Abstract
Objective: To investigate the effect of hemogram parameters on predicting pathological complete response (pCR) in locally advanced rectal cancer.Methodology: A total of 227 patients with rectal cancer treated with neoadjuvant concurrent chemoradiotherapy (CRT) were retrospectively analyzed. All patients were divided into two subgroups as high or low hemogram parameters according to the cut-off value obtained using the receiver operating characteristic (ROC) curve.Results: In patients with low neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) levels, pCR rate was statistically significantly higher than the group with high NLR and PLR levels (for NLR: 39.77% vs. 5.34%; p<0.001, for PLR: 32.38% vs 7.01%; p<0.001 respectively). In addition, the pCR rate was significantly better in patients with high lymphocyte levels compared to the group with low lymphocyte levels (33.33% vs. 7.5%; p<0.001, respectively). According to the multivariate logistic regression analysis result, NLR and PLR levels were considered as independent predictors to predict pathological complete response [p<0.001, HR: 0.128 (95% CI=0.051 - 0.322) for NLR; p=0.017, HR: 0.332 (95% CI=0.134 - 0.821) for PLR, respectively].Conclusion: Our study showed that high NLR, PLR, and low lymphocyte levels were correlated with worse pCR rates. In addition to that, NLR and PLR emerged as independent predictive markers.
Highlights
Colorectal cancer is the third most common malignancy and ranks second among cancer deaths [1]
Mean neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) levels were determined to be significantly lower in the pathological complete response (pCR) group compared to the nonpCR group (p1
We demonstrated that the pCR rate was higher in low NLR and PLR values and high lymphocyte levels
Summary
Colorectal cancer is the third most common malignancy and ranks second among cancer deaths [1]. The standard treatment approach in locally advanced rectal cancer is neoadjuvant concurrent chemoradiotherapy (CRT) followed by total mesorectal excision (TME) after six to eight weeks of waiting, and treatment outcomes have improved remarkably in recent years [4,5]. There are both long-term and short-term CRT applications. The total neoadjuvant approach, which has come to the fore with the RAPIDO and PRODIGE 23 studies recently, has short- and long-term results such as higher pathological complete response (pCR) and longer disease-free survival (DFS) than the standard treatment arm, especially in T4 and node-positive patients [6,7]. There is limited information about which patients can get a complete response
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