Prognostic impact of lymphopenia and neutrophil-lymphocyte ratio for patients with anal squamous cell carcinoma

69 Background: The study explored the prognostic impacts of clinical parameters including neutrophil to lymphocyte ratio (NLR) in recurrent/metastatic esophageal squamous cell carcinoma (R/M ESCC) patients receiving anti-programmed cell death protein-1 (PD-1)/PD ligand 1 (PD-L1)-based therapy. Methods: Thirty-eight patients were enrolled. Tumor response evaluation was made according to Response Evaluation Criteria in Solid Tumours 1.1, and the clinical benefit response (CBR) was defined as complete response, partial response or stable disease at least 6 months. Clinical factors were analyzed for their impacts on patients' overall survival (OS) and progression-free survival (PFS). Formalin-fixed, paraffin-embedded tissues from 8 patients were analyzed by NanoString nCounter Human PanCancer Immune Profiling (NanoString Technologies, Seattle, WA, US). Results: Twenty-six recurrent and 12 de novo metastatic ESCC patients were enrolled. The response rate is 11.8%, and the CBR rate was 21.1%. The median PFS and OS are 2.7 and 5.5 months, respectively. The CBR group has lower blood white blood cells (WBC) ( P = 0.029), monocytes (p = 0.003), and NLR (p = 0.005). In univariate analysis, WBC, neutrophils, and NLR were statistically associated with PFS; performance status (PS), disease extent, albumin, WBC, neutrophils, and NLR were statistically associated with OS. In multivariate analysis, NLR (p = 0.007) was statistically associated with PFS; PS (p = 0.029) and NLR (p = 0.050) were statistically associated with OS. On examining the immune-related genes in ESCC tissues’ microenvironment, the ratios of mast cells, neutrophils, and macrophages relative to tumor-infiltrating lymphocytes (TILs) have significantly lower in the CBR group than in the non-CBR group. Conclusions: High NLR was associated with inferior prognosis in R/M ESCC patients receiving anti-PD-1/PD-L1-based therapy. The increased ratio of neutrophil to TILs in the ESCC tumor microenvironment of non-CBR patients may suggest a mechanistic role of neutrophils in affecting the efficacy of anti-PD-1/PD-L1 therapy. (Supported by the grant of MOST 105-2314-B-002 -186 -MY3)

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The prognostic nutritional index as a predictor of long-term outcome in patients with resected esophageal squamous cell carcinoma

10.21203/rs.2.22791/v1 ◽

2020 ◽

Author(s):

Tsunehiko Maruyama ◽

Mitsugi Shimoda ◽

Akihiro Sako ◽

Hiroyuki Hakoda ◽

Kazumitsu Ueda ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Prognostic Nutritional Index ◽

Long Term Outcome ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Nutritional Index

Abstract Background Preoperative nutritional and inflammation indexes have been shown to be associated with postoperative complications and the prognosis of patients with a malignant tumor. We evaluated several clinicopathological prognostic factors in patients with resected esophageal squamous cell carcinoma (ESCC). Methods Seventy-eight patients who underwent curative resection for ESCC were included in this retrospective study. The associations of body mass index (BMI), the prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and protein-albumin ratio (CAR) with various clinicopathological factors were evaluated. Results In multivariate analyses, only low PNI (<46.8) independently and significantly predicted overall survival (OS) (P=0.002). Conclusions The PNI is a simple, useful marker for predicting the long-term prognosis of patients with ESCC after esophagectomy. The PNI should be included in the routine assessment of patients with ESCC.

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Pretreatment neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio to guide the treatment decision (radical surgery versus definitive chemoradiotherapy) for locally advanced squamous cell carcinoma located in the middle and upper esophagus

10.21203/rs.3.rs-91121/v1 ◽

2020 ◽

Author(s):

Wang Chen ◽

Jia Qi Tong ◽

Meng Qiu Tang ◽

Yun Yun Lu ◽

Gao Feng Liang ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cox Regression ◽

Radical Surgery ◽

Survival Curve ◽

Locally Advanced ◽

Definitive Chemoradiotherapy ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio

Abstract Background: Various inflammatory biomarkers, such as the neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR), have been well authenticated to predict clinical outcomes in numerous types of cancer. The optimal treatment for patients with locally advanced esophageal squamous cell carcinoma (ESCC) located in middle or upper region is still inconclusive. The aim of the study was to examine pretreatment NLR and PLR to select from radical surgery or definitive chemoradiotherapy (dCRT) for these patients. The linkage between pretreatment NLR / PLR and prognosis was also analyzed.Methods: NLR and PLR were calculated in 113 locally advanced ESCC located in middle or upper esophagus of patients who underwent radical surgery or dCRT between January 2014 and December 2019. A receiver operating characteristic curve was plotted to select the best cut-off value of NLR and PLR for predicting survival. A survival curve was plotted using the Kaplan–Meier method. Univariate and multivariate Cox regression analyses were applied to assess predictors for survival. Results: NLR and PLR was both associated with the extent of lymph node metastasis (NLR: P = 0.045; PLR: P = 0.002). Additionally, high PLR and recurrence with distant organs metastasis were closely related (P = 0.014), and NLR was related to the tumor stage (P = 0.043). The results of multivariate analysis revealed that NLR (> 2.07) and PLR (> 183.06) were independently associated with poor prognosis. It is noteworthy that surgery was associated with a superior OS compared with dCRT in the low NLR population (P = 0.045). Conclusions: Low pretreatment NLR patients made a decision to undergo radical surgery with a substantial therapeutic benefit. Pretreatment NLR and PLR are independent predictors for patients with locally advanced ESCC located in the middle and upper esophagus who underwent radical surgery or dCRT.

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