Cargando…

Prognostic Impact of the Neutrophil-to-Lymphocyte and Lymphocyte-to-Monocyte Ratio, in Patients with Rectal Cancer: A Retrospective Study of 1052 Patients

Despite the description of several new prognostic markers, colorectal cancer still represents the third most frequent cause of cancer-related death. As immunotherapy is considered a therapeutic alternative in such patients, neutrophil-to-lymphocyte (NLR) and lymphocyte-to-monocyte ratio (LMR) are hy...

Descripción completa

Detalles Bibliográficos
Autores principales: Fülöp, Zsolt Zoltán, Fülöp, Réka Linda, Gurzu, Simona, Bara, Tivadar, Tímár, József, Drágus, Emőke, Jung, Ioan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712240/
https://www.ncbi.nlm.nih.gov/pubmed/33081102
http://dx.doi.org/10.3390/jpm10040173
_version_ 1783618329003425792
author Fülöp, Zsolt Zoltán
Fülöp, Réka Linda
Gurzu, Simona
Bara, Tivadar
Tímár, József
Drágus, Emőke
Jung, Ioan
author_facet Fülöp, Zsolt Zoltán
Fülöp, Réka Linda
Gurzu, Simona
Bara, Tivadar
Tímár, József
Drágus, Emőke
Jung, Ioan
author_sort Fülöp, Zsolt Zoltán
collection PubMed
description Despite the description of several new prognostic markers, colorectal cancer still represents the third most frequent cause of cancer-related death. As immunotherapy is considered a therapeutic alternative in such patients, neutrophil-to-lymphocyte (NLR) and lymphocyte-to-monocyte ratio (LMR) are hypothesized to provide reliable prognostic information. A retrospective study was conducted on 1052 patients operated on during 2013–2019 in two clinical hospitals from Hungary and Romania. Inclusion criteria targeted patients over 18 years old, diagnosed with rectal cancer, with preoperatively defined NLR and LMR. The overall survival rate, along with clinical and histopathological data, was evaluated. Overall survival was significantly associated with increased NLR (p = 0.03) and decreased LMR (p = 0.04), with cut-off values of 3.11 and 3.39, respectively. The two parameters were inversely correlated (p < 0.0001). There was no statistically significant association between tumor stage and NLR or LMR (p = 0.30, p = 0.06, respectively). The total mesorectal excision was especially obtained in cases with low NLR (p = 0.0005) and high LMR (p = 0.0009) values. A significant association was also seen between preoperative chemoradiotherapy and high NLR (p = 0.0001) and low LMR (p = 0.0001). In patients with rectal cancer, the preoperative values of NLR and LMR can be used as independent prognostic parameters. An NLR value of ≥3.11 can be used to indicate the response to preoperative chemoradiotherapy, but a low chance of sphincter preservation or obtaining a complete TME. Higher values of NLR and lower values of LMR require a more attentive preoperative evaluation of the mesorectum.
format Online
Article
Text
id pubmed-7712240
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-77122402020-12-04 Prognostic Impact of the Neutrophil-to-Lymphocyte and Lymphocyte-to-Monocyte Ratio, in Patients with Rectal Cancer: A Retrospective Study of 1052 Patients Fülöp, Zsolt Zoltán Fülöp, Réka Linda Gurzu, Simona Bara, Tivadar Tímár, József Drágus, Emőke Jung, Ioan J Pers Med Article Despite the description of several new prognostic markers, colorectal cancer still represents the third most frequent cause of cancer-related death. As immunotherapy is considered a therapeutic alternative in such patients, neutrophil-to-lymphocyte (NLR) and lymphocyte-to-monocyte ratio (LMR) are hypothesized to provide reliable prognostic information. A retrospective study was conducted on 1052 patients operated on during 2013–2019 in two clinical hospitals from Hungary and Romania. Inclusion criteria targeted patients over 18 years