Absolute Lymphocyte Count in Preoperative Chemoradiotherapy for Rectal Cancer: Changes Over Time and Prognostic Significance

Abstract

We analyzed the changes in absolute lymphocyte count and its changes over time in 139 patients treated with preoperative chemoradiotherapy for locally advanced rectal cancer. The baseline absolute lymphocyte count was defined as the median of absolute lymphocyte count levels measured during 30 days before preoperative chemoradiotherapy. Absolute lymphocyte count at 1 month, 0.5 to 1 year, 1 to 2 years, and 2 to 3 years were determined by the median values of the absolute lymphocyte counts during the respective periods. Absolute lymphocyte count decreased after delivering preoperative chemoradiotherapy, reached minimum level at 1 month, and then gradually increased after the completion of chemoradiotherapy. Baseline absolute lymphocyte count had significant correlations with the absolute lymphocyte count of every period (range of coefficient, 0.41-0.64, P < .001). The overall survival of the group with high baseline absolute lymphocyte count was significantly higher than that of the group with low baseline absolute lymphocyte count (5-year overall survival: 82.4% vs 62.9%, P = .012). In multivariable analyses, the baseline absolute lymphocyte count remained as a significant prognostic factor for overall survival, favoring the group with a high baseline absolute lymphocyte count (hazard ratio = 0.405, P = .017). This study showed that the level of baseline absolute lymphocyte count was an independent prognostic factor, and it correlated with the absolute lymphocyte counts across varying periods of treatments and follow-up in patients treated with preoperative chemoradiotherapy for rectal adenocarcinoma.

Neutrophil-to-lymphocyte ratio can predict outcome in extensive-stage small cell lung cancer

“… 24 , 25 On the other hand, the lymphocyte count reflects the immunological status of a host, thus a low lymphocyte count is a predictor of poorer outcome. 26 The prognostic value of combinations of these and other parameters has also been extensively investigated. Among them, the neutrophil-to-lymphocyte ratio in various chronic diseases, including numerous malignant diseases, has been investigated the most.…”

Dose–volume parameters of MRI-based active bone marrow predict hematologic toxicity of chemoradiotherapy for rectal cancer

“…Lymphocytes play a key role in these mechanisms. In colorectal cancer, baseline ALC and the ratio of lymphocytes to neutrocytes is are prognostic factors affecting overall and progression-free survival [5,31,32]. It is important to note that almost three quarters of the patients included in the current study had grade 3 lymphopenia.…”

“…On the other hand, radiotherapy may stimulate the immune system and augment the potential of immunotherapy [4]. As with other cancers, absolute lymphocyte count (ALC) before, during, and after radiotherapy (chemoradiotherapy) is known to serve as a predictive and prognostic marker in rectal cancer [5][6][7]. In addition, ALC can affect the incidence of complete clinical response, which allows implementation of a promising, cost-effective watch-and-wait strategy [6,8].…”

Taxane/gemcitabine-Containing Chemotherapy Plus Locoregional IMRT for Patients With De Novo Metastatic Nasopharyngeal Carcinoma: The Treatment Outcomes and Prognostic Factors Analysis

“…Further prospective studies are warranted to investigate the treatment alternative and potential prognostic factors found in this study. Additional declarations for articles in life science journals that report the results of studies involving humans and/or animals: Not applicable b: M1 stage subdivision M1a, single lesion con ned to an isolated organ or location except the liver; M1b, single lesion in the liver and/or multiple lesions in any organs or locations except the liver; and M1c, multiple lesions in the liver 16 1426 (22) n(%) 34 (29) 21 1812 (10) 8 73 (…”