caa a22 4500 445334614 CHVBK 20180317142750.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1245/s10434-011-1754-8 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1754-8 Elevated Preoperative Neutrophil:Lymphocyte Ratio as a Predictor of Postoperative Disease Recurrence in Esophageal Cancer [Elektronische Daten] [Reem Sharaiha, Karim Halazun, Farooq Mirza, Jeffrey Port, Paul Lee, Alfred Neugut, Nasser Altorki, Julian Abrams] Background: The 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. Methods: We 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. Results: We identified a total of 295 patients who underwent esophagectomy. The median duration of follow-up was 31months (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). Conclusions: Preoperative 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. Society of Surgical Oncology, 2011 Sharaiha Reem Department of Medicine, Columbia University Medical Center, New York, NY, USA aut Halazun Karim Department of Surgery, Columbia University Medical Center, New York, NY, USA aut Mirza Farooq Division of Thoracic Surgery, Weill Cornell Medical Center, New York, NY, USA aut Port Jeffrey Division of Thoracic Surgery, Weill Cornell Medical Center, New York, NY, USA aut Lee Paul Division of Thoracic Surgery, Weill Cornell Medical Center, New York, NY, USA aut Neugut Alfred Department of Medicine, Columbia University Medical Center, New York, NY, USA aut Altorki Nasser Division of Thoracic Surgery, Weill Cornell Medical Center, New York, NY, USA aut Abrams Julian Department of Medicine, Columbia University Medical Center, New York, NY, USA aut Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3362-3369 1068-9265 18:12<3362 2011 18 10434 https://doi.org/10.1245/s10434-011-1754-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1754-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sharaiha Reem Department of Medicine, Columbia University Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Halazun Karim Department of Surgery, Columbia University Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Mirza Farooq Division of Thoracic Surgery, Weill Cornell Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Port Jeffrey Division of Thoracic Surgery, Weill Cornell Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Lee Paul Division of Thoracic Surgery, Weill Cornell Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Neugut Alfred Department of Medicine, Columbia University Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Altorki Nasser Division of Thoracic Surgery, Weill Cornell Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Abrams Julian Department of Medicine, Columbia University Medical Center, New York, NY, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3362-3369 1068-9265 18:12<3362 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer