Prognostic significance of neutrophil-to-lymphocyte ratio in esophageal squamous cell carcinoma

OBJECTIVE: The purpose of the study was to assess the effect of neutrophil-to-lymphocyte ratio (NLR) on recurrence and survival in patients with Esophageal Squamous Cell Carcinoma (ESCC) undergoing surgery.
METHODS: This was a retrospective analysis of the 80 resectable ESCC patients who underwent surgery at Yuzuncu Yil University Faculty of Medicine between 2008 and 2018. Receiver operator characteristics curve of NLR was plotted for disease-free survival (DFS). The area under the curve of NLR was 0.692 (p=0.008) with 65.2% sensitivity and 2.8 with 69.5% specificity. Patients were divided into two groups based on the NLR as follows: NLR <2.8 and NLR ≥2.8.
RESULTS: Among 80 ESCC patients, 54 (65.5%) were female. The median age was 55 years (range, 26–77). The NLR was <2.8 in 47 (58.7%) patients. Median DFS was 55 months in patients with NLR ≥2.8, whereas it was not reached in those with NLR <2.8 (p=0.008), with corresponding overall survival (OS) durations of 71 months and not reached (p=0.027). Eastern Cooperative Oncology Group performance score 2, presence of obstruction at diagnosis, lower 1/3 esophageal localization, neoadjuvant treatment, and NLR ≥2.8 were found to be the factors related to survival.
CONCLUSION: The present study demonstrated that high pre-treatment NLR was associated with worse DFS and OS in patients with resectable esophageal cancer. We believe that pre-treatment NLR may help guide predicting treatment outcomes in non-metastatic resectable ESCC patients.

Özofagus skuamöz hücreli karsinomda nötrofil / lenfosit oranýnýn prognostik önemi

Amaç: Bu çalýþmada opere Skuamöz hücreli özefagus kanseri(ÖSHK) hastalarýnda taný anýndaki Nötrofil lenfosit oranýnýn(NLO) rekürrense ve saðkalýma olan etkisine bakýlmasý amaçlandý.
Materyal ve Metod: Çalýþmaya 2008-2018 yýllarý arasýnda XXX Üniversitesi onkoloji kliniðinde takipli hastalar olarak alýndý. Çalýþmaya ÖSHK’i nedeni ile opere olmuþ 18 yaþ ve üzerinde olan, metastatik evrede olmayan hastalar alýndý. NLO ile hastalýksýz saðkalým (HSK) için ROC eðrisi çizildi. NLO için eðri altýnda kalan alan 0.692 (P=0.008) % 65.2 duyarlýlýk, %69.5 özgüllük ile 2.8 olarak saptandý. Hastalar NLO deðerine göre NLO<2.8 ve NLO≥2.8 olarak gruplandýrýldý.
Bulgular: Çalýþmaya 26 (32.5%) erkek ve 54 (65.5%) kadýn olmak üzere 80 hasta alýndý. Hastalarýn ortanca yaþý 55 yýl (range;26-77) idi. 47(58.7%) hastanýn NLO deðeri<2.8 iken 33 hastanýn NLO deðeri ≥ 2.8 idi. NLO ≥ 2.8 olan grupta mHSK 55 ay iken, NLO<2.8 olan grupta mHSK' ye ulaþýlamadý (p=0.008). Benzer þekilde NLO ≥ 2.8 olan grupta ortanca genel saðkalým (mGSK) 71 ay iken, NLO<2.8 olan grupta mHSK' ya ulaþýlamadý (p=0.027). Çok deðiþkenli analizde, Eastern cooperative oncology group performans skoru 2 (tehlike oraný [TO], 2.99), taný anýnda obstrüksyon olmasý (TO, 3.25), Alt özefagus lokalizayon (TO, 0.62),Neoadjuvan tedavi verilmesi (TO,0.58) ve NLO ≥2.8 olmasý (TO, 5.44,) HSK ‘yi etkileyen faktörler olarak saptandý.
Tartýþma: Sonuç olarak çalýþmamýzda, tedavi öncesi yüksek NLO 'nin ÖSHK olan hastalarda daha kötü HSK ve GSK ile iliþkili olduðunu ortaya koymuþtur. non-metastatik opera ÖSHK hastalarýnda tedavi öncesi NLO deðerinin, tedavi sonuçlarýný tahmin etmek için önemli destekleyici bilgiler saðlayabileceði kanaatindeyiz. (NCI-2020-0090.R2)