Pretreatment Neutrophil-to-Lymphocyte Ratio Associated with Tumor Recurrence and Survival in Patients Achieving a Pathological Complete Response Following Neoadjuvant Chemoradiotherapy for Rectal Cancer

• Published in: Cancers Vol. 13; no. 18; p. 4589
• Main Authors: Huang, Chun-Ming, Huang, Ming-Yii, Tsai, Hsiang-Lin, Huang, Ching-Wen, Su, Wei-Chih, Chang, Tsung-Kun, Chen, Yen-Cheng, Li, Ching-Chun, Wang, Jaw-Yuan
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 13.09.2021; MDPI
• Subjects: Abdomen; Cancer; Cancer therapies; Chemoradiotherapy; Chemotherapy; Colorectal cancer; Leukocytes (neutrophilic); Lymphocytes; Magnetic resonance imaging; Medical prognosis; Metastasis; Neutrophils; Patients; Prognosis; Radiation therapy; Rectum; Tumors
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers13184589

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.