Neutrophil to Lymphocyte Ratio (NLR) and Derived Neutrophil to Lymphocyte Ratio (d-NLR) Predict Non-Responders and Postoperative Complications in Patients Undergoing Radical Surgery After Neo-Adjuvant Radio-Chemotherapy for Rectal Adenocarcinoma

Abstract

In order to evaluate neutrophil-to-lymphocyte ratio (NLR) and derived neutrophil-to-lymphocyte ratio (d-NLR) in predicting response and complications in rectal cancer patients who underwent surgery after neo-adjuvant radio-chemotherapy, 87 patients were evaluated. Cutoffs before and after radio-chemotherapy were respectively 2.8 and 3.8 for NLR, and 1.4 and 2.3 for d-NLR. They were analyzed in relation to clinical and pathological outcomes. Patients with preoperative NLR and d-NLR higher than cutoffs had significantly higher rates of tumor regression grade response (TRG ≥ 4) and postoperative complications. Elevated NLR and d-NLR after radio-chemotherapy are associated with worse pathological and clinical outcome.

Neutrophil to Lymphocyte Ratio as Prognostic Indicator for Patients with Esophageal Squamous Cell Cancer

“…NLR has been reported to be correlated with patients' prognosis in different cancer studies. It has been reported that the pretreatment median NLR ranged from about 1.5 to3.3 (13,14,33).Forexample,ithasbeenreportedthata medianpreoperativeNLRof2.1wasofsignificantprognostic valuefordisease-specificmortalityinESCCpatientswhounderwentsurgery (34).Invariouscancerpatients,ithasbeen shownthatNLRcutoffsrangingfrom1.9to4.2wereofsignificantpredictivevaluefortreatmentresponses (12,18,35). Inthecurrentstudy,themedianpretreatmentNLRinESCC patientswasestimatedtobe2.3.Thisresultisconsistentwith previousstudies.Variousstudiesindifferentpatientpopulations haveidentified a relativelysmall variation in pretreatment NLR.…”

Predictive and Prognostic Molecular Biomarkers for Response to Neoadjuvant Chemoradiation in Rectal Cancer

“…Caputo et al recently examined NLR and derived neutrophil-to-lymphocyte ratio (d-NLR) before and after nCRT in 87 rectal cancer patients. Higher NLR and d-NLR after nCRT was significantly associated with poor response to nCRT and postoperative complications [127]. Dong et al conducted a meta-analysis which included seven cohorts involving 959 patients to evaluate the prognostic value of NLR in patients with rectal cancer.…”

Predicting complications in hepatic resection for colorectal liver metastasis: the lymphocyte‐to‐monocyte ratio

“…17,18 Furthermore, CRP has been extensively investigated for its role in the prediction of post-operative complications and as an independent prognostic marker, [26][27][28] and it is widely used as a marker in monitoring for post-operative complications globally. 17,18 Furthermore, CRP has been extensively investigated for its role in the prediction of post-operative complications and as an independent prognostic marker, [26][27][28] and it is widely used as a marker in monitoring for post-operative complications globally.…”

“…There has been a significant body of work studying the potential utilization of the NLR in predicting complications following gastrointestinal surgery, and it has been previously shown to be superior to WCC and CRP in this capacity. 17,18 Furthermore, CRP has been extensively investigated for its role in the prediction of post-operative complications and as an independent prognostic marker, [26][27][28] and it is widely used as a marker in monitoring for post-operative complications globally. However, we have demonstrated that the LMR may be more clinically useful in predicting such complications following liver resection.…”

“…Previous studies have demonstrated that combined serum parameters, such as the neutrophil-tolymphocyte ratio (NLR) and the lymphocyte-to-monocyte ratio (LMR), may be more effective at detecting post-operative complications as opposed to traditional parameters, such as white blood cell count (WCC) and C-reactive protein (CRP). 17,18 The LMR is an inflammatory marker. The absolute lymphocyte count is thought to represent the immunological state of the host, with low levels representing immunosuppression, whilst studies have previously shown elevated monocyte and macrophage levels to be associated with adverse outcomes.…”