Neutrophil-lymphocyte-ratio in the prediction of the prognosis of neoadjuvant chemoradiotherapy for locally advanced rectal cancer / 中华普通外科杂志

ABSTRACT

Objective:To determine whether the neutrophil-lymphocyte-ratio (NLR) a inflammatory factor can predict tumor response to neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer.Methods:Between 2014 and 2019, 205 locally advanced rectal cancer patients underwent CRT before curative surgery. After propensity score matching, 148 patients (74 matched pairs) were enrolled in this study. The hematological parameters were collected and their relationship with tumor response was investigated.Results:After propensity score matching, NLR before CRT in good response group were significantly lower than that in poor response group(2.2±1.0 vs. 2.4±1.2, Z=-2.465, P<0.05), while there was no significant difference in all hematological characteristics between two groups after CRT. The cutoff values of pre-CRT NLR was 3.88 after receiver operating characteristic analysis(AUC=0.618, 95% CI 0.528-0.708). Multivariate analysis model indicated that pre-CRT NLR≥3.88 was the predictor of poor tumor response ( OR=5.826, 95% CI 1.299-26.132, P<0.05). Conclusion:The increased NLR before CRT can be regarded as a hematological factor for poor tumor response in locally advanced rectal cancer.