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Prognostic significance of inflammatory-related parameters in patients with anal canal cancer

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

To investigate the correlation between inflammatory-related parameters and overall survival (OS) and disease-free survival (DFS) in anal canal cancer population.

Methods and materials

Patients diagnosed with anal canal carcinoma and treated with curative intent chemoradiotherapy (CRT) were included. Data about pre-treatment complete blood count were collected. Neutrophil to lymphocyte ratio (NLR), fibrinogen (F), and a combination of these (F-NLR score) were correlated with OS.

Results

A total of 58 patients were enrolled. In multivariate analysis, the strongest OS prognostic factor was NLR, with a hazard ratio (HR) for low NLR compared to high NLR of 1.30 (95% confidence interval 1.01–14.12). Kaplan-Meier survival analysis showed that patients with high NLR, F, and F-NLR had significantly shorter OS and DFS.

Conclusion

To our knowledge, this is the first study providing evidence that elevated pre-treatment NLR, F, and F-NLR score significantly correlate with worse survival outcomes in patients with anal canal carcinoma. In view of our findings, future clinical trials in anal canal cancer patients are warranted to verify our results.

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References

  1. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Anal carcinoma version 2.2018. http://www.nccn.org/. Accessed June 2018

  2. Ji R, Ren Q, Bai S, Wang Y, Zhou Y (2018) Prognostic significance of pretreatment plasma fibrinogen level in patients with digestive system tumors: a meta-analysis. Int J Biol Markers 1724600818773627

  3. Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA Cancer J Clin 68(1):7–30

    Article  Google Scholar 

  4. Surveillance, Epidemiology, and End Results (SEER) Program. Cancer stat facts: anal cancer https://seer.cancer.gov/statfacts/html/anus.html. Accessed June 2018

  5. Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, Leibowitz-Amit R, Sonpavde G, Knox JJ, Tran B, Tannock IF, Amir E (2014) Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst 106(6):dju124

    Article  CAS  Google Scholar 

  6. Peng B, Wang YH, Liu YM, Ma LX (2015) Prognostic significance of the neutrophil to lymphocyte ratio in patients with non-small cell lung cancer: a systemic review and meta-analysis. Int J Clin Exp Med 8(3):3098–3106

    PubMed  PubMed Central  Google Scholar 

  7. Hu K, Lou L, Ye J, Zhang S (2015) Prognostic role of the neutrophil-lymphocyte ratio in renal cell carcinoma: a meta-analysis. BMJ Open 5(4):e006404

    Article  PubMed  PubMed Central  Google Scholar 

  8. Marchetti C, Romito A, Musella A, Santo G, Palaia I, Perniola G, Di Donato V, Muzii L, Benedetti Panici P (2018) Combined plasma fibrinogen and neutrophil lymphocyte ratio in ovarian cancer prognosis may play a role? Int J Gynecol Cancer 28(5):939–944

    Article  PubMed  Google Scholar 

  9. Perisanidis C, Psyrri A, Cohen EE, Engelmann J, Heinze G, Perisanidis B, Stift A, Filipits M, Kornek G, Nkenke E (2015) Prognostic role of pretreatment plasma fibrinogen in patients with solid tumors: a systematic review and meta-analysis. Cancer Treat Rev 41(10):960–970

    Article  CAS  PubMed  Google Scholar 

  10. Amin MB (2017) AJCC cancer staging manual. Eight Edition. https://doi.org/10.1007/978-3-319-40618-3_21

  11. De Felice F, Martinetti MT, Orelli S, Bulzonetti N, Musio D, Tombolini V (2018) Definitive chemoradiotherapy for anal carcinoma: long-term results based on consistent time-to-event endpoints. Oncology 94(1):25–30

    Article  CAS  PubMed  Google Scholar 

  12. Musio D, De Felice F, Raffetto N, Tombolini V (2014) Management of persistent anal canal carcinoma after combined-modality therapy: a clinical review. Radiat Oncol 9:39

    Article  PubMed  PubMed Central  Google Scholar 

  13. Clauss A (1957) Rapid physiological coagulation method in determination of fibrinogen. Acta Haematol 17(4):237–246

    Article  CAS  PubMed  Google Scholar 

  14. Toh E, Wilson J, Sebag-Montefiore D, Botterill I (2014) Neutrophil:lymphocyte ratio as a simple and novel biomarker for prediction of locoregional recurrence after chemoradiotherapy for squamous cell carcinoma of the anus. Color Dis 16(3):O90–O97

    Article  CAS  Google Scholar 

  15. Luo Y, She DL, Xiong H, Fu SJ, Yang L (2015) Pretreatment neutrophil to lymphocyte ratio as a prognostic predictor of urologic tumors: a systematic review and meta-analysis. Medicine (Baltimore) 94(40):e1670

    Article  Google Scholar 

  16. Sun W, Zhang L, Luo M, Hu G, Mei Q, Liu D, Long G, Hu G (2016) Pretreatment hematologic markers as prognostic factors in patients with nasopharyngeal carcinoma: neutrophil-lymphocyte ratio and platelet-lymphocyte ratio. Head Neck 38(Suppl 1):E1332–E1340

    Article  PubMed  Google Scholar 

  17. Wang H, Zhao J, Zhang M, Han L, Wang M, Xingde L (2018) The combination of plasma fibrinogen and neutrophil lymphocyte ratio (F-NLR) is a predictive factor in patients with resectable non small cell lung cancer. J Cell Physiol 233(5):4216–4224

    Article  CAS  PubMed  Google Scholar 

  18. Kijima T, Arigami T, Uchikado Y, Uenosono Y, Kita Y, Owaki T, Mori S, Kurahara H, Kijima Y, Okumura H, Maemura K, Ishigami S, Natsugoe S (2017) Combined fibrinogen and neutrophil-lymphocyte ratio as a prognostic marker of advanced esophageal squamous cell carcinoma. Cancer Sci 108(2):193–199

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Arigami T, Uenosono Y, Ishigami S, Okubo K, Kijima T, Yanagita S, Okumura H, Uchikado Y, Kijima Y, Nakajo A, Kurahara H, Kita Y, Mori S, Maemura K, Natsugoe S (2016) A novel scoring system based on fibrinogen and the neutrophil-lymphocyte ratio as a predictor of chemotherapy response and prognosis in patients with advanced gastric cancer. Oncology 90(4):186–192

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiotherapy, Policlinico Umberto I, “Sapienza” University of Rome, Viale Regina Elena 326, 00161, Rome, Italy

    Francesca De Felice, Filippo Lorenzo Rubini, Luca Romano, Nadia Bulzonetti, Rossella Caiazzo, Daniela Musio & Vincenzo Tombolini

Authors
  1. Francesca De Felice
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  2. Filippo Lorenzo Rubini
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  3. Luca Romano
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  4. Nadia Bulzonetti
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  5. Rossella Caiazzo
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  6. Daniela Musio
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  7. Vincenzo Tombolini
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Corresponding author

Correspondence to Francesca De Felice.

Ethics declarations

The protocol was reviewed and approved by the institutional review board and the scientific review committee. Written informed consent was obtained from all patients before the initiation of therapy.

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The authors declare that they have no conflict of interest.

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De Felice, F., Rubini, F.L., Romano, L. et al. Prognostic significance of inflammatory-related parameters in patients with anal canal cancer. Int J Colorectal Dis 34, 519–525 (2019). https://doi.org/10.1007/s00384-018-03225-7

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  • DOI: https://doi.org/10.1007/s00384-018-03225-7

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