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

Abstract

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.

Potential Molecular Biomarkers of Vestibular Schwannoma Growth: Progress and Prospects

“…The local inflammatory response is mediated by chemokines, cytokines, growth factors and matrix metalloproteinases (MMPs) secreted from in situ tumor cells, stromal cells, and infiltrating immune cells, and can became accomplices to cancer development by enhancing cell survival, invasion, neovascularization, and adaptive immunity suppression (98). Meanwhile, inflammation in the tumor microenvironment could be reflected in peripheral circulation, i.e., systemic inflammatory response that characterized by white cell components in peripheral blood, such as the platelet−to− lymphocyte ratio (PLR) and neutrophil−to−lymphocyte ratio (NLR), which have been highlighted as probable markers of pathologic responses for numerous types of solid tumors (99,100).…”

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

“…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).…”

“…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.…”

Can pretreatment platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios predict long-term oncologic outcomes after preoperative chemoradiation followed by surgery for locally advanced rectal cancer?

“…In their analysis, the degree of increase in PLR after CRT was the strongest predictor of pCR among various serologic markers. Lai et al [ 27 ] demonstrated that pretreatment PLR and NLR did not correlate with pCR, but a 21.5% change in NLR after neoadjuvant CRT was a predictor of poor pCR.…”