@article {OHSAWA1499, author = {MANATO OHSAWA and YOICHI HAMAI and MANABU EMI and YUTA IBUKI and TOMOAKI KUROKAWA and TORU YOSHIKAWA and RYOSUKE HIROHATA and NAO KITASAKI and MORIHITO OKADA}, title = {Neutrophil-to-Lymphocyte Ratio as a Predictor of Postoperative Recurrence and Prognosis in Oesophageal Squamous Cell Carcinoma}, volume = {42}, number = {3}, pages = {1499--1507}, year = {2022}, doi = {10.21873/anticanres.15622}, publisher = {International Institute of Anticancer Research}, abstract = {Background: Trimodal therapy is frequently used for patients with locally advanced, resectable oesophageal cancer. However, it does not provide a satisfactory prognosis. The neutrophil-to-lymphocyte ratio (NLR) is an important indicator of patients{\textquoteright} inflammatory and immune statuses. We investigated the prognostic role of NLR values obtained at different treatment stages in patients with oesophageal squamous cell carcinoma. Patients and Methods: We evaluated the correlation between NLR values or their change and prognosis at each treatment point (before chemoradiotherapy; before surgery; and at 14 days, and 1 and 2 months postoperatively) in 163 patients with oesophageal squamous cell carcinoma who underwent oesophagectomy after neoadjuvant chemoradiotherapy from April 2003 to August 2018. The outcomes studied were overall (OS) and relapse-free (RFS) survival. Results: The NLR at 1 month postoperatively showed the strongest correlation with prognosis, with an optimal cut-off value of 4.5 (area under the curve=0.7878; 95\% confidence interval=0.70-0.85; p\<0.0001). Univariate and multivariate analyses showed that NLR >=4.5 was a significant factor for both RFS (hazard ratio=4.44, 95\% confidence interval=2.69-7.34) and OS (hazard ratio=3.88, 95\% confidence interval=2.38-6.32). Furthermore, NLR significantly stratified patients for the RFS and OS regardless of the pathological response (complete/non-complete response) and postoperative complications (Clavien{\textendash}Dindo grade \<IIIa/>= IIIa). Conclusion: NLR measurement at 1 month postoperatively correlated with prognosis and was also a useful predictor of recurrence. Patients with high NLRs need more rigorous follow-up as they constitute a high-risk group. Postoperative adjuvant therapy may also be considered for such patients.}, issn = {0250-7005}, URL = {https://ar.iiarjournals.org/content/42/3/1499}, eprint = {https://ar.iiarjournals.org/content/42/3/1499.full.pdf}, journal = {Anticancer Research} }