Value of the preoperative neutrophil‐to‐lymphocyte ratio as a prognostic factor for long‐term survival in postoperative esophageal squamous cell carcinoma patients

Xu, Guangwen; Wu, Hanran; Xiong, Ran; Li, Cai‐wei; Liu, Chang‐qing; Xu, Meiqing

doi:10.1111/1759-7714.12885

Cited by 9 publications

(10 citation statements)

References 22 publications

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“…Besides, the locoregional relapse rate was significantly higher in the patients with NLR ≥2.8. Similar to the findings observed in other studies, we showed that high pre-operative NLR negatively affected both DFS and OS [ 12 , 14 , 15 ].…”

Section: Discussionsupporting

confidence: 91%

“…Duan et al [ 14 ] found that patients with high pre-operative NLR had significantly worse tumor-specific survival and recurrence-free survival rates than those with low pre-operative NLR in ESCC patients who underwent curative surgery, indicating that NLR had the most significant predictive effect, particularly for patients with Stage IIIA disease. Similarly, Xu et al [ 15 ] reported the cutoff value for NLR to be 2.99 in their study with ESCC patients and concluded that pre-operative NLR was significantly associated with long-term prognosis, especially in patients with lymph node metastasis and Stage II–III disease. However, Rashid et al [ 16 ] reported that NLR (cutoff; 3.5) was not associated with DFS in their study including 294 EC patients, only 50 of whom were ESCC.…”

Section: Discussionmentioning

confidence: 91%

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Prognostic significance of neutrophil to lymphocyte ratio in esophageal squamous cell carcinoma

Sakin

2020

North Clin Istanbul

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OBJECTIVE: The purpose of the study was to assess the effect of neutrophil-to-lymphocyte ratio (NLR) on recurrence and survival in patients with Esophageal Squamous Cell Carcinoma (ESCC) undergoing surgery. METHODS: This was a retrospective analysis of the 80 resectable ESCC patients who underwent surgery at Yuzuncu Yil University Faculty of Medicine between 2008 and 2018. Receiver operator characteristics curve of NLR was plotted for disease-free survival (DFS). The area under the curve of NLR was 0.692 (p=0.008) with 65.2% sensitivity and 2.8 with 69.5% specificity. Patients were divided into two groups based on the NLR as follows: NLR <2.8 and NLR ≥2.8. RESULTS: Among 80 ESCC patients, 54 (65.5%) were female. The median age was 55 years (range, 26–77). The NLR was <2.8 in 47 (58.7%) patients. Median DFS was 55 months in patients with NLR ≥2.8, whereas it was not reached in those with NLR <2.8 (p=0.008), with corresponding overall survival (OS) durations of 71 months and not reached (p=0.027). Eastern Cooperative Oncology Group performance score 2, presence of obstruction at diagnosis, lower 1/3 esophageal localization, neoadjuvant treatment, and NLR ≥2.8 were found to be the factors related to survival. CONCLUSION: The present study demonstrated that high pre-treatment NLR was associated with worse DFS and OS in patients with resectable esophageal cancer. We believe that pre-treatment NLR may help guide predicting treatment outcomes in non-metastatic resectable ESCC patients.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 91%

Prognostic significance of neutrophil to lymphocyte ratio in esophageal squamous cell carcinoma

Sakin

2020

North Clin Istanbul

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“…The close link between inflammation and cancer is well documented, and many reports have shown a correlation between prognosis and systemic inflammation. 7 Among the blood parameters thought to reflect systemic inflammation (eg, C-reactive protein), evidence suggests the preoperative NLR associates with survival in several solid tumors. 8 Moreover, some reports suggest a relationship between the NLR and lymph node metastasis in various cancers, including advanced gastric cancer and esophageal squamous cell cancer.…”

Section: Discussionmentioning

confidence: 99%

“…8 Moreover, some reports suggest a relationship between the NLR and lymph node metastasis in various cancers, including advanced gastric cancer and esophageal squamous cell cancer. 7,9 Patients with lymph node metastasis and a high blood NLR had significantly poorer cancer-specific survival than those with a low NLR. 7 The present study suggests there is no significant association between the NLR and CD16b-positive neutrophil accumulation or lymph node metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…7,9 Patients with lymph node metastasis and a high blood NLR had significantly poorer cancer-specific survival than those with a low NLR. 7 The present study suggests there is no significant association between the NLR and CD16b-positive neutrophil accumulation or lymph node metastasis. It is also noteworthy that peritumoral neutrophil numbers do not correlate with systemic inflammation.…”