old, diagnosed with rectal cancer, with preoperatively defined NLR and LMR. The overall survival rate, along with clinical and histopathological data, was evaluated. Overall survival was significantly associated with increased NLR (p = 0.03) and decreased LMR (p = 0.04), with cut-off values of 3.11 and 3.39, respectively. The two parameters were inversely correlated (p < 0.0001). There was no statistically significant association between tumor stage and NLR or LMR (p = 0.30, p = 0.06, respectively). The total mesorectal excision was especially obtained in cases with low NLR (p = 0.0005) and high LMR (p = 0.0009) values. A significant association was also seen between preoperative chemoradiotherapy and high NLR (p = 0.0001) and low LMR (p = 0.0001). In patients with rectal cancer, the preoperative values of NLR and LMR can be used as independent prognostic parameters. An NLR value of ≥3.11 can be used to indicate the response to preoperative chemoradiotherapy, but a low chance of sphincter preservation or obtaining a complete TME. Higher values of NLR and lower values of LMR require a more attentive preoperative evaluation of the mesorectum. MDPI 2020-10-16 /pmc/articles/PMC7712240/ /pubmed/33081102 http://dx.doi.org/10.3390/jpm10040173 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fülöp, Zsolt Zoltán
Fülöp, Réka Linda
Gurzu, Simona
Bara, Tivadar
Tímár, József
Drágus, Emőke
Jung, Ioan
Prognostic Impact of the Neutrophil-to-Lymphocyte and Lymphocyte-to-Monocyte Ratio, in Patients with Rectal Cancer: A Retrospective Study of 1052 Patients
title Prognostic Impact of the Neutrophil-to-Lymphocyte and Lymphocyte-to-Monocyte Ratio, in Patients with Rectal Cancer: A Retrospective Study of 1052 Patients
title_full Prognostic Impact of the Neutrophil-to-Lymphocyte and Lymphocyte-to-Monocyte Ratio, in Patients with Rectal Cancer: A Retrospective Study of 1052 Patients
title_fullStr Prognostic Impact of the Neutrophil-to-Lymphocyte and Lymphocyte-to-Monocyte Ratio, in Patients with Rectal Cancer: A Retrospective Study of 1052 Patients
title_full_unstemmed Prognostic Impact of the Neutrophil-to-Lymphocyte and Lymphocyte-to-Monocyte Ratio, in Patients with Rectal Cancer: A Retrospective Study of 1052 Patients
title_short Prognostic Impact of the Neutrophil-to-Lymphocyte and Lymphocyte-to-Monocyte Ratio, in Patients with Rectal Cancer: A Retrospective Study of 1052 Patients
title_sort prognostic impact of the neutrophil-to-lymphocyte and lymphocyte-to-monocyte ratio, in patients with rectal cancer: a retrospective study of 1052 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712240/
https://www.ncbi.nlm.nih.gov/pubmed/33081102
http://dx.doi.org/10.3390/jpm10040173
work_keys_str_mv AT fulopzsoltzoltan prognosticimpactoftheneutrophiltolymphocyteandlymphocytetomonocyteratioinpatientswithrectalcanceraretrospectivestudyof1052patients
AT fuloprekalinda prognosticimpactoftheneutrophiltolymphocyteandlymphocytetomonocyteratioinpatientswithrectalcanceraretrospectivestudyof1052patients
AT gurzusimona prognosticimpactoftheneutrophiltolymphocyteandlymphocytetomonocyteratioinpatientswithrectalcanceraretrospectivestudyof1052patients
AT barativadar prognosticimpactoftheneutrophiltolymphocyteandlymphocytetomonocyteratioinpatientswithrectalcanceraretrospectivestudyof1052patients
AT timarjozsef prognosticimpactoftheneutrophiltolymphocyteandlymphocytetomonocyteratioinpatientswithrectalcanceraretrospectivestudyof1052patients
AT dragusemoke prognosticimpactoftheneutrophiltolymphocyteandlymphocytetomonocyteratioinpatientswithrectalcanceraretrospectivestudyof1052patients
AT jungioan prognosticimpactoftheneutrophiltolymphocyteandlymphocytetomonocyteratioinpatientswithrectalcanceraretrospectivestudyof1052patients