Prognostic significance of neutrophil to lymphocyte ratio in esophageal squamous cell carcinoma

Abstract

OBJECTIVE: The purpose of the study was to assess the effect of neutrophil-to-lymphocyte ratio (NLR) on recurrence and survival in patients with Esophageal Squamous Cell Carcinoma (ESCC) undergoing surgery. METHODS: This was a retrospective analysis of the 80 resectable ESCC patients who underwent surgery at Yuzuncu Yil University Faculty of Medicine between 2008 and 2018. Receiver operator characteristics curve of NLR was plotted for disease-free survival (DFS). The area under the curve of NLR was 0.692 (p=0.008) with 65.2% sensitivity and 2.8 with 69.5% specificity. Patients were divided into two groups based on the NLR as follows: NLR <2.8 and NLR ≥2.8. RESULTS: Among 80 ESCC patients, 54 (65.5%) were female. The median age was 55 years (range, 26–77). The NLR was <2.8 in 47 (58.7%) patients. Median DFS was 55 months in patients with NLR ≥2.8, whereas it was not reached in those with NLR <2.8 (p=0.008), with corresponding overall survival (OS) durations of 71 months and not reached (p=0.027). Eastern Cooperative Oncology Group performance score 2, presence of obstruction at diagnosis, lower 1/3 esophageal localization, neoadjuvant treatment, and NLR ≥2.8 were found to be the factors related to survival. CONCLUSION: The present study demonstrated that high pre-treatment NLR was associated with worse DFS and OS in patients with resectable esophageal cancer. We believe that pre-treatment NLR may help guide predicting treatment outcomes in non-metastatic resectable ESCC patients.

Prognostic Effect of the Controlling Nutritional Status Score in Patients With Esophageal Cancer Treated With Immune Checkpoint Inhibitor

“…24,25 The relationship between the CONUT score and the perioperative surgical risk and postoperative prognosis of malignancies such as gastric, esophageal, pancreatic, liver, cervical, and bladder cancers has been reported. [26][27][28][29][30][31] Studies have shown that the CONUT score is related to the prognosis of cancer patients receiving chemotherapy. However, its effectiveness in patients receiving ICI has not been studied.…”

“…The Controlling Nutritional Status (CONUT), which consists of serum albumin, peripheral lymphocyte count, and serum total cholesterol, was used to assess early nutritional status 24,25. The relationship between the CONUT score and the perioperative surgical risk and postoperative prognosis of malignancies such as gastric, esophageal, pancreatic, liver, cervical, and bladder cancers has been reported 26–31. Studies have shown that the CONUT score is related to the prognosis of cancer patients receiving chemotherapy.…”

Prognostic significance of a novel index score based on the inflammation‐based prognostic scores of patients with colorectal cancer

“…We searched and summarized the literature review related to the use of IBPSs for predicting the prognosis of gastrointestinal cancers. [7][8][9][13][14][15][16][21][22][23][24][25][26][27][28][29][30] Although the results of these studies vary, the cut-off values and tendencies are generally similar (Table S2). Aside from IBPS, male sex, age ≥ 75 years, and a CEA level of > 5 were also associated with poor OS.…”

Combination of neutrophil-to-lymphocyte ratio and albumin concentration to predict the prognosis of esophageal squamous cell cancer patients undergoing esophagectomy

“…A study which enrolled 68 ESCC patients who underwent definitive concurrent chemoradiotherapy showed that higher posttherapy NLR was associated with poorer OS (median 9.4 vs.15.2 months, P=0.03) (29). Studies have shown that among patients with EC who underwent surgery, lower pre-treatment NLR was also associated with diseasefree survival (DFS) or OS (30)(31)(32). Moreover, a study reported that preoperative NLR was an independent variable associated with the development of postoperative complications (33).…”