Neutrophil-to-lymphocyte Ratio as a Prognostic Factor for Colon Cancer in Elderly Patients: A Propensity Score Analysis

Mazaki, Junichi; Katsumata, Kenji; Sujino, Hiroki; Udo, Ryutaro; Tago, Tomoya; Kasahara, Kenta; Kuwabara, Hiroshi; Enomoto, Masanobu; Ishizaki, Tetsuo; Nagakawa, Yuichi; Tsuchida, Akihiko

doi:10.21873/anticanres.15256

Cited by 9 publications

(10 citation statements)

References 21 publications

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“…Several studies suggested that the elevation of perioperative NLR is a prognostic factor for worse outcome in LARC patients, while the decrease of NLR suggests a better prognosis [ 11 , 14 ]. However, some studies showed an opposite trend of the relationship between NLR change and the overall survival [ 12 , 16 ]. Our data demonstrated that the clinical remission rate of LARC patients with NLR reduction was 72.09% (31/43), which was significantly higher than NLR elevation group (51.16%).…”

Section: Discussionmentioning

confidence: 99%

“…The correlations between immunologic biomarkers including NLR and PLR and the prognosis in colorectal cancer patients have also been reported [ 10 – 15 ]. However, there seem to be conflicting results that whether NLR and PLR can serve as effective prognostic predictor in rectal cancer [ 12 , 16 ]. In addition, the potential implications of NLR and PLR in nCRT responsiveness remain to be clarified.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio on Predicting Responsiveness to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients

Liu

Feng

Zhang

et al. 2022

BioMed Research International

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Objective. Neutrophil-lymphocyte ratio (NLR) and Platelet-lymphocyte ratio (PLR) have been proposed as prognostic biomarkers in multiple cancers. However, the implications of NLR and PLR in the responsiveness to neoadjuvant chemoradiotherapy (nCRT) remain to be clarified in locally advanced rectal cancer (LARC) patients. This retrospective study investigated the prognostic value of NLR and PLR in nCRT responsiveness of LARC patients. Methods. A total number of 86 patients diagnosed with LARC and treated with nCRT and total mesorectal excision were retrospectively followed from 2013 to 2016. Receiver operating characteristic (ROC) curve was used to determine the cutoff values of NLR and PLR, and the patients were divided into NLR elevation and NLR decrease groups, or PLR elevation and PLR decrease groups. The correlation between NLR and PLR changes, and clinicopathological factors were analyzed. The relationship between NLR and PLR changes and the curative responsiveness towards nCRT were further evaluated. Results. NLR and PLR changes after nCRT were significantly correlated with the distance of tumors to the anus and BMI (body mass index) ( P < 0.05 ). The clinical remission rate of patients with NLR reduction was 72.09% (31/43), which was significantly higher than that in patients with NLR increment (22/43, 51.16%). There was no significant difference in the clinic remission rate between the patients with PLR reduction and those with PLR increment ( P > 0.05 ). However, the pathological responsiveness rate was significantly higher in patients with PLR reduction (21/43, 48.84%) when compared to the ones with PLR increment (9/43, 20.9%) ( P = 0.036 ). Conclusion. Our data indicate that in LARC patients with nCRT, the reduction of NLR and the reduction of PLR could serves as predictors for the clinic remission rate and pathological responsiveness rate, respectively. The combination of NLR and PLR changes may be employed as a simple and effective prognostic parameter to predict the treatment outcome of nCRT in LARC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio on Predicting Responsiveness to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients

Liu

Feng

Zhang

et al. 2022

BioMed Research International

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“…24 In addition, myeloidderived inhibitory cells, which are strongly associated with the immunosuppressive environment, are considered to be a population of immature neutrophils. 9 Thus, neutrophils strongly correlate with cancer progression and the immunosuppressive environment surrounding the cancer. In clinical practice, NLR is reported to be useful in predicting the prognosis and therapeutic effect of various malignant tumors such as colorectal cancer, 9 lung cancer, 10 renal cancer, 25 and melanoma.…”

Section: Discussionmentioning

confidence: 99%

“…8 Pretreatment NLR has been reported as a preoperative factor predicting the therapeutic effect and prognosis with ICIs in various cancer types. It is reported to be a useful predictor of therapeutic effects and OS in colorectal cancer, 9 lung cancer, 10 and melanoma. 11 Neutrophil-to-lymphocyte ratios are associated with OS and PFS even with atezolizumab plus bevacizumab treatment for HCC, [12][13][14][15] but the number of reports on this topic remains scarce.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of neutrophil‐to‐lymphocyte ratio in predicting progression and survival outcomes after atezolizumab–bevacizumab treatment for hepatocellular carcinoma

