PT  - JOURNAL ARTICLE
AU  - MANATO OHSAWA
AU  - YOICHI HAMAI
AU  - MANABU EMI
AU  - YUTA IBUKI
AU  - TOMOAKI KUROKAWA
AU  - TORU YOSHIKAWA
AU  - RYOSUKE HIROHATA
AU  - NAO KITASAKI
AU  - MORIHITO OKADA
TI  - Neutrophil-to-Lymphocyte Ratio as a Predictor of Postoperative Recurrence and Prognosis in Oesophageal Squamous Cell Carcinoma
AID  - 10.21873/anticanres.15622
DP  - 2022 Mar 01
TA  - Anticancer Research
PG  - 1499--1507
VI  - 42
IP  - 3
4099  - http://ar.iiarjournals.org/content/42/3/1499.short
4100  - http://ar.iiarjournals.org/content/42/3/1499.full
SO  - Anticancer Res2022 Mar 01; 42
AB  - 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’ 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–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.