]. Neutrophils promote tumor development.…”

Section: Discussionmentioning

confidence: 99%

To Explore the Effect of NLR and PLR on Prognosis of Rectal Cancer on the basis of T3 substage, and to draw the related nomogram

Wang

Yang

et al. 2021

Preprint

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Background: Approximately 50% of patients with rectal cancer are classified into T3 stage, and they are positioned as substage by various criteria. These patients with different neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) develop disparate outcomes. We sought to develop and validate nomograms to predict survival in patients with rectal cancer on the basis of T3 substage.Methods: We conducted a retrospective cohort study by collecting 170 cases from China. Individuals with rectal cancer after 2 or more years of follow up after surgery were eligible for inclusion. Candidate predictors consisted of NLR, PLR, T3 substage and clinical characteristics available at the time of rectal cancer diagnosis. The optimal cut-off values for NLR and PLR were determined using X-Tile (Version 3.6.1) software and were determined before statistical analyses. Variables with P values below 0.1 in the univariable analyses were further evaluated using Cox multivariate analysis. Model discrimination was assessed using receiver operating characteristic (ROC) curve and concordance index (C-index) analysis. Results were internally validated using related software.Results: We analyzed data from 170 patients with T3 rectal cancer. The optimal cut-off value of NLR in relation to overall and disease-free survival were 3.1 and 2.9, and that of PLR were 181.9 and 202.7. Among them, postoperative adjuvant chemotherapy, T3 substage, N stage, CA199 and NLR were independent risk factors affecting overall survival（OS）and disease-free survival (DFS). There was no significant difference in survival rate between T3a and T3b, or between T3c and T3d. The final nomograms of 2-year OS (area under the curve,0.886; The c-index,0.870) and 2-year DFS (area under the curve,0.895; The c-index,0.867) were developed according to independent risk factors analyzed by SPSS 26 (SPSS Inc., Chicago, IL, USA) software. The calibration curves showed negligible optimism.Conclusion: We developed nomograms based on postoperative adjuvant chemotherapy, T3 substage, N stage, CA199 and NLR to help identify patients with poor prognosis and to guide individualized therapy.

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Is the neutrophil-lymphocyte ratio (NLR) a predictive and prognostic factor in rectal cancer patients treated with neoadjuvant chemoradiation (nCRT)?

Cited by 5 publications

References 0 publications

Systemic inflammatory indices predict tumor response to neoadjuvant chemoradiotherapy for locally advanced rectal cancer

Systemic inflammatory indices predict tumor response to neoadjuvant chemoradiotherapy for locally advanced rectal cancer

Neutrophil-to-Lymphocyte Ratio (NLR) as a Poor Predictive Biomarker for Pathological Response to Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer: A Prospective Study

To Explore the Effect of NLR and PLR on Prognosis of Rectal Cancer on the basis of T3 substage, and to draw the related nomogram

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