Prognostic role of neutrophil‐to‐lymphocyte ratio on esophageal cancer patients who received definitive chemoradiotherapy

Abstract

AbstractObjectiveThe neutrophil‐to‐lymphocyte ratio (NLR), a simple biomarker that can reflect the host antitumor immune response, has been associated with patient prognosis in several solid tumors. The aim of the present study was to evaluate the ability of NLR to predict clinical tumor response and prognosis in patients with locally advanced esophageal squamous cell carcinoma who received definitive chemoradiotherapy.MethodsA total of 147 patients with advanced esophageal squamous cell carcinoma treated at Shandong Cancer Hospital Affiliated with Shandong University, Jinan, China, between January 1, 2012 and December 31, 2013 were retrospectively recruited for analysis. The patients were divided into a low NLR group (NLR ≤2.46, n = 74) and a high NLR group (NLR >2.46, n = 73) according to pretreatment NLR. The predictive value of NLR for clinical tumor response and prognosis was examined.ResultsCompared with their matched counterparts, patients in the low NLR group showed a good clinical tumor response (P < 0.001). The NLR before chemoradiotherapy was significantly lower in patients who achieved complete response than in patients who did not achieve complete response (2.2 ± 0.9 vs. 2.7 ± 1.1, P = 0.024). Logistic regression analysis revealed that pretreatment NLR was negatively correlated with tumor response (odds ratio 0.60, 95% confidence interval 0.43–0.84; P = 0.003). In the univariate analysis, cT stage status (PPFS = 0.001; POS = 0.007), tumor response (PPFS < 0.001; POS < 0.001) and NLR (PPFS = 0.005; POS = 0.008) were significantly associated with PFS and OS. The Cox proportional hazards model showed that tumor response (PPFS = 0.002; POS = 0.003) and NLR (PPFS = 0.021; POS = 0.017) were independent predictors of prognosis.ConclusionsIn patients with esophageal squamous cell carcinoma, NLR can be used as a simple marker to predict clinical tumor response and prognosis.