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01-02-2021 | Rectal Cancer | Original Article

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

Authors: 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

Published in: Journal of Gastrointestinal Surgery | Issue 2/2021

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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Title: Prognostic Potential of Lymphocyte–C-Reactive Protein Ratio in Patients with Rectal Cancer Receiving Preoperative Chemoradiotherapy
Authors: 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
Publication date: 01-02-2021
Publisher: Springer US
Keywords: Rectal Cancer
Rectal Cancer
Published in: Journal of Gastrointestinal Surgery / Issue 2/2021
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-019-04495-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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