A new prognostic index associated with pathological complete response in rectal cancer
Öz
Purpose: Approximately half of rectal cancer cases are diagnosed at a locally advanced stage. It is important to identify biomarkers that can predict pathological complete response in patients undergoing surgery following neoadjuvant chemoradiotherapy.
Materials and Methods: This retrospective study included 205 patients with locally advanced rectal cancer who underwent surgery and adjuvant chemotherapy following neoadjuvant chemoradiotherapy. Inflammatory biomarkers were assayed in the complete blood count before neoadjuvant therapy.
Results: A pathological complete response was detected in 20.5% of the patients. The neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and pan-immune inflammation value were significantly lower in the pathological complete response (+) group than in the pathological complete response (-) group. The cut-off of the pan-immune inflammation value was ≤ 331.2, and this parameter had the best diagnostic performance of 90.4%.
Conclusion: Neoadjuvant chemoradiotherapy followed by surgery and adjuvant chemotherapy remains the standard treatment approach for rectal cancer. Since pathological complete response improves oncological outcomes, it is important to identify biomarkers that can predict pathological complete response in rectal cancer
Anahtar Kelimeler
rectal cancer, pathological complete response, inflammatory biomarkers, pan-immune inflammation value
Destekleyen Kurum
yok
Proje Numarası
yok
Kaynakça
- Mazidimoradi A, Tiznobaik A, Salehiniya H. Impact of the covid-19 pandemic on colorectal cancer screening: a systematic review. J Gastrointest Cancer. 2022;53:730-44.
- Oronsky B, Reid T, Larson C, Knox SJ. Locally advanced rectal cancer: the past, present, and future. Semin Oncol. 2020;47:85-92.
- Bahadoer RR, Dijkstra EA, van Etten B, Marijnen CAM, Putter H, Kranenbarg EM et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. Lancet Oncol. 2021;22:29-42.
- Conroy T, Bosset JF, Etienne PL, Rio E, François É, Mesgouez-Nebout N et al. Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER-PRODIGE 23): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2021;22:702-15.
- Allegra CJ, Yothers G, O'Connell MJ, Beart RW, Wozniak TF, Pitot HC et al. Neoadjuvant 5-FU or capecitabine plus radiation with or without oxaliplatin in rectal cancer patients: a phase III randomized clinical trial. J Natl Cancer Inst. 2015;107:djv248.
- 6-Tang M, Gao X, Sun H, Tian S, Dong J, Liu Z et al. Neutrophil-lymphocyte ratio as a prognostic parameter in NSCLC patients receiving EGFR-TKIs: a systematic review and meta-analysis. J Oncol. 2021;2021:6688346.
- Li Q, Yu L, Yang P, Hu Q. Prognostic value of inflammatory markers in nasopharyngeal carcinoma patients in the intensity-modulated radiotherapy era. Cancer Manag Res. 2021;13:6799-6810.
- Timudom K, Akaraviputh T, Chinswangwatanakul V, Pongpaibul A, Korpraphong P, Petsuksiri J et al. Predictive significance of cancer related-inflammatory markers in locally advanced rectal cancer. World J Gastrointest Surg. 2020;12:390-396.
- Morrison L, Laukkanen JA, Ronkainen K, Kurl S, Kauhanen J, Toriola AT. Inflammatory biomarker score and cancer: a population-based prospective cohort study. BMC Cancer. 2016;16:80.
- Mandaliya H, Jones M, Oldmeadow C, Nordman II. Prognostic biomarkers in stage IV non-small cell lung cancer (NSCLC): neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR) and advanced lung cancer inflammation index (ALI). Transl Lung Cancer Res. 2019;8:886-94.
