Prognostic significance of neutrophil–lymphocyte ratio in resectable pancreatic neuroendocrine tumors with special reference to tumor-associated macrophages

Harimoto, Norifumi; Hoshino, Kouki; Muranushi, Ryo; Hagiwara, Kaoru; Yamanaka, Takahiro; Ishii, Norihiro; Tsukagoshi, Mariko; Igarashi, Takamichi; Tanaka, Hiroshi; Watanabe, Akira; Kubo, Norio; Araki, Kenichirou; Hosouchi, Yasuo; Suzuki, Hitoshi; Arakawa, Kazuhisa; Hirai, Keitarou; Fukazawa, Takaharu; Ikota, Hayato; Shirabe, Ken

doi:10.1016/j.pan.2019.08.003

Cited by 32 publications

(43 citation statements)

References 26 publications

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“…The high NLR can be caused by neutrophilia and/or lymphopenia linked to the inflammatory response and depletion of anti-tumor immune function, which in turn leads to tumor progression 26 – 28 . Few data revealed that the high NLR was associated with increased peri-tumoral macrophages, which contribute to chemotherapy resistance 29 , 30 . In addition, anthracycline and taxane-based chemotherapy that most patients received in this study provide an anti-cancer immune response via triggering immunogenic cell death 31 , which may affect the difference in chemotherapy efficacy according to NLR.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of neutrophil-to-lymphocyte ratio in human epidermal growth factor receptor 2-negative breast cancer patients who received neoadjuvant chemotherapy

Bae

Jin

Yoon

et al. 2020

Sci Rep

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We aimed to investigate the correlation between neutrophil-to-lymphocyte ratio (NLR) and pathologic complete response (pCR) and survival outcomes in human epidermal growth factor receptor 2 (HER2)-negative breast cancer patients who received neoadjuvant chemotherapy. The baseline NLR was evaluated in non-metastatic, HER2-negative breast cancer patients who received neoadjuvant chemotherapy. Baseline NLR was calculated as absolute neutrophil per lymphocyte count from pre-treatment blood samples. Any value ≥ 2.74 was considered to be a high NLR. In the 1,097 patients studied, 272 (24.4%) had high NLR and 825 (75.6%) had low NLR. The high NLR was an independent factor for pCR (OR 0.595; 95% CIs 0.398-0.890; P = 0.011). Furthermore, high NLR was a significant independent parameter affecting DFS (HR 2.298; 95% CIs 1.691-3.124; P < 0.001) and OS (HR 1.905; 95% CIs 1.167-3.108; P = 0.010). Regardless of the baseline NLR, survival outcomes were excellent in patients who achieved pCR, but high NLR was associated with worse survival for patients with residual invasive disease. Our study showed that NLR was predictive for treatment response and a prognostic factor in patients with HER2-negative breast cancer who received neoadjuvant chemotherapy. Moreover, we identified that high NLR was associated with poor survival outcomes in patients who did not achieve pCR. Neoadjuvant chemotherapy before definitive cancer surgery is increasingly being accepted as a treatment for breast cancer 1. Neoadjuvant chemotherapy has survival outcomes equivalent to those of adjuvant chemotherapy 2,3 , but also has the following advantages: it can increase the rate of breast-conserving surgery by reducing the size and extent of locally advanced tumors, control occult micro-metastasis, and estimate sensitivity to treatment regimen 4,5. Besides, it encourages the development and approval of new agents by allowing rapid assessment of drug efficacy in neoadjuvant trials 6. To date, pathologic complete response (pCR) following the reception of neoadjuvant chemotherapy has been suggested as a surrogate marker for a long-term clinical benefit 7-9. In particular, patients with HER2-positive breast cancer or triple-negative breast cancer (TNBC) who achieved pCR show improved survival than those with residual invasive disease 10 .

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Section: Discussionmentioning

confidence: 99%

Prognostic value of neutrophil-to-lymphocyte ratio in human epidermal growth factor receptor 2-negative breast cancer patients who received neoadjuvant chemotherapy

Bae

Jin

Yoon

et al. 2020

Sci Rep

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“…A few retrospective studies have evaluated NLR's role as a biomarker to predict recurrence of PanNET following curative surgery (55,56). Increased preoperative NLR has been associated with higher Ki67, presence of nodal and liver metastasis, LVI, and PNI (56). Values above 3.4-3.7 at surgery have been found prognostic of recurrence following curative resection; however, NLR values are affected by several other medical conditions as concomitant infection, inflammatory disorders, and use of drugs, including steroids, therefore accurate studies controlling for these factors are required (55,56).…”

