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. 2010 Jan 6:8:1.
doi: 10.1186/1477-7819-8-1.

A pre-operative elevated neutrophil: lymphocyte ratio does not predict survival from oesophageal cancer resection

Affiliations

A pre-operative elevated neutrophil: lymphocyte ratio does not predict survival from oesophageal cancer resection

Farhan Rashid et al. World J Surg Oncol. .

Abstract

Background: Elevated pre-operative neutrophil: lymphocyte ratio (NLR) has been identified as a predictor of survival in patients with hepatocellular and colorectal cancer. The aim of this study was to examine the prognostic value of an elevated preoperative NLR following resection for oesophageal cancer.

Methods: Patients who underwent resection for oesophageal carcinoma from June 1997 to September 2007 were identified from a local cancer database. Data on demographics, conventional prognostic markers, laboratory analyses including blood count results, and histopathology were collected and analysed.

Results: A total of 294 patients were identified with a median age at diagnosis of 65.2 (IQR 59-72) years. The median pre-operative time of blood sample collection was three days (IQR 1-8). The median neutrophil count was 64.2 x 10-9/litre, median lymphocyte count 23.9 x 10-9/litre, whilst the NLR was 2.69 (IQR 1.95-4.02). NLR did not prove to be a significant predictor of number of involved lymph nodes (Cox regression, p = 0.754), disease recurrence (p = 0.288) or death (Cox regression, p = 0.374). Furthermore, survival time was not significantly different between patients with high (>or= 3.5) or low (< 3.5) NLR (p = 0.49).

Conclusion: Preoperative NLR does not appear to offer useful predictive ability for outcome, disease-free and overall survival following oesophageal cancer resection.

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Figures

Figure 1
Figure 1
NLR median and IQR box plot for three oesophageal cancer groups.
Figure 2
Figure 2
NLR value and TNM nodal status.
Figure 3
Figure 3
NLR and ratio of involved to total lymph node yields.
Figure 4
Figure 4
Survival for patients with NLR < 3.5 and > = 3.5(Censored = alive) (p = 0.49).
Figure 5
Figure 5
Survival for patients with NLR < 4 and > = 4(Censored = alive) (p = 0.680).
Figure 6
Figure 6
Survival for patients with NLR < 3 and > = 3(Censored = alive) (p = 0.340).
Figure 7
Figure 7
Survival for patients with NLR < 5 and > = 5(Censored = alive) (p = 0.868).
Figure 8
Figure 8
a Oesophageal cancer histopathology: there is marked dysplastic change but little polymorphic infiltration. 8b: Colonic tumour with excessive polymorphic infiltration but little dysplasia.

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