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Neutrophil-lymphocyte ratio as a predictor of response to neoadjuvant chemotherapy and survival in oesophageal adenocarcinoma

Powell, Arfon G. M. T., Chin, Carven, Coxon, Alexandra H., Chalishazar, Anuja, Christian, Adam, Roberts, S. A. and Lewis, Wyn G. 2020. Neutrophil-lymphocyte ratio as a predictor of response to neoadjuvant chemotherapy and survival in oesophageal adenocarcinoma. BJS Open 10.1002/bjs5.50277
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Background: Inflammation has an important role in cancer survival, yet whether serum markers of inflammation predict response to potentially curative neoadjuvant chemotherapy (NAC) in oesophageal adenocarcinoma (OAC) is controversial. This study aimed to determine whether systemic inflammatory response (SIR) was associated with response to NAC and survival. Methods: Consecutive patients with OAC planned to undergo surgery with curative intent received blood neutrophil and lymphocyte measurements at diagnosis to calculate Neutrophil-lymphocyte ratio (NLR). Pathological variables including pTNM stage, differentiation, vascular invasion, and Mandard Tumour Regression Grade (TRG) were recorded. TRGs 1&2 were taken to represent good response and primary outcome was overall survival (OS). Results: During follow-up of 136 patients, 36 patients (26.5%) suffered recurrence and 69 patients (50.7%) died. Receiver-Operator-Characteristic (ROC) analysis of NLR before NAC predicted poor TRG (area-under-the-curve (AUC) 0.71 (95% confidence interval (CI) 0.58-0.83, p=0.002). On univariable analysis, pT-stage (p<0.001), pN-stage (p<0.001), poor differentiation (p=0.006), margin positivity (p=0.001), poor TRG (p=0.014), and NLR (dichotomised 2.25, p=0.017) were associated with poor OS. but only NLR (Hazard Ratio (HR) 2.28 95% CI (1.03-4.93), p=0.042) retained independent significance on multivariable analysis. Conclusions: Pre-treatment NLR was associated with OAC pathological response to NAC and OS.

Item Type: Article
Date Type: Published Online
Status: In Press
Schools: Medicine
Publisher: Wiley
ISSN: 2474-9842
Date of First Compliant Deposit: 13 February 2020
Date of Acceptance: 12 February 2020
Last Modified: 31 May 2020 15:58

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