Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Predicting Complete Pathological Response in Rectal...

Area of Science:

• Oncology
• Clinical Medicine
• Biomarkers

Background:

• Neoadjuvant therapy improves outcomes in rectal cancer.
• Inflammatory markers like neutrophil-to-lymphocyte ratio (NLR) are being studied for predicting treatment response and survival.
• The role of NLR in predicting pathological response and outcomes after neoadjuvant chemoradiotherapy (nCRT) in rectal cancer requires further investigation.

Purpose of the Study:

• To evaluate the association between preoperative neutrophil-to-lymphocyte ratio (NLR) and pathological response.
• To assess the relationship between preoperative NLR and survival outcomes in rectal cancer patients undergoing nCRT.

Main Methods:

• Retrospective analysis of 187 rectal cancer patients treated with nCRT and surgery (2016-2020).
• Calculation of NLR from complete blood count records and determination of optimal cut-off value (3.63) using ROC curve analysis.
• Kaplan-Meier survival analysis and Cox regression to evaluate NLR's predictive value for prognosis.

Main Results:

• An NLR >3.63 was the optimal cut-off for predicting progression.
• Near-complete pathological response rates were significantly higher in patients with NLR <3.63 (38%) compared to NLR >3.63 (18%) (P=0.035).
• The 5-year progression-free survival rate was significantly higher for the NLR <3.63 group (63.6%) versus the NLR >3.63 group (40.1%) (P=0.007).

Conclusions:

• A preoperative NLR <3.63 is associated with a higher rate of near-complete pathological response in rectal cancer patients receiving nCRT.
• Low preoperative NLR appears to be a favorable prognostic factor for predicting pathological response.
• These findings highlight the potential utility of NLR as a predictive biomarker in rectal cancer management.