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Elevated Preoperative Neutrophil:Lymphocyte Ratio as a Predictor of Postoperative Disease Recurrence in Esophageal Cancer
Open accessAbstract
BackgroundThe prognosis for patients with esophageal cancer is poor, even among those who undergo potentially curative esophagectomy. The neutrophil:lymphocyte ratio (NLR) is hypothesized to reflect the systemic inflammatory response created by a tumor and is possibly predictive of tumor aggressiveness and propensity for metastasis.MethodsWe performed a single-center retrospective analysis of esophageal cancer patients who underwent attempted curative esophagectomy at Weill Cornell Medical Center between 1996 and 2009. We collected data on patient demographics, clinical characteristics, and receipt of neoadjuvant treatment. Preoperative blood tests were used to calculate NLR. Elevated NLR was defined a priori as ≥5.0. Logistic regression modeling was performed to analyze characteristics associated with elevated NLR. We conducted Kaplan-Meier analyses and Cox regression modeling to determine estimates and predictors of disease-free and overall survival.ResultsWe identified a total of 295 patients who underwent esophagectomy. The median duration of follow-up was 31 months (interquartile range [IQR] 13–61). There were 56 patients (18.9%) who had elevated NLR preoperatively. Receipt of neoadjuvant therapy was independently associated with high NLR (odds ratio [OR] 2.14, 95% confidence interval [95% CI] 1.02–4.51). In multivariable analyses, elevated NLR was associated with significantly worse disease-free (hazard ratio [HR] 2.26, 95% CI 1.43–3.55) and overall survival (HR 2.31, 95% CI 1.53–3.50).ConclusionsPreoperative NLR is a potential prognostic marker for recurrence and death after esophagectomy. It is unclear whether NLR reflects the degree of inflammatory response to the primary tumor or other patient-specific or tumor characteristics that predispose to recurrence. Further investigation is warranted to clarify the mechanisms explaining the observed associations between elevated NLR and poor outcomes in esophageal cancer.
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Jemal, A., Siegel, R., Ward, E., Hao, Y., Xu, J., & Thun, M. J. (2009) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.20006 · Cited by 9,709
Cited by
Templeton, A. J., McNamara, M. G., Šeruga, B., Vera-Badillo, F. E., Aneja, P., Ocaña, A., Leibowitz-Amit, R., Sonpavde, G., Knox, J. J., Tran, B., et al. (2014) · JNCI: Journal of the National Cancer Institute · doi:10.1093/jnci/dju124 · Cited by 2,829
Tong, Y.-S., Tan, J., Zhou, X.-L., Song, Y.-Q., & Song, Y.-J. (2017) · Journal of Translational Medicine · doi:10.1186/s12967-017-1326-1 · Cited by 233
Neutrophils: important contributors to tumor progression and metastasis
Swierczak, A., Mouchemore, K. A., Hamilton, J. A., & Anderson, R. L. (2015) · Cancer and Metastasis Reviews · doi:10.1007/s10555-015-9594-9 · Cited by 220
(2019) · PubMed Central · doi:10.22088/cjim.10.3.320 · Cited by 57
Metadata
- Authors
- Sharaiha, R. Z., Halazun, K. J., Mirza, F., Port, J. L., Lee, P. C., Neugut, A. I., Altorki, N. K., & Abrams, J. A.
- Venue
- Annals of Surgical Oncology
- Published
- 2011-05-06
- Volume
- 18
- Issue
- 12
- Pages
- 3362-3369
- ISSN
- 1068-9265 (ISSN-L)
- 1534-4681
- OpenAlex
- W2048083571
- Cited by
- 325
- References
- 1
- FWCI
- 9.38
- Type
- journal article
- Language
- en
- Open access
- green
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- CoChat. (2026). Citation check: Elevated Preoperative Neutrophil:Lymphocyte Ratio as a Predictor of Postoperative Disease Recurrence in Esophageal Cancer. https://app.cochat.ai/papers/10.1245/s10434-011-1754-8
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- Sharaiha, R. Z., Halazun, K. J., Mirza, F., Port, J. L., Lee, P. C., Neugut, A. I., Altorki, N. K., & Abrams, J. A. (2011). Elevated Preoperative Neutrophil:Lymphocyte Ratio as a Predictor of Postoperative Disease Recurrence in Esophageal Cancer. Annals of Surgical Oncology. https://doi.org/10.1245/s10434-011-1754-8
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