Open AccessPrognostic role of neutrophil‐to‐lymphocyte ratio on esophageal cancer patients who received definitive chemoradiotherapy
Author(s) -
Liu Xuemei,
Li Minghuan,
Duan Qilong,
Qiao Xiaoming,
Yu Jinming,
Yue Shuying
Publication year - 2018
Publication title -
precision radiation oncology
Language(s) - English
Resource type - Journals
ISSN - 2398-7324
DOI - 10.1002/pro6.42
Subject(s) - medicine , neutrophil to lymphocyte ratio , univariate analysis , chemoradiotherapy , odds ratio , gastroenterology , confidence interval , esophageal cancer , oncology , esophageal squamous cell carcinoma , stage (stratigraphy) , logistic regression , lymphocyte , cancer , multivariate analysis , paleontology , biology
Objective The neutrophil‐to‐lymphocyte ratio (NLR), a simple biomarker that can reflect the host antitumor immune response, has been associated with patient prognosis in several solid tumors. The aim of the present study was to evaluate the ability of NLR to predict clinical tumor response and prognosis in patients with locally advanced esophageal squamous cell carcinoma who received definitive chemoradiotherapy. Methods A total of 147 patients with advanced esophageal squamous cell carcinoma treated at Shandong Cancer Hospital Affiliated with Shandong University, Jinan, China, between January 1, 2012 and December 31, 2013 were retrospectively recruited for analysis. The patients were divided into a low NLR group (NLR ≤2.46, n = 74) and a high NLR group (NLR >2.46, n = 73) according to pretreatment NLR. The predictive value of NLR for clinical tumor response and prognosis was examined. Results Compared with their matched counterparts, patients in the low NLR group showed a good clinical tumor response ( P < 0.001). The NLR before chemoradiotherapy was significantly lower in patients who achieved complete response than in patients who did not achieve complete response (2.2 ± 0.9 vs. 2.7 ± 1.1, P = 0.024). Logistic regression analysis revealed that pretreatment NLR was negatively correlated with tumor response (odds ratio 0.60, 95% confidence interval 0.43–0.84; P = 0.003). In the univariate analysis, cT stage status ( P PFS = 0.001; P OS = 0.007), tumor response ( P PFS < 0.001; P OS < 0.001) and NLR ( P PFS = 0.005; P OS = 0.008) were significantly associated with PFS and OS. The Cox proportional hazards model showed that tumor response ( P PFS = 0.002; P OS = 0.003) and NLR ( P PFS = 0.021; P OS = 0.017) were independent predictors of prognosis. Conclusions In patients with esophageal squamous cell carcinoma, NLR can be used as a simple marker to predict clinical tumor response and prognosis.