Neutrophil to lymphocyte ratio as predictor of treatment response in esophageal squamous cell cancer Journal Article


Authors: Barbetta, A.; Nobel, T. B.; Sihag, S.; Hsu, M.; Tan, K. S.; Bains, M. S.; Isbell, J. M.; Janjigian, Y. Y.; Wu, A. J.; Bott, M. J.; Jones, D. R.; Molena, D.
Article Title: Neutrophil to lymphocyte ratio as predictor of treatment response in esophageal squamous cell cancer
Abstract: Background: The aim of this study was to assess the difference (Δ) in neutrophil to lymphocyte ratio (NLR), before and after chemoradiotherapy, as a predictor of treatment response and a prognostic factor for recurrence and disease-free survival in patients with esophageal squamous cell cancer treated with chemoradiotherapy with or without surgery. Methods: Patients with locally advanced esophageal squamous cell cancer treated with chemoradiation with and without surgery who had a complete blood count before and after chemoradiotherapy were included. Pretreatment and posttreatment NLR were calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. The ΔNLR was defined as posttreatment minus pretreatment NLR. Characteristics were evaluated for association with ΔNLR using the Wilcoxon signed rank test or the Kruskal-Wallis test. Risk of recurrence and disease-free survival were evaluated using Gray's and the log rank tests, respectively. Results: We included 217 patients. Of them, 133 patients (61.3%) received only chemoradiotherapy and 84 (38.7%) underwent surgery after chemoradiotherapy. Among the surgical patients, 43% with pathologic complete response showed significantly lower median ΔNLR than patients with residual disease (−0.03 versus 1.04, p = 0.004). High ΔNLR was a negative predictor of treatment response (odds ratio 0.77, 95% confidence interval: 0.62 to 0.9, p = 0.004). A significant association between high ΔNLR and increased risk of recurrence was also identified. Conclusions: The ΔNLR was inversely related to pathologic complete response and associated with risk of recurrence. This simple test, in concert with other clinical tools, can help identify patients with pathologic complete response. © 2018 The Society of Thoracic Surgeons
Journal Title: Annals of Thoracic Surgery
Volume: 106
Issue: 3
ISSN: 0003-4975
Publisher: Elsevier Science, Inc.  
Date Published: 2018-09-01
Start Page: 864
End Page: 871
Language: English
DOI: 10.1016/j.athoracsur.2018.04.007
PROVIDER: scopus
PMCID: PMC6117834
PUBMED: 29738752
DOI/URL:
Notes: Article -- Export Date: 4 September 2018 -- Source: Scopus
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MSK Authors
  1. Meier Hsu
    102 Hsu
  2. Yelena Yuriy Janjigian
    133 Janjigian
  3. Abraham Jing-Ching Wu
    198 Wu
  4. Matthew Bott
    32 Bott
  5. Manjit S Bains
    219 Bains
  6. David Randolph Jones
    150 Jones
  7. Daniela   Molena
    35 Molena
  8. Kay See   Tan
    68 Tan
  9. James Michael Isbell
    26 Isbell
  10. Smita Sihag
    4 Sihag
  11. Tamar B Nobel
    5 Nobel