Section: Peripheral Inflammatory Blood Markersmentioning

confidence: 99%

“…Increased preoperative NLR has been associated with higher Ki67, presence of nodal and liver metastasis, LVI, and PNI (56). Values above 3.4-3.7 at surgery have been found prognostic of recurrence following curative resection; however, NLR values are affected by several other medical conditions as concomitant infection, inflammatory disorders, and use of drugs, including steroids, therefore accurate studies controlling for these factors are required (55,56). To date, only a small study including 34 patients has prospectively evaluated the prognostic values of NLR for PanNETs undergoing surgery without finding any prognostic relevance (57).…”

Section: Peripheral Inflammatory Blood Markersmentioning

confidence: 99%

Clinical and Molecular Risk Factors for Recurrence Following Radical Surgery of Well-Differentiated Pancreatic Neuroendocrine Tumors

et al. 2020

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Well-differentiated pancreatic neuroendocrine tumors are increasingly diagnosed neoplasms. For localized disease, surgery is the first-line therapy and is curative in most cases. However, although recurrence is a rare event, it can still occur up to 10 years from surgery, worsening the prognosis. Many clinical and pathological factors have been associated with recurrence; however, it is currently unclear how to accurately discern patients at risk for relapse of disease from those that should be considered cured. In this review, we focus on clinical, pathological, and molecular factors associated with recurrence and discuss available prediction tools to assess the risk of recurrence following surgery.

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“…Twenty-one full-text articles were downloaded to assess their eligibility, in which 8 were excluded because non-effective HR data could be collected (n = 2), Conference abstract(n = 17); Data comes from the same sample(n = 2). Ultimately, 13 studies [6][7][8][9][10][11][12][13][14][15][16][17][18] published between 2014 and 2020 were included for this meta-analysis, where the sample sizes ranged from 48 to 259, and the total sample size was 1598. (Fig.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…1) The characteristics of the included studies are summarized in Table 1; among them, 12 studies [6][7][8][9][10][12][13][14][15][16][17][18] are retrospective cohort studies, one [11] is a prospective study. In terms of the research area, seven studies [6,8,[12][13][14][15][16] were performed in China, two [10,18] in Japan, one [9] in Italy, one [7] in the UK, one [18] in Turkey and one [11] in the USA. Regarding tumor site, seven studies concentrated on pancreatic neuroendocrine neoplasm (P-NEN), three studies enrolled patients with gastric neuroendocrine neoplasm (G-NEN), two studies one study enrolled patients with gastrointestinal and pancreatic neuroendocrine neoplasms (GEP-NEN), one study only included enteric neuroendocrine neoplasms (E-NEN).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Prognostic Function of Neutrophil-to-Lymphocyte Ratio in Patients with GEP-NEN: A Systematic Review and Meta-Analysis

Wang

Wen

Zhang

et al. 2020

Preprint

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Purpose: A high neutrophil-to-lymphocyte ratio (NLR) might be related to unfavorable prognosis. We sought to conduct a systematic review and meta-analysis of published studies exploring the relationship between NLR with the prognosis in patients with gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN).Methods: The databases PubMed, Embase, and Web of Science were searched using words like 'neutrophil lymphocyte ratio', neuroendocrine tumors', and others through May 2020. We evaluated the significance of NLR on overall survival (OS) and recurrence-free survival (RFS) of patients with GEP-NEN in our study.Results: We gathered thirteen cohorts with 1598 cases. The pooled analysis revealed that a higher NLR related to worse OS (hazards ratio (HR): 4.59, 95% confidence interval (CI) 3.35-6.29, P < 0.00001) and poor RFS (HR: 4.05, 95% CI: 2.78–5.90, P＜0.00001) in patients with GEP-NEN.Conclusion: A high NLR can be considered a high-risk prognostic factor in GEP-NEN.

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Prognostic significance of neutrophil–lymphocyte ratio in resectable pancreatic neuroendocrine tumors with special reference to tumor-associated macrophages

Cited by 32 publications

References 26 publications

Prognostic value of neutrophil-to-lymphocyte ratio in human epidermal growth factor receptor 2-negative breast cancer patients who received neoadjuvant chemotherapy

Prognostic value of neutrophil-to-lymphocyte ratio in human epidermal growth factor receptor 2-negative breast cancer patients who received neoadjuvant chemotherapy

Clinical and Molecular Risk Factors for Recurrence Following Radical Surgery of Well-Differentiated Pancreatic Neuroendocrine Tumors

Prognostic Function of Neutrophil-to-Lymphocyte Ratio in Patients with GEP-NEN: A Systematic Review and Meta-Analysis

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