Lymphocyte-to-monocyte ratio (LMR) is prognostic factor for selection of neoadjuvant treatment in locally advanced rectal cancer patients: Sub-set analysis of Polish-2 study

Winiarek, M.; Rybski, Sebastian; Spałek, Mateusz; Kryński, J; Zajâc, Leszek; Kosakowska, Ewa; Zwoliński, Jakub; Rutkowski, A.; Michalski, Wojciech; Bujko, Krzysztof; Wyrwicz, Lucjan

doi:10.1093/annonc/mdx261.352

Cited by 6 publications

(9 citation statements)

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“…It predicts a pathological response to neoadjuvant chemoradiotherapy [26]. LMR was also investigated as a predictive factor for a neo-adjuvant radiation regimen with promising results [10]. An association between the biomarker and tumor location (sidedness), metabolic parameters of baseline 18 F-FDG PET/CT or postoperative infectious complications in patients with CRC have been demonstrated in recent years [27][28][29].…”

Section: Discussionmentioning

confidence: 99%

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Reproducibility of lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with locally advanced rectal cancer.

Gawiński¹

2022

JCO

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166 Background: Rectal cancer constitutes over one-third of all colorectal cancers (CRC) and is one of the leading cause of cancer-related death in developed countries. Treatment modalities applied in locally advanced tumors differ substantially among research centers. In order to identify high-risk patients and better adjust the therapy new markers are needed. Systemic inflammatory response (SIR) markers such as LMR, NLR and PLR have been proved highly prognostic in many malignancies, including CRC; however, they lack proper validation. In our study we assessed the reproducibility of LMR, NLR and PLR. Methods: Sixty patients with locally advanced rectal cancer treated in Maria-Sklodowska Curie National Institute of Oncology in Warsaw, Poland between 08.2017 and 12.2020 were prospectively enrolled in the study. Three consecutive blood morphology tests of each patient within a median period of 21 days were obtained before start of the treatment. Results: LMR, NLR and PLR calculated at two time-points were correlated with the coefficient of 0.776, 0.696 and 0.751 (p < 0.005 in all measurements), respectively. Patients were divided into LMR, NLR, PLR-high and low groups. If LMR at the first test was out of the range of 2.2-3.0 (+/- 0.4 from the cut-off) the risk of misclassification in the second measurement defined as an affiliation to a different (high or low) group than initially was 5.0% (95% CI 1.0-13.9%). In case of NLR, when outside of the range of 2.5-3.5 (+/- 0.5) it was 8.3% (95% CI 2.8-18.4%) and PLR outside of the range of 125-175 (+/- 25) 10.0% (95% CI 3.8-20.5%). Mean percentage change between the third and the first measurement of lymphocytes, monocytes, neutrophils and platelets count ranged from -5.59% to 4.76% and the standard error from 2.0 to 3.9. Conclusions: In conclusion SIR markers are reproducible, easily obtained biomarkers with potential application in clinical practice.

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Section: Discussionmentioning

confidence: 99%

“…Patients were divided in terms of baseline values of SIR markers into LMR,NLR,PLR-high and low groups. The cut-off values were determined based on our previous studies and data available in the literature [4,6,10,11].…”

Section: Methodsmentioning

confidence: 99%

Reproducibility of lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with locally advanced rectal cancer.

Gawiński¹

2022

JCO

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“…The patients were divided in terms of pre-treatment values of SIR markers. The cut-off values were predetermined based on available data in the literature and our previous studies [4,6,8,9]. For LMR, the cut-off value was 2.6, for NLR 3.0 and for PLR 150.…”

Section: Methodsmentioning

confidence: 99%

Correlation between Lymphocyte-to-Monocyte Ratio (LMR), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR) and Tumor-Infiltrating Lymphocytes (TILs) in Left-Sided Colorectal Cancer Patients

Gawiński

Michalski

Mróz

et al. 2022

Biology

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Colorectal cancer (CRC) is one of the leading causes of cancer-related mortality worldwide. Novel markers are required in order to select high-risk patients and better adjust the treatment. Both peripheral and local markers of cancer-related inflammation (CRI) such as lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR) or platelet-to-lymphocyte ratio (PLR) and tumor-infiltrating lymphocytes (TILs) have been thoroughly investigated in recent years and deemed to be highly prognostic. We hypothesized that there is an association between local and peripheral CRI indices and that blood-based biomarkers may serve as a surrogate of TILs. We retrospectively analyzed 87 patients with locally advanced left-sided CRC treated with radical-intent surgery in the Maria Skłodowska-Curie National Research Institute of Oncology in Warsaw, Poland, between January 2014 and December 2015. Fifty patients were found eligible for the study. The patients were divided in terms of pre-treatment values of systemic inflammatory response (SIR) markers into LMR/NLR/PLR-high and low groups. We evaluated the resected specimens by immunohistochemistry in order to assess the densities of CD3+ and CD8+ lymphocytes in the center of the tumor and in the invasive margin. We found that the level of CD3+ lymphocytes in the center of the tumor was statistically significantly higher in patients with low pre-treatment NLR (p = 0.044); however, no correlation between any of the SIR markers and CD3+ or CD8+ TILs was observed. Five-year overall survival (OS) was longer in patients with high LMR (p < 0.001), low NLR (p = 0.001) and low PLR (p = 0.095). No correlation between the density of TILs and OS was demonstrated. In conclusion, based on our study, peripheral blood-based markers and CD3+ and CD8+ TILs are not interrelated.

