Predictive value of lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) in patients with oesophageal cancer undergoing concurrent chemoradiotherapy

BMC Cancer. 2019 Oct 26;19(1):1004. doi: 10.1186/s12885-019-6157-4.

Abstract

Background and objectives: The survival rate of patients with advanced oesophageal cancer is very low and can vary significantly, even among patients with the same TNM stage. It is important to look for indicators that are economical and readily available to predict overall survival. The aim of this study was to determine whether lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) could be potential predictors of survival in patients with advanced oesophageal squamous cell carcinoma (ESCC) undergoing concurrent chemoradiotherapy.

Methods: Differences in survival among 204 patients with advanced oesophageal cancer who underwent concurrent chemoradiotherapy were collected and analysed. Univariate and multivariate COX regression analyses were used to investigate the association between blood inflammatory markers and patient survival before treatment.

Results: Univariate COX regression analyses showed that a history of alcohol use, neutrophil count, LMR, NLR, tumour length, and N stage were significantly associated with the survival of tumour patients receiving concurrent chemoradiotherapy. Multivariate COX regression analysis showed that NLR and LMR were predictors of outcome in tumour patients receiving chemoradiotherapy. According to receiver operating characteristic (ROC) curve analysis, the AUC of LMR and NLR was 0.734 and 0.749, and the best cutoff point for LMR and NLR was 3.03 and 2.64, respectively.

Conclusions: LMR and NLR can be used to predict the survival of patients with advanced oesophageal cancer receiving concurrent chemoradiotherapy, thereby providing clinicians with suggestions for further treatment options.

Keywords: Blood inflammatory markers; Concurrent chemoradiotherapy; Oesophageal cancer; Overall survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / adverse effects
  • Area Under Curve
  • Chemoradiotherapy*
  • Esophageal Neoplasms / blood*
  • Esophageal Neoplasms / drug therapy*
  • Esophageal Neoplasms / mortality
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphocyte Count
  • Lymphocytes / pathology*
  • Male
  • Middle Aged
  • Monocytes / pathology*
  • Multivariate Analysis
  • Neoplasm Staging
  • Neutrophils / pathology*
  • Prognosis
  • Proportional Hazards Models
  • ROC Curve
  • Retrospective Studies
  • Survival Rate