TY - JOUR
T1 - Systemic inflammatory dynamics during chemoradiotherapy predict response, relapse, metastasis, and survival in esophageal carcinoma
AU - Sherry, Alexander D.
AU - Newman, Neil B.
AU - Anderson, Joshua L.
AU - Osmundson, Evan C.
N1 - Publisher Copyright:
© 2019 Wiley Periodicals, Inc.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Background and Objectives: Lymphopenia associated with chemoradiotherapy predicts prognosis in esophageal carcinoma. The purpose of our study was to evaluate alterations in hematologic measures of inflammation during chemoradiation. Methods: We performed an observational study evaluating adults treated with chemoradiation in the neoadjuvant or definitive setting for stage II-III esophageal carcinoma. Multivariable logistic regression evaluated predictors of pathologic response. Survival was analyzed by time-varying multivariable Cox proportional hazards regressions. Results: A total of 94 patients were included with median follow-up of 1.6 years. Elevated neutrophil:lymphocyte ratio (NLR) was predictive of incomplete pathologic response to neoadjuvant chemoradiation (OR, 1.07; P =.0030) as well as shorter distant metastasis-free survival (HR, 1.01; P =.0369) and reduced overall survival (HR, 1.01; P =.0448). An NLR > 5.55 in week two of chemoradiation predicted shorter overall survival (P =.0070). Upon adjusted analysis, NLR was independently associated with reduced probability of complete pathologic response (OR, 0.80; P =.0291), as well as poor histologic response to neoadjuvant chemoradiation (OR, 1.05; P =.0303), shorter disease-free survival (HR, 1.02; P =.0077), and reduced overall survival (HR, 1.02; P =.0070). Conclusions: Dynamic time-dependent changes in NLR during chemoradiation predict response, relapse, metastasis, and survival in esophageal carcinoma. Prospective validation is warranted.
AB - Background and Objectives: Lymphopenia associated with chemoradiotherapy predicts prognosis in esophageal carcinoma. The purpose of our study was to evaluate alterations in hematologic measures of inflammation during chemoradiation. Methods: We performed an observational study evaluating adults treated with chemoradiation in the neoadjuvant or definitive setting for stage II-III esophageal carcinoma. Multivariable logistic regression evaluated predictors of pathologic response. Survival was analyzed by time-varying multivariable Cox proportional hazards regressions. Results: A total of 94 patients were included with median follow-up of 1.6 years. Elevated neutrophil:lymphocyte ratio (NLR) was predictive of incomplete pathologic response to neoadjuvant chemoradiation (OR, 1.07; P =.0030) as well as shorter distant metastasis-free survival (HR, 1.01; P =.0369) and reduced overall survival (HR, 1.01; P =.0448). An NLR > 5.55 in week two of chemoradiation predicted shorter overall survival (P =.0070). Upon adjusted analysis, NLR was independently associated with reduced probability of complete pathologic response (OR, 0.80; P =.0291), as well as poor histologic response to neoadjuvant chemoradiation (OR, 1.05; P =.0303), shorter disease-free survival (HR, 1.02; P =.0077), and reduced overall survival (HR, 1.02; P =.0070). Conclusions: Dynamic time-dependent changes in NLR during chemoradiation predict response, relapse, metastasis, and survival in esophageal carcinoma. Prospective validation is warranted.
KW - cancer-related inflammation
KW - chemoradiation
KW - esophageal carcinoma
KW - neutrophil:lymphocyte ratio
KW - prognostic biomarkers
UR - http://www.scopus.com/inward/record.url?scp=85076216676&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85076216676&partnerID=8YFLogxK
U2 - 10.1002/jso.25793
DO - 10.1002/jso.25793
M3 - Article
C2 - 31799692
AN - SCOPUS:85076216676
SN - 0022-4790
VL - 121
SP - 303
EP - 312
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
IS - 2
ER -