Section: Discussionmentioning

confidence: 99%

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Peritumoral CD16b positive-neutrophil accumulation strongly correlates with regional lymph node metastasis in thoracic esophageal squamous cell cancer

Fujita

Motoyama

et al. 2022

Surgery

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Background: The mechanism underlying cancer cell metastasis from the tumor to regional lymph nodes is not yet fully understood. We hypothesized that peritumoral neutrophil accumulation promotes regional lymph node metastasis in thoracic esophageal squamous cell cancer. Methods: Between 2010 and 2019, 126 thoracic esophageal squamous cell cancer patients received curative (R0) esophagectomy without preoperative treatment in our hospital. Using paraffin-embedded resected tumors, we performed immunohistochemical analysis of CD16b-positive neutrophil accumulation in the peritumoral area, which was defined as a 1-mm region centered on the border separating the malignant cell nests from the host tissue. The relationship between the density of peritumoral CD16b staining and pathological lymph node metastasis or 5-year overall survival was evaluated. Results: Although the clinicopathological characteristics of CD16b-high and CD16b-low patients did not differ, greater pathological lymph node metastasis (P < .001) and lymphatic invasion by the tumor (P ¼ .024) and a poorer 5-year survival (P ¼ .010) were seen in CD16b-high patients. Moreover, CD16b-positive neutrophil density was generally higher in the peritumoral area than within the tumor itself. Univariate and multivariate analyses showed that CD16b-positive neutrophil accumulation was an independent factor for lymph node metastasis with an odds ratio >25 (P < .001). On the other hand, blood neutrophil counts did not correlate with lymph node metastasis. Conclusion: Peritumoral accumulation of CD16b-positive neutrophils is an independent factor strongly correlated with lymph node metastasis in thoracic esophageal squamous cell cancer.

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Platelet-to-albumin ratio and radiation-induced lymphopenia—prognostic biomarker for carcinoma esophagus

Ghosh,

Dagar,

Bharat

et al. 2024

J Egypt Natl Canc Inst

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Background Esophageal cancer has a poor survival outcome with 5-year OS at 16.7% despite treatment. Some inflammation-based prognostic indicators like the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been previously studied as potential biomarker for predicting outcome in esophageal cancer. Recently, platelet-to-albumin ratio (PAR) has been reported as a promising prognostic factor in gastrointestinal malignancies. Methods We performed a retrospective analysis of prospectively treated patients of carcinoma esophagus to evaluate the prognostic significance of inflammation-based prognostic indicators—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and a composite inflammation-nutrition index: platelet-to-albumin ratio (PAR) in esophageal cancer. Based on previous studies, the optimal cut-off value of PAR was kept at 5.7 × 10^9, and 2.62 for NLR. Results A total of 71 patients of locally advanced esophageal cancer treated between 2019 and 2022, with either neoadjuvant or definitive chemoradiotherapy, were included. Median follow-up time was 19 months [range: 7–44 months]. Median OS and PFS in our study cohort were 11.3 months [range: 7–23 months] and 7.8 months [range: 3–17 months], respectively. In univariate analysis, lower PAR was found to be significantly correlated with shorter survival time (HR = 2.41; 1.3–4.76; p = 0.047). There was no association found between the OS and the NLR [HR = 1.09; 0.95–1.26; p = 0.222]. Univariate and multivariate linear and logistic regressions found no association between V15, V10, V5, or V2 of spleen and nadir lymphocyte count or between Dmax or Dmean and nadir lymphocyte counts. Conclusion Present analysis found a trend toward an inverse association between PAR and OS. PAR, in the not-so-distant future, may evolve as a novel, convenient, and inexpensive prognostic indicator in esophageal cancer.

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Value of the preoperative neutrophil‐to‐lymphocyte ratio as a prognostic factor for long‐term survival in postoperative esophageal squamous cell carcinoma patients

Cited by 9 publications

References 22 publications

Prognostic significance of neutrophil to lymphocyte ratio in esophageal squamous cell carcinoma

Prognostic significance of neutrophil to lymphocyte ratio in esophageal squamous cell carcinoma

Peritumoral CD16b positive-neutrophil accumulation strongly correlates with regional lymph node metastasis in thoracic esophageal squamous cell cancer

Platelet-to-albumin ratio and radiation-induced lymphopenia—prognostic biomarker for carcinoma esophagus

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