Öz
Amaç: Rektal kanserlerin yaklaşık yarısı lokal ileri evrede tanı almaktadır. Neoadjuvan kemoradyoterapiyi takiben cerrahi uygulanan hastalarda patolojik tam yanıtı öngörecek biyobelirteçlerin saptanması önemlidir.
Gereç ve Yöntem: Retrospektif planlanan çalışmaya neoadjuvan kemoradyoterapiyi takiben cerrahi geçirmiş ve adjuvan kemoterapi almış lokal ileri evre rektum kanserli 205 hasta dahil