Delikgöz Soykut, ElaKemal, YaseminOdabaşı, EylemŞahin, NilgünKeskinkılıç Yağız, Betül2022-04-112022-04-112022Delikgoz Soykut, E., Kemal, Y., Odabasi, E., Odabasi, E., Sahin, N., Keskinkilic Yagiz, B., Yazicioglu, I. M., Aytac Arslan, S., Guney, V. (2022). Pre-treatment and post-treatment neutrophil-to-lymphocyte ratio predict pathological tumor response and survival in rectal cancer patients treated with neoadjuvant chemoradiotherapy. Turk Onkoloji Dergisi-Turkish Journal of Oncology.1300-7467https://doi.org/10.5505/tjo.2022.3467https://hdl.handle.net/20.500.12713/2624OBJECTIVE The aim of this study is to investigate the relationship between baseline and post-treatment neutrophil-to-lymphocyte ratio (NLR) levels and response to neoadjuvant chemoradiotherapy (CRT) in terms of good pathological response and survival. METHODS Fifty-six patients who underwent neoadjuvant CRT and curative surgery for locally advanced rectal cancer (LARC) were analyzed retrospectively. Pre-CRT and post-CRT hematologic parameters were recorded. The link between NLR and clinical outcomes was explored. RESULTS The receiver operating characteristic analysis revealed appropriate cut-off values of 2.87 for pre-CRT NLR associated with good pathological response and 8.68 for post-CRT NLR predicting survival. The low pre-CRT NLR group had better outcomes in terms of good pathological response compared to the high pre-CRT NLA group (OR 4.15, 95% CI 1.23-13.76, p=0.021). However, the analysis failed to show the correlation between NLR and pCR (OR 2.74, 95% CI 0.37-20.15, p=0.320). Patients with elevated post-CRT NLR had significantly worse 5-year overall survival (OS), disease-free survival (DFS) and local regional recurrence-free survival (LRRFS) rates compared to low post-CRT NLR in multivariate analysis (46.6% vs. 74.4%, p=0.020; 35.3% vs. 71.9%, p=0.018; 40.8% vs. 78.1%, p=0.006). CONCLUSION High pre-CRT NLR might be used as a poor pathological tumor response predictor in LARC patients treated with neoadjuvant CRT. In addition, low post-CRT NLR is associated with favorable OS, DFS, and LRRFS. Therefore, easily accessible and cost-effective NLR can be considered as a potential predictive marker to identify patients and establish personalized treatment strategies.eninfo:eu-repo/semantics/openAccessNeoadjuvant ChemoradiotherapyNeutrophil-to-lymphocyte RatioPathological Tumor ResponsePrognosisrectal CancersurvivalArticleWOS:0007673145000012-s2.0-85132762050N/A10.5505/tjo.2022.3467Q41136703