Abstract

BackgroundsThe lymphocyte to C-reactive protein (CRP) ratio (LCR) is an indicator of systemic inflammation and host–tumor cell interactions. The aim of this study was to investigate the prognostic significance of LCR in lower rectal cancer patients who received preoperative chemo-radiotherapy (CRT).MethodsForty-eight patients with lower rectal cancer who underwent CRT followed by curative surgery were enrolled in this study. Routine blood examinations were performed before and after CRT were used to calculate pre-CRT LCR and post-CRT LCR. The median LCR was used to stratify patients into low and high LCR groups for analysis. The correlation between pre- and post-CRT LCR and clinical outcomes was retrospectively investigated.ResultsThe pre-CRT LCR was significantly higher than the post-CRT LCR (11,765 and 6780, respectively, P < 0.05). The 5-year overall survival rate was significantly higher for patients with high post-CRT LCR compared with low post-CRT LCR (90.6% and 65.5%, respectively, P < 0.05). In univariate analysis, post-CRT LCR, post-CRT neutrophil to lymphocyte ratio, and fStage were significant prognostic factors for overall survival. In multivariate analysis, post-CRT LCR, but not other clinicopathological factors or prognostic indexes, was a significant prognostic factor for overall survival (P < 0.05).ConclusionsPost-CRT LCR could be a prognostic biomarker for patients with lower rectal cancer.

Highlights

  • Preoperative chemoradiotherapy (CRT) has become the standard treatment for patients with locally advanced lower rectal cancer (RC)

  • We previously reported that post-CRT neutrophil to lymphocyte ratio (NLR) correlated with overall survival (OS) after surgery in patients with lower

  • Total lymphocyte count (TLC) was significantly lower postCRT compared with pre-CRT (810/μL and 1662/μL, respectively, P < 0.05; Fig. 1A), whereas serum C-reactive protein (CRP) did not change significantly (0.14 mg/dL and 0.12 mg/dl, respectively, Fig. 1B)

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Summary

Introduction

Preoperative chemoradiotherapy (CRT) has become the standard treatment for patients with locally advanced lower rectal cancer (RC). Among the various prognostic scores investigated, preoperative LCR has been identified as an independent prognostic biomarker in patients with colorectal cancer (CRC) [10]. Only a few reports have considered the prognostic significance of LCR, including the utility of pre- and post-CRT LCR, in patients with cancers of the gastrointestinal tract [10, 14,15,16].

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