110P - Neutrophil to lymphocyte ratio as a predictor of poor prognosis in advanced esophageal cancer

Background

The neutrophil to lymphocyte ratio (NLR) reflects the balance between systemic inflammation and immunity and is emerging as a prognostic biomarker in many diseases. This study aimed to evaluate the prognostic impact of NLR in patients with advanced esophageal cancer.

Methods

A retrospective study of ninety-four stage IV esophageal cancer patients was conducted from January 2018 to December 2020. In our retrospective analysis, the pretreatment NLR of patients was calculated and analyzed. The Youden index was estimated to select the optimal cut-off value for NLR. Univariate and multivariate flexible parametric proportional hazards models with restricted cubic splines (RCS) were used to identify independent prognostic factors, and the Kaplan-Meier method was used to estimate survival curves.

Results

The median follow-up period was 5 months (ranging from 0.06 to 36.92 months). We determined 4.24 as the cut-off value by using the maximum Youden index. Subsequently, patients in the testing group were classified into high PNI and low PNI groups. Kaplan–Meier curves showed the high NLR group had significantly poorer overall survival (OS) than the low NLR group. Median OS in the high NLR group was 3.67 months compared with 7.21 months in the low PNI group (crude HR 1.80, 95% CI 1.14-2.82, p = 0.011). In the multivariate analysis, high NLR was an independent prognostic factor for OS (adjusted HR 1.91, 95% CI 1.15-3.17, p = 0.012).

Conclusions

Pretreatment NLR is a simplified biomarker useful for an independent prognostic factor in advanced stage esophageal cancer and would be easily integrated into clinical practice.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.