Neutrophil-to-lymphocyte ratio predicts prognosis after neoadjuvant chemotherapy and resection of intrahepatic cholangiocarcinoma

Surgery ◽  
2017 ◽  
Vol 162 (4) ◽  
pp. 752-765 ◽  
Author(s):  
Kiyohiko Omichi ◽  
Jordan M. Cloyd ◽  
Suguru Yamashita ◽  
Ching-Wei D. Tzeng ◽  
Claudius Conrad ◽  
...  
2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Cong Jiang ◽  
Yubo Lu ◽  
Shiyuan Zhang ◽  
Yuanxi Huang

Background and Methods. As a parameter integrating neutrophil (N), lymphocyte (L), and platelet (P) levels, altered systemic immune-inflammation index (SII) has been investigated in a number of malignant tumor types. Here, we explore the impact of SII in a cohort of 249 breast cancer patients receiving neoadjuvant chemotherapy (NAC), investigating the prognostic value of SII, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). All patients had complete follow-up data and pathological confirmation of breast cancer by a core needle biopsy prior to NAC treatment and surgery. All blood samples were obtained within one week prior to NAC. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off value for patient classification by SII, NLR, and PLR. Associations between clinicopathological variables by SII, NLR, and PLR were determined by a chi-squared test or Fisher’s exact test. Overall survival (OS) analysis was performed using Kaplan-Meier plots, log-rank tests, and Cox proportional hazards regression models. The Z test is used to compare the prognostic ability of SII, NLR, and PLR. Results. SII, NLR, and PLR did not define patient groups with distinct clinicopathological characteristics. SII, NLR, and PLR cut-off values were 547, 2.13, and 88.23, as determined by ROC analysis; the corresponding areas under the curve (AUCs) were 0.625, 0.555, and 0.571, respectively. Cox regression models identified SII as independently associated with OS. Patients with low SII had prolonged OS (65 vs. 41 months, P = 0.017 , HR: 3.24, 95% CI: 1.23-8.55). In the Z test, the difference in AUC between SII and NLR was statistically significant ( Z = 2.721 , 95% CI: 0.0194-0.119, P = 0.0065 ). Conclusion. Our study suggests that the pretreatment SII value is significantly correlated with OS in breast cancer patients undergoing NAC and that the prognostic utility of SII is superior to that of NLR and PLR.


BJS Open ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. 416-423 ◽  
Author(s):  
A. G. M. T. Powell ◽  
C. Chin ◽  
A. H. Coxon ◽  
A. Chalishazar ◽  
A. Christian ◽  
...  

2021 ◽  
Vol 8 ◽  
Author(s):  
Ziyi Liu ◽  
Yahang Liang ◽  
Xiaolong Tang ◽  
Hui Qu

Introduction: Gastric cancer is the fifth most commonly diagnosed tumor and is the fourth leading cause of cancer-related mortality, worldwide. Due to the low rate of early diagnosis, approximately two-thirds of patients are first diagnosed at an advanced stage. Neoadjuvant chemotherapy (NAC) is recommended for patients with advanced gastric cancer (AGC). The neutrophil-to-lymphocyte ratio (NLR), a combined inflammatory and immunogenic factor, has been universally used for predicting outcomes in AGC patients. Given that NLR is a dynamic process, in this study, we investigated the value of NLR change for the prediction of chemotherapeutic responses and prognosis in patients with AGC.Methods: We retrospectively enrolled 111 patients with AGC who underwent NAC following curative surgery. Patients were divided into two groups according to the NLR change after chemotherapy into the increased and decreased groups. Outcome measures were overall survival (OS) and disease-free survival (DFS). Univariate was calculated by Kaplan-Meier method. Multivariate analysis was performed using the Cox proportional hazards regression model.Results: Post-chemotherapy, NLR increased in 36 patients and decreased in 75 patients. After a median follow-up time of 19 months, six patients developed local recurrence, 23 developed distant recurrence, and 34 died. Patients with reduced post-chemotherapy NLR showed significantly longer OS (p < 0.001) and DFS (p < 0.001). A decrease in the NLR after NAC was an independent indicator associated with better OS (p < 0.001) and DFS (p < 0.001).Conclusions: In patients with AGC, a decrease in NLR after NAC indicated better survival. NLR change could serve as a robust indicator for the efficiency of NAC and prognostic prediction in patients with AGC.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
M. Liontos ◽  
A. Andrikopoulou ◽  
K. Koutsoukos ◽  
C. Markellos ◽  
E. Skafida ◽  
...  

Abstract Background Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is the recommended approach in patients with advanced epithelial ovarian cancer (EOC). However, most patients eventually relapse despite the initial high response rate to chemotherapy. Neutrophil-to-lymphocyte ratio is a well-known biomarker that reflects severe inflammation, critical illness, and mortality in various diseases. Chemotherapy response score (CRS) and neutrophil-to-lymphocyte ratio (NLR) have been identified as potential biomarkers of platinum resistance and disease prognosis. We retrospectively evaluated 132 patients with stage IIIc or IV ovarian/fallopian tube/primary peritoneal cancer who had received NACT followed by IDS from 01/01/2003 to 31/12/2018. CRS was assessed on omental specimens collected from IDS according to ICCR guidelines. Results Median age was 64.57 years (SD: 9.72; range 39.2–87.1). Most ovarian tumors were serous epithelial (90.9%; 120/132). An elevated NLR (defined as > 3) was observed in 72% (95/132) of patients in contrast with 28% (37/132) of patients characterized by low NLR status. Median PFS (mPFS) and median overall survival (mOS) were 13.05 months (95% CI: 11.42–14.67)) and 34.69 months (95% CI: 23.26–46.12) respectively. In univariate analysis, CRS3 score was significantly associated with prolonged mPFS (CRS1/2: 12.79 months vs CRS3: 17.7 months; P = 0.008). CRS score was not associated with mOS (P = 0.876). High NLR was not significantly associated with mPFS (P = 0.128), however it was significantly associated with poor mOS (P = 0.012). In multivariate analysis, only performance of surgery maintained its statistical significance with both PFS (P = 0.001) and OS (P = 0.008). Conclusion NLR could serve as a useful predictor of OS but not PFS in ovarian cancer patients receiving NACT. In accordance with our previous study, CRS score at omentum was found to be associated with PFS but not OS in ovarian cancer patients treated with NACT and IDS.


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