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10.02.2020 | Original Article

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

Zeitschrift:
Journal of Gastrointestinal Surgery
Autoren:
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
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s11605-019-04495-4) contains supplementary material, which is available to authorized users.

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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.

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