Abstract
Background
Prognostic features in locally recurrent rectal cancer (LRRC), beyond R0 surgery,
are unknown.
Aims
Aim of the present study was to evaluate the prognostic role of peripheral immune
estimators, such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte
ratio (PLR), on survival outcomes in LRRC patients.
Methods
184 LRRC patients treated at the National Cancer Institute of Milan (Italy) were included.
Optimal cut-off values for NLR and PLR were determined. Kaplan-Meier curves and multivariate
Cox analyses were used to assess the 5-yr overall survival (OS) according to NLR and
PLR, also considering margins status.
Results
NLR >3.9 (hazard ratio [HR] 3.96, P = 0.049), PLR >275 (HR 5.39, P = 0.002) and size on imaging (HR 1.36, P = 0.044) were associated to worse OS. R+ patients with NLR >3.9 showed a significantly
lower 5-yr OS compared to NLR ≤3.9 (13.5% vs. 36.7%, P < 0.0001). Also PLR >275 was related with a lower 5-yr OS compared to PLR ≤275 in
R+ patients (6.4% vs. 36.8%, P = 0.0003). Conversely, NLR and PLR were irrelevant in case of R0 surgery.
Conclusion
NLR and PLR predict 5-yr OS in LRRC, also identifying a subset of R+ patients with
a similar expected survival compared to R0 cases.
Keywords
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Article info
Publication history
Published online: January 26, 2022
Accepted:
January 5,
2022
Received:
October 19,
2021
Footnotes
Disclosure statement: This article received no funding and did not receive financial grants. No author has relevant industrial links or affiliations.
Identification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
