Prognostic Potential of Lymphocyte-C-Reactive Protein Ratio in Patients with Rectal Cancer Receiving Preoperative Chemoradiotherapy.

Abstract

PURPOSE:

The systemic inflammatory response is attracting increasing attention as a predictive biomarker for oncological outcome in patients with colorectal cancer. This study is aimed at verifying if the lymphocyte-C-reactive protein (CRP) ratio (LCR) could be used as a predictor of oncological outcome in patients with rectal cancer (RC) receiving preoperative chemoradiotherapy (CRT).

METHODS:

We analyzed data for 86 patients with RC who received preoperative CRT followed by total mesorectal excision at our institution. A ratio of 6000 was used as the cut-off value for LCR for further analysis.

RESULTS:

The post-CRT LCR was significantly lower than the pre-CRT LCR in patients with RC. Although post-CRT LCR status was not significantly correlated with overall survival (OS), low pre-CRT LCR was significantly associated with shorter recurrence-free survival (RFS: p = 0.02) and OS (p = 0.017) in this population and was an independent prognostic factor for both RFS and OS (hazard ratio (HR) 3.19, 95% confidence interval (CI) 1.33-7.66, p = 0.009; HR 2.83, 95%CI 1.14-7.01, p = 0.025, respectively). Furthermore, low pre-CRT LCR was a stronger indicator of early recurrence (p = 0.001) and poor prognosis (p = 0.025) in RC patients without pathological lymph node metastasis compared with patients with pathological lymph node metastasis, and prognostic potential of pre-CRT LCR was clearly revealed especially RC patients receiving long-course CRT.

CONCLUSIONS:

Assessment of pretreatment LCR status might aid decision-making regarding postoperative treatment strategies in patients with RC receiving CRT followed by potentially curative resection.

• Authors: Yoshinaga Okugawa, Yuji Toiyama, Hiroyuki Fujikawa, Shozo Ide, Akira Yamamoto, Yusuke Omura, Chengzeng Yin, Kurando Kusunoki, Yukina Kusunoki, Hiromi Yasuda, Takeshi Yokoe, Junichiro Hiro, Masaki Ohi, Masato Kusunoki
• Journal: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract (J Gastrointest Surg) Vol. 25 Issue 2 Pg. 492-502 (02 2021) ISSN: 1873-4626 [Electronic] United States
• PMID: 32040814 (Publication Type: Journal Article)

Chemical References

• C-Reactive Protein

Topics

• C-Reactive Protein
• Chemoradiotherapy
• Disease-Free Survival
• Humans
• Lymphocytes (pathology)
• Neoadjuvant Therapy
• Neoplasm Staging
• Prognosis
• Rectal Neoplasms (pathology)
• Retrospective Studies