Lymphocyte-to-monocyte ratio before chemoradiotherapy represents a prognostic predictor for locally advanced rectal cancer

Abstract

Yu-Xiang Deng,1,* Jun-Zhong Lin,1,* Jian-Hong Peng,1,* Yu-Jie Zhao,1 Qiao-Qi Sui,1 Xiao-Jun Wu,1 Zhen-Hai Lu,1 Yuan-Hong Gao,2 Zhi-Fang Zeng,2 Zhi-Zhong Pan1 1Department of Colorectal Surgery, 2Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, People’s Republic of China *These authors contributed equally to this work Abstract: Research indicates that cancer-triggered inflammation plays a pivotal role in carcinogenesis. Here, we aimed to evaluate the correlation of lymphocyte-to-monocyte ratio (LMR) before neoadjuvant chemoradiotherapy (CRT) with clinical outcomes in patients with locally advanced rectal cancer (LARC). We retrospectively enrolled 317 consecutive patients with LARC between 2004 and 2013. The optimal cutoff values of LMR were determined using receiver operating curve analysis. Overall survival (OS) and disease-free survival related to the LMR were analyzed using the log-rank test and multivariate Cox regression methods. We found that a low LMR (≤4.91) was prominently correlated with worse prognostic features and a shorter 3-year survival rate of LARC. Moreover, multivariate Cox analysis revealed that elevated LMR was an independent factor for better OS (hazard ratio 0.538, 95% confidence interval 0.292–0.991, P=0.047). In addition, univariate logistic regression analysis showed that the LMR was not associated with tumor pathologic regression. In conclusion, LMR is identified as a valuable prognostic marker for predicting the OS of LARC patients receiving CRT. Keywords: rectal cancer, lymphocyte-monocyte ratio, prognosis, systemic inflammation

Keywords

• rectal cancer
• lymphocyte-monocyte ratio
• prognosis
• systemic inflammation