High platelet-to-lymphocyte ratio predicts improved survival outcome for perioperative NSAID use in patients with rectal cancer

Huang, Zenghong; Xiao-lin, Wang; Zou, Qi; Zhuang, Zhuokai; Xie, Yumo; Cai, Du; Bai, Liangliang; Tang, Ge; Huang, Meijin; Luo, Yanxin; Yu, Huichuan

doi:10.1007/s00384-020-03528-8

Cited by 20 publications

(21 citation statements)

References 33 publications

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“…The IDPCD has prospectively enrolled and followed 18,013 patients with CRC since 2007. [14][15][16] The IDPCD cohort integrated the patients from the National Basic Research Program of Evolution from Precancerous Disease to Cancer [17][18][19][20][21] and the National Key Research and Development Project of CRC Screen, Surveillance, and Intervention. [22][23][24][25] The patients' disposition flow and timeline for the longitudinal analysis in this study are described in Figure 1.…”

Section: Patient Cohortsmentioning

confidence: 99%

Current Surveillance After Treatment is Not Sufficient for Patients With Rectal Cancer With Negative Baseline CEA

Shen

Xiao-lin²,

Wang³

et al. 2022

Journal of the National Comprehensive Cancer Network

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Background: Serum CEA has been widely used to screen for potential recurrent disease after resection in rectal cancer. However, the influence of baseline CEA on the performance of CEA in recurrence surveillance needs to be investigated. Patients and Methods: This longitudinal cohort study included 484 patients with nonmetastatic rectal cancer from 18,013 patients in a prospectively enrolled institutional database program of colorectal disease. Baseline CEA levels were determined before treatment, and CEA-based follow-up tests and examinations were applied in the surveillance after treatment. Results: A total of 62.6% (62/99) overall, 53.5% (23/43) local, and 64.9% (50/77) distant recurrences were seen in patients who had similar CEA levels with their baseline statuses. The sensitivity of elevated CEA levels during surveillance for overall recurrence was significantly lower in patients with negative baseline CEA than in those with elevated baseline CEA levels (41.3% vs 69.4%; P =.007). Moreover, similar results were observed in the surveillance for local (50% vs 61.5%; P =.048) and distant (39.6% vs 72.4%; P =.005) recurrences between these 2 patient groups. However, CEA had comparable and excellent specificity during surveillance for recurrent disease in these groups. The addition of CA19-9 to the CEA assay significantly improved the sensitivity in recurrence surveillance for patients with negative baseline CEA (49.2% vs 41.3%; P =.037). Finally, we identified a subgroup of CEA-turn recurrences characterized by negative CEA at baseline, elevated CEA at recurrence, and worse survival outcomes after recurrence (hazard ratio, 1.88; 95% CI, 1.07–3.30; P =.026). Conclusions: In patients with rectal cancer with negative baseline CEA, serum CEA had insufficient sensitivity in recurrence surveillance after treatment, and additional surveillance may improve oncologic outcomes. Baseline CEA should be considered before CEA-based surveillance can be applied in the follow-up trials.

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Section: Patient Cohortsmentioning

confidence: 99%

Current Surveillance After Treatment is Not Sufficient for Patients With Rectal Cancer With Negative Baseline CEA

Shen

Xiao-lin²,

Wang³

et al. 2022

Journal of the National Comprehensive Cancer Network

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“…An elevated preoperative PLR is usually accompanied by thrombocytosis or lymphocytopenia, implying an activated inflammatory status and repressed immune response of patients. Expectedly, PLR, a marker that represents the balance between two inflammatory status, has shown prognostic values in multiple studies (8)(9)(10). In addition, elevated platelets tend to gather tumor cells by release biological factors, help stimulate the development of new vessels by interacting with PDGF, VEGF and PF4, and activate DNA-damagepromoting agents, which may promote carcinogenesis (32).…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that inflammation plays a vital role in tumorigenesis and development of CRC (6,7). In this context, some models based on markers representing the systemic inflammation status in perioperative period, such as platelet-to-lymphocyte ratio (PLR), have been proposed to predict prognosis of CRC patients in multiple studies (8)(9)(10). However, their prognostic values remain controversial with high variability and limited reproducibility (10,11), suggesting a dramatic heterogeneity among cancer populations, and the current inflammation marker panels need to be improved by combining other markers.…”

Section: Original Articlementioning

confidence: 99%

Serum calcium improved systemic inflammation marker for predicting survival outcome in rectal cancer