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“…Following title and abstract review, 44 potentially relevant articles were selected for further evaluation. Finally, 23 studies [12][13][14][15][16][17][18][19][20][21][22][23][32][33][34][35][36][37][38][39][40][41][42] published between 2012 and 2021 were included for evidence synthesis (Fig. 1).…”

Section: Study Identification and Characteristicsmentioning

confidence: 99%

“…Eighteen studies were from Asia, 3 were from Europe, and 2 were from North America. Patients received short-or long-course nCRT before surgery in 16 studies [12][13][14][17][18][19]23,[32][33][34][35][36][37][38][39][40] and surgery alone in 5 studies 15,16,[20][21][22] ; in 2 studies, patients underwent surgery with or without long-course nCRT. 41,42 Nine studies evaluated only PLR, [16][17][18][19][20]33,36,40,41 7 studies evaluated only LMR, 12,13,15,21,32,37,39 and the remaining 7 studies evaluated both LMR and PLR.…”

Section: Study Identification and Characteristicsmentioning

confidence: 99%

Prognostic Significance of Lymphocyte-to-Monocyte and Platelet-to-Lymphocyte Ratio in Rectal Cancer: A Systematic Review, Meta-analysis, and Meta-regression

Hamid

Emile

Davis

2022

Diseases of the Colon &Amp; Rectum

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BACKGROUND:The low lymphocyte-to-monocyte ratio and high platelet-to-lymphocyte ratio have been reported to be poor prognostic indicators in various solid tumors, but the prognostic significance in rectal cancer remains controversial. OBJECTIVES:We sought to determine the prognostic value of the lymphocyte-to-monocyte ratio and the platelet-to-lymphocyte ratio following curative-intent surgery for rectal cancer.DATA SOURCES: Following PRISMA guidelines (PROSPERO, ID: CRD42020190880), PubMed and Embase databases were searched through January 2021 including 3 other registered medical databases.STUDY SELECTION: Studies evaluating the impact of pretreatment lymphocyte-to-monocyte ratio and plateletto-lymphocyte ratio on overall or disease-free survival in patients undergoing curative rectal cancer resection were selected. MAIN OUTCOMES MEASURES:The main outcome measures were overall and disease-free survival.RESULTS: A total of 23 studies (6683 patients) were included; lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio were evaluated in 14 and 16 studies. A low lymphocyteto-monocyte ratio was associated with poorer overall survival (HR, 1.57; 95% CI, 1.29-1.90; p < 0.001) and disease-free survival (HR, 1.29; 95% CI, 1.13-1.46; p < 0.001). However, when the analysis was limited to patients treated with surgery alone or to those with stage I to III tumors, lymphocyte-tomonocyte ratio was not a predictor of overall survival and disease-free survival. The platelet-to-lymphocyte ratio did not predict for overall or disease-free survival, regardless of the treatment modality, studied population, tumor stage, or cutoff value. Finally, a low lymphocyte-to-monocyte ratio, but not a high platelet-to-lymphocyte ratio, was inversely correlated with complete pathologic response rate.LIMITATIONS: The retrospective nature of most included studies was a limitation.CONCLUSIONS: Pretreatment lymphocyte-to-monocyte ratio, but not platelet-to-lymphocyte ratio, correlates with tumor response to neoadjuvant chemoradiotherapy and poorer prognosis after curative-intent surgery for rectal cancer, and it potentially represents a simple and reliable biomarker that could help optimize individualized clinical decision-making in high-risk patients.

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Lymphocyte-to-monocyte ratio (LMR) is prognostic factor for selection of neoadjuvant treatment in locally advanced rectal cancer patients: Sub-set analysis of Polish-2 study

Cited by 6 publications

References 0 publications

Reproducibility of lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with locally advanced rectal cancer.

Reproducibility of lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with locally advanced rectal cancer.

Correlation between Lymphocyte-to-Monocyte Ratio (LMR), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR) and Tumor-Infiltrating Lymphocytes (TILs) in Left-Sided Colorectal Cancer Patients

Prognostic Significance of Lymphocyte-to-Monocyte and Platelet-to-Lymphocyte Ratio in Rectal Cancer: A Systematic Review, Meta-analysis, and Meta-regression

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