High Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Low Lymphocyte Levels Are Correlated With Worse Pathological Complete Response Rates

Serdar Karakaya; İbrahim Karadağ; Mehmet Emin Yılmaz; Ömür Berna Çakmak Öksüzoğlu

doi:10.7759/cureus.22972

High Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Low Lymphocyte Levels Are Correlated With Worse Pathological Complete Response Rates

Cureus. 2022 Mar 8;14(3):e22972. doi: 10.7759/cureus.22972. eCollection 2022 Mar.

Authors

Serdar Karakaya¹, İbrahim Karadağ², Mehmet Emin Yılmaz³, Ömür Berna Çakmak Öksüzoğlu⁴

Affiliations

¹ Medical Oncology, Health Science University, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, TUR.
² Department of Medical Oncology, Çorum Hittite University Erol Olçok Training and Research Hospital, Çorum, TUR.
³ Department of Internal Medicine, Health Sciences University, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, TUR.
⁴ Department of Medical Oncology, Health Sciences University, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, TUR.

Abstract

Objective: To investigate the effect of hemogram parameters on predicting pathological complete response (pCR) in locally advanced rectal cancer.

Methodology: A total of 227 patients with rectal cancer treated with neoadjuvant concurrent chemoradiotherapy (CRT) were retrospectively analyzed. All patients were divided into two subgroups as high or low hemogram parameters according to the cut-off value obtained using the receiver operating characteristic (ROC) curve.

Results: In patients with low neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) levels, pCR rate was statistically significantly higher than the group with high NLR and PLR levels (for NLR: 39.77% vs. 5.34%; p<0.001, for PLR: 32.38% vs 7.01%; p<0.001 respectively). In addition, the pCR rate was significantly better in patients with high lymphocyte levels compared to the group with low lymphocyte levels (33.33% vs. 7.5%; p<0.001, respectively). According to the multivariate logistic regression analysis result, NLR and PLR levels were considered as independent predictors to predict pathological complete response [p<0.001, HR: 0.128 (95% CI=0.051 - 0.322) for NLR; p=0.017, HR: 0.332 (95% CI=0.134 - 0.821) for PLR, respectively].

Conclusion: Our study showed that high NLR, PLR, and low lymphocyte levels were correlated with worse pCR rates. In addition to that, NLR and PLR emerged as independent predictive markers.

Keywords: neoadjuvant chemoradiotherapy; neutrophil-lymphocyte ratio; pathological response; platelet-lymphocyte ratio; rectum cancer.