Ochi

Kurosaki

Joko

et al. 2022

Hepatology Research

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JP20fk0210067h0001hepatocellular carcinoma (HCC) and determined the predictive ability of combined liver reserve-NLR. Methods:This retrospective, multicenter study enrolled 242 patients receiving atezolizumab plus bevacizumab for unresectable HCC. Pretreatment NLR <2.56 was designated as the "low group" and NLR ≥2.56 as the "high group" (120 and 122 patients, respectively). Propensity score-matched analysis was undertaken between the low and high groups.Results: In this cohort, the objective response and disease control rates were 20% and 72.5%, respectively, in the low group and 19.6% and 72.9%, respectively, in the high group. After matching, median progression-free survival (PFS) time was 283 and 167 days in the low and high groups, respectively (p = 0.022). Neutrophil-tolymphocyte ratio ≥2.56 (hazard ratio [HR], 1.54; 95% confidence interval [CI],1.05-2.28; p = 0.028), modified albumin-bilirubin index (mALBI) grade 2b or 3 (HR 1.55; 95% CI, 1.05-2.29; p = 0.025), and protein induced by vitamin K absence or antagonist-II ≥ 400 (HR 2.03; 95% CI, 1.36-3.02; p = 0.001) were significantly associated with PFS in univariate analysis using the Cox proportional hazards model.In cases involving mALBI grade 1 or 2a (n = 131), the median PFS time was not reached in the low group, whereas it was 210 days in the high group (p = 0.037).

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“…As with other cancers, a higher NLR is strongly associated with shorter survival in cholangiocarcinoma [111]. B. Dapsone in colon adenocarcinoma: Specifically in colon adenocarcinoma, a higher NLR is associated with shorter survival, while a low NLR is associated with longer survival [112][113][114]. Bevacizumab, a pharmaceutical monoclonal antibody to vascular endothelial growth factor (VEGF), is often used in the treatment of colon adenocarcinoma and NSCLC.…”

Section: Dapsonementioning

confidence: 99%

MDACT: A New Principle of Adjunctive Cancer Treatment Using Combinations of Multiple Repurposed Drugs, with an Example Regimen

Kast¹,

Alfieri

Assi

et al. 2022

Cancers

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In part one of this two-part paper, we present eight principles that we believe must be considered for more effective treatment of the currently incurable cancers. These are addressed by multidrug adjunctive cancer treatment (MDACT), which uses multiple repurposed non-oncology drugs, not primarily to kill malignant cells, but rather to reduce the malignant cells’ growth drives. Previous multidrug regimens have used MDACT principles, e.g., the CUSP9v3 glioblastoma treatment. MDACT is an amalgam of (1) the principle that to be effective in stopping a chain of events leading to an undesired outcome, one must break more than one link; (2) the principle of Palmer et al. of achieving fractional cancer cell killing via multiple drugs with independent mechanisms of action; (3) the principle of shaping versus decisive operations, both being required for successful cancer treatment; (4) an idea adapted from Chow et al., of using multiple cytotoxic medicines at low doses; (5) the idea behind CUSP9v3, using many non-oncology CNS-penetrant drugs from general medical practice, repurposed to block tumor survival paths; (6) the concept from chess that every move creates weaknesses and strengths; (7) the principle of mass—by adding force to a given effort, the chances of achieving the goal increase; and (8) the principle of blocking parallel signaling pathways. Part two gives an example MDACT regimen, gMDACT, which uses six repurposed drugs—celecoxib, dapsone, disulfiram, itraconazole, pyrimethamine, and telmisartan—to interfere with growth-driving elements common to cholangiocarcinoma, colon adenocarcinoma, glioblastoma, and non-small-cell lung cancer. gMDACT is another example of—not a replacement for—previous multidrug regimens already in clinical use, such as CUSP9v3. MDACT regimens are designed as adjuvants to be used with cytotoxic drugs.

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Neutrophil-to-lymphocyte Ratio as a Prognostic Factor for Colon Cancer in Elderly Patients: A Propensity Score Analysis

Cited by 9 publications

References 21 publications

Evaluation of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio on Predicting Responsiveness to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients

Evaluation of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio on Predicting Responsiveness to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients

Usefulness of neutrophil‐to‐lymphocyte ratio in predicting progression and survival outcomes after atezolizumab–bevacizumab treatment for hepatocellular carcinoma

MDACT: A New Principle of Adjunctive Cancer Treatment Using Combinations of Multiple Repurposed Drugs, with an Example Regimen

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