Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after radical resection of esophageal squamous cell carcinoma

Abstract

To investigate the prognostic significance of the preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with esophageal squamous cell carcinoma (ESCC) who received radical resection. A retrospective review was performed on 475 patients who underwent radical resection for ESCC in our hospital between January 2007 and December 2008, all patients were diagnosed with ESCC by pathological examination. None accepted neoadjuvant therapy. The median value of NLR was 1.77 (range, 0.53-11). Based on this cut-off value of 2.5, all the patients were divided into 2 groups: a low NLR (<2.5, n = 389) group and a high NLR ( ≥ 2.5, n = 86) group. The 5-year overall survival rate was 48.6% in patients of the low NLR group and 36.0% in those of the high NLR group (P = 0.009). The ratio of women was higher in the low NLR group (P = 0.04). Univariate analysis showed NLR, age, history of smoking, T stage, N stage, and postoperative adjuvant therapy were associated with survival (P < 0.05 for all). We also found that NLR could be used to divide patients with or without lymph node metastasis into a high and low risk groups. Multivariate analysis revealed that NLR, age, N stage, and postoperative adjuvant therapy were independent risk factors of prognosis. Our results show that preoperative NLR ≥ 2.5 may be a convenient biomarker to predict patients with a poor prognosis after radical resection for ESCC.