Prognostic Value of Neutrophil to Lymphocyte Ratio in Patients Presenting With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention (original) (raw)
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Annals of Surgical Oncology, 2020
Background. Neutrophil-to-lymphocyte ratio (NLR) has been identified as a biomarker for multiple malignancies. There is emerging evidence that implicates neutrophils in cancer progression. Alterations of neutrophil counts and NLR during treatment may reflect a change in oncologic outcome that is more important than baseline values. The aim of this study is to investigate the prognostic role of NLR changes during the treatment trajectory of patients with esophageal adenocarcinoma. Patients and Methods. NLR values of patients with esophageal adenocarcinoma who underwent surgery between 2005 and 2016 were measured at baseline and in the late postoperative period. Primary outcomes were overall survival (OS) and disease-free survival (DFS). The secondary outcome was pathological response to neoadjuvant chemotherapy. Results. 330 patients were included; mean age was 65.6 years, and 82% were male. Most patients had cT3 (74.8%), cN-positive (59.7%) disease. Two-thirds (65.2%) received neoadjuvant chemotherapy. The independent predictors of OS were pathological N-stage, size of primary tumor, and delta NLR (late-baseline NLR). Patients with persistently elevated NLR did worse than those with decreasing NLR trends between baseline and postoperative time points (3-year OS 43.4% versus 71.3%, p \ 0.0001, 3-year DFS 29.7% versus 61.9%, p \ 0.0001). High baseline and postoperative NLR were associated with significantly worse OS and DFS. Patients with complete pathological response had lower mean baseline NLR. Conclusion. Dynamic changes in NLR during treatment are associated with survival and may be more informative than static baseline values. Y. Al Lawati and J. Cools-Lartigue contributed equally to this manuscript and should both be considered as first coauthors.
PubMed, 2021
Aim: In this study, we aimed to determine the clinical value and prognostic significance of the Neutrophil / Lymphocyte Ratio in patients undergoing curative surgery due to esophageal cancer. Material and method: Patients who underwent curative resection for esophageal cancer between 2015-2019 were included in the study. Two groups, Group1 (low NLR) and Group2 (high NLR), were created. Demographic and clinical features, intraoperative and postoperative results, tumor characteristics and mean survival were compared in the groups. Results: A total of 48 patients participated in our study. Group 1 consisted of 18 patients and Group 2 consisted of 30 patients. Male sex was dominant in both groups (66.7% vs 73.3%, p. 0.431). Preoperative CEA was higher in Group 2 (3.97 vs 9.57, p. 0.032). Tumor diameter was larger in Group2 (3.33 vs 5.40 cm, p. 0.000). Adenocarcinoma was higher in Group 2 (33% vs 53.3%, p. 0.047), while squamous cell carcinoma was higher in Group 1 (66.7% vs 33.3%, p. 0.047). Lymph node positivity was higher in Group 2 (66.7% vs 93.3%, p. 0.024). The anastomosis leak was higher in Group 2 (0% vs 20%, p. 0.048). Postoperative hospital stay was longer in Group 2 (13.27 vs 23.9 days, p. 0.009). 90-day readmission was higher in Group1 (33.3% vs 3.3%, p. 0.008). Survival duration was shorter in Group 2 (29 vs 15 months, p. 0.005). Conclusion: This study revealed that preoperative high NLR was associated with poor survival, along with greater tumor diameter, increased lymph node metastasis rate, and increased anastomosis leakage in patients with esophageal cancer. These results suggest that modifying inflammatory responses and modulating the immune system may improve survival outcomes in patients with esophageal cancer. Key words: Esophagus cancer, Neutrophil/lymphocyte ratio, Preoperative neutrophil/lymphocyte ratio, Prognosis.
European Journal of Cancer, 2016
A high preoperative neutrophil-lymphocyte ratio (NLR) has been shown in several studies as a predictor of worse survival in many solid neoplasms, including esophageal cancer, but its impact remains unclear. The goal of this systematic review was to gain all the evidence about NLR in order to analyse its potential in predicting survival in esophageal cancer. Therefore, we conducted a systematic literature search of all relevant studies reporting data on NLR as prognostic marker in esophageal cancer patients. We considered overall survival (OS) as primary outcome, disease-free survival (DFS) and progression-free survival (PFS) as secondary outcomes. We included studies with a directly or indirectly available hazard ratio (HR), furthermore we used both fixed effect model and random effect model depending on heterogeneity. We included a total of 20 studies, published between 2011 and 2017, consisting of 6,457 patients. The NLR cutoff value ranges from 1.7 to 5. The HR for OS of all included studies was 1.60. The HR for DFS and PFS was 1.75 and 1.66 respectively. The survival sub-analysis about tumor characteristics, treatment modality, blood sample timing also confirmed NLR prognostic relevance with statistically significant results. The meta-analysis showed that high preoperative NLR is associated with worse survival in esophageal cancer, as shown in several solid tumors, but its use in the clinical practice is still underestimated. Highquality studies are needed to assess the most effective cutoff in survival prognostication and NLR relevance on postoperative complications.