Zhuang¹,

Wang²,

Huang³

et al. 2021

J Gastrointest Oncol

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Background: Systemic inflammation markers have shown prognostic values with variability in rectal cancer. Considering the association of serum calcium with inflammation, we aimed to examine whether it could improve systemic inflammation markers for survival prediction.Methods: We enrolled 508 patients with stage I to III rectal cancer who underwent curative resection. The cohort was grouped by corrected serum calcium (cCa), platelet-to-lymphocyte ratio (PLR), and CaPLR (a score model combining cCa with PLR) for survival analysis. The LR (likelihood ratio) test and AIC (Akaike information criterion) were applied to compare models in survival prediction. The primary endpoint was disease-free survival (DFS). Results: A total of 26.7% (136/508) patients reached recurrence after curative surgery. Both high cCa (HR 1.486; 95% CI, 1.018-2.171; P=0.040) and high PLR (HR 1.452; 95% CI, 1.059-1.991; P=0.021) were significantly associated with worse DFS. In model comparison, the AIC and LR were improved after cCa was

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“…Eighteen studies were from Asia, 3 were from Europe, and 2 were from North America. Patients received short-or long-course nCRT before surgery in 16 studies [12][13][14][17][18][19]23,[32][33][34][35][36][37][38][39][40] and surgery alone in 5 studies 15,16,[20][21][22] ; in 2 studies, patients underwent surgery with or without long-course nCRT. 41,42 Nine studies evaluated only PLR, [16][17][18][19][20]33,36,40,41 7 studies evaluated only LMR, 12,13,15,21,32,37,39 and the remaining 7 studies evaluated both LMR and PLR.…”

Section: Study Identification and Characteristicsmentioning

confidence: 99%

Prognostic Significance of Lymphocyte-to-Monocyte and Platelet-to-Lymphocyte Ratio in Rectal Cancer: A Systematic Review, Meta-analysis, and Meta-regression

Hamid

Emile

Davis

2022

Diseases of the Colon &Amp; Rectum

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BACKGROUND:The low lymphocyte-to-monocyte ratio and high platelet-to-lymphocyte ratio have been reported to be poor prognostic indicators in various solid tumors, but the prognostic significance in rectal cancer remains controversial. OBJECTIVES:We sought to determine the prognostic value of the lymphocyte-to-monocyte ratio and the platelet-to-lymphocyte ratio following curative-intent surgery for rectal cancer.DATA SOURCES: Following PRISMA guidelines (PROSPERO, ID: CRD42020190880), PubMed and Embase databases were searched through January 2021 including 3 other registered medical databases.STUDY SELECTION: Studies evaluating the impact of pretreatment lymphocyte-to-monocyte ratio and plateletto-lymphocyte ratio on overall or disease-free survival in patients undergoing curative rectal cancer resection were selected. MAIN OUTCOMES MEASURES:The main outcome measures were overall and disease-free survival.RESULTS: A total of 23 studies (6683 patients) were included; lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio were evaluated in 14 and 16 studies. A low lymphocyteto-monocyte ratio was associated with poorer overall survival (HR, 1.57; 95% CI, 1.29-1.90; p < 0.001) and disease-free survival (HR, 1.29; 95% CI, 1.13-1.46; p < 0.001). However, when the analysis was limited to patients treated with surgery alone or to those with stage I to III tumors, lymphocyte-tomonocyte ratio was not a predictor of overall survival and disease-free survival. The platelet-to-lymphocyte ratio did not predict for overall or disease-free survival, regardless of the treatment modality, studied population, tumor stage, or cutoff value. Finally, a low lymphocyte-to-monocyte ratio, but not a high platelet-to-lymphocyte ratio, was inversely correlated with complete pathologic response rate.LIMITATIONS: The retrospective nature of most included studies was a limitation.CONCLUSIONS: Pretreatment lymphocyte-to-monocyte ratio, but not platelet-to-lymphocyte ratio, correlates with tumor response to neoadjuvant chemoradiotherapy and poorer prognosis after curative-intent surgery for rectal cancer, and it potentially represents a simple and reliable biomarker that could help optimize individualized clinical decision-making in high-risk patients.

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High platelet-to-lymphocyte ratio predicts improved survival outcome for perioperative NSAID use in patients with rectal cancer

Cited by 20 publications

References 33 publications

Current Surveillance After Treatment is Not Sufficient for Patients With Rectal Cancer With Negative Baseline CEA

Current Surveillance After Treatment is Not Sufficient for Patients With Rectal Cancer With Negative Baseline CEA

Serum calcium improved systemic inflammation marker for predicting survival outcome in rectal cancer

Prognostic Significance of Lymphocyte-to-Monocyte and Platelet-to-Lymphocyte Ratio in Rectal Cancer: A Systematic Review, Meta-analysis, and Meta-regression

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