期刊
CANCERS
卷 13, 期 18, 页码 -出版社
MDPI
DOI: 10.3390/cancers13184589
关键词
locally advanced rectal cancer; neoadjuvant chemoradiotherapy; neutrophil-to-lymphocyte ratio; prognostic factor; pathological complete response
类别
资金
- Ministry of Science and Technology [MOST 109-2314-B-037-035, MOST 109-2314-B-037-040, MOST 109-2314-B-037-046-MY3, MOST110-2314-B-037-097]
- Ministry of Health and Welfare [MOHW109-TDU-B-212-134026, MOHW109-TDU-B-212-114006, MOHW110-TDU-B-212-1140026]
- health and welfare surcharge on tobacco products
- Kaohsiung Medical University Hospital [KMUH109-9R32, KMUH109-9R33, KMUH109-9R34, KMUH109-9M30, KMUH109-9M31, KMUH109-9M32, KMUH109-9M33, KMUHS10903, KMUHSA10903, KMUH-DK(C)110010, KMUH-DK(B)110004-3]
- KMU Center for Cancer Research [KMU-TC109A04-1]
- KMU Center for Liquid Biopsy
- Cohort Research Center Grant, Kaohsiung Medical University [KMU-TC109B05]
- Taiwan Precision Medicine Initiative, Academia Sinica, Taiwan, R.O.C
The study found that a high neutrophil-to-lymphocyte ratio (NLR) before treatment (>= 3.2) was an independent predictor of reduced overall survival and disease-free survival in locally advanced rectal cancer patients who achieved a pathological complete response to neoadjuvant chemoradiotherapy. High NLR was significantly associated with tumor recurrence and could serve as a promising predictor for poor outcomes in this patient population.
Simple Summary Patients with locally advanced rectal cancer who achieve a pathological complete response to neoadjuvant chemoradiotherapy have been associated with excellent long-term prognosis. However, approximately 9% to 12% of patients with a pathological complete response have been reported to experience tumor recurrence and thereby experience poor outcomes. Identifying predictors of recurrence in patients with a pathological complete response is crucial for precise medicine. The neutrophil-to-lymphocyte ratio is a widely available biomarker of systemic inflammation and affects colorectal prognosis. The study aimed to assess the association between neutrophil-to-lymphocyte ratio and oncological outcomes in rectal cancer patients exhibiting a pCR. We found that a pretreatment high neutrophil-to-lymphocyte ratio (>= 3.2) was an independent predictor of reduced overall survival and disease-free survival in patients with locally advanced rectal cancer who achieved a pathological complete response to neoadjuvant chemoradiotherapy. Our findings demonstrate that the neutrophil-to-lymphocyte ratio helps identify patients with a pathological complete response who are at high risk of tumor relapse and might facilitate patient selection for precise medicine. The clinical influence of the neutrophil-to-lymphocyte ratio (NLR) in predicting outcomes in patients with locally advanced rectal cancer (LARC) who achieve a pathological complete response (pCR) to neoadjuvant chemoradiotherapy (NACRT) has seldom been investigated. We retrospectively recruited 102 patients with LARC who achieved a pCR to NACRT and the association of NLR status with survival and tumor recurrence in the patients was analyzed. Thirteen patients (12.7%) developed tumor recurrence. A high NLR (>= 3.2) was significantly associated with tumor recurrence (p = 0.039). The 5-year OS rates in patients with a low NLR and patients with a high NLR were 95.1% and 77.7%, respectively (p = 0.014); the 5-year DFS rates in patients with low NLR and patients with a high NLR were 90.6% and 71.3%, respectively (p = 0.031). The Cox proportional hazards model indicated that an NLR of >= 3.2 was an independent poor prognostic factor for DFS (hazard ratio [HR] = 3.12, 95% confidence interval [CI] = 1.06-9.46, p = 0.048) and OS (HR = 6.96, 95% CI = 1.53-35.51, p = 0.013). A pretreatment high NLR (>= 3.2) was a promising predictor of reduced OS and DFS in patients with LARC who achieved a pCR to NACRT.
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