Journal of Clinical Oncology, 2016
172 Background: The prognosis for esophageal cancer remains poor despite advances in therapeutic modalities. Elevations of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been shown to be associated with poorer prognosis in several types of solid cancer. However, their prognostic value remains controversial in esophageal cancer. The aim of this study was to assess the prognostic value of NLR and PLR in esophageal and gastroesophageal junction (GEJ) cancer. Methods: We retrospectively reviewed the database of 77 patients who underwent neoadjuvant chemoradiation and potentially curative resection for esophageal cancer in our institute, between July 2006 and December 2011. NLR and PLR were calculated from laboratory data obtained prior to the start of chemoradiation. The predictive value of NLR and PLR was assessed using Kaplan-Meier curves and Cox regression models for an association with pathologic response to chemoradiation, relapse-free survival...
OncoTargets and therapy, 2017
There is increasing evidence that systemic inflammation influences the prognosis in patients with malignant tumors. The aim of this research was to investigate the prognostic value of neutrophil/lymphocyte ratio (NLR) in patients with primary small-cell carcinoma of the esophagus. This study retrospectively analyzed 129 patients with primary small-cell carcinoma of the esophagus who underwent esophagectomy in The Fourth Hospital of Hebei Medical University between January 2008 and December 2010. NLRs were calculated by using the following formula: peripheral neutrophil count/lymphocyte count (10(9)/L). Correlations of NLR with other clinicopathologic data and prognosis were analyzed. The survival rate was calculated by Kaplan-Meier analysis. The differences between groups were compared by using the log-rank test. Cox regression was used to analyze the factors that may affect the survival of the patients. The survival rate was found to be related to tumor stage, tumor location, nodal...
The preoperative hemoglobin, albumin, lymphocyte and platelet (HALP) score is a useful predictor in patients with resectable esophageal squamous cell carcinoma, 2021
The hemoglobin, albumin, lymphocyte and platelet (HALP) score has been confirmed as a prognostic factor in several types of cancers. The current study aimed to assess the prognostic value of preoperative HALP score, an inflammatory and nutritional based score, in predicting cancer-specific survival (CSS) in resectable patients undergoing curative resection for esophageal squamous cell carcinoma (ESCC). The clinical data of 355 consecutive patients with ESCC who underwent curative resection were retrospectively conducted and analyzed. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value for preoperative HALP. The areas under the curve (AUC) for preoperative HALP and other variables were calculated and compared. Cox regression analyses and Kaplan–Meier methods were used to identify the factors associated with CSS. According to the ROC curve, the optimal cut-off value for preoperative HALP was 31.8. The 5-year CSS for preoperative HALP low (≤31.8) and high (>31.8) was 15.1% and 47.5%, respectively (p < 0.001). Preoperative HALP had reliable abilities to predict CSS in resectable ESCC patients in any stage or gender, according to the subgroup analysis based on the patients’ cancer stage and gender. Multivariate analyses confirmed that preoperative HALP was an independent prognostic score regarding CSS in patients with resectable ESCC (p < 0.001). This study confirmed that the postoperative HALP score could be regarded as a potential independent prognostic factor for CSS in patients with resectable ESCC.
Annals of medical research, 2020
Elevated preoperative neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) predict overall survival rates among patients with several types of cancer. The current study was conducted to clarify whether NLR and PLR are clinically useful in predicting overall survival among patients undergoing curative resections for gastric cancer. Material and Methods: 202 gastric cancer patients were reviewed retrospectively who had been appealed to our clinic between 2006 and 2013. 192 patients who had local disease, and underwent curative surgery for gastric cancer were included to the study. Data regarding potential prognostic factors including age, sex, preoperative neutrophil, lymphocyte, and platelet counts, postoperative tumor characteristic such as tumor location, tumor size, lymph node metastasis, tumor-nodes-metastasis staging, Lauren's classification of subtypes and survival times were obtained from medical records. Results: No significant correlations were noted between NLR, PLR and tumor location, size, Lauren's classification of subtypes, histology, stage, and type of gastrectomy. Univariate analysis revealed that metastasis at the follow up, sex, T, N stage, and lymph node ratio (LNR) were predictors of worse overall survival. In multivariate analysis, metastasis at follow up (p=0.014; HR:1.81; CI:1,126-2,911) and LNR (p=0.001; HR:3,564; CI:2,175-5,842) were found to be independent variables with worse overall survival. Conclusion: Preoperative NLR and PLR cannot be used as independent variables for prediction of overall survival in patients with operable gastric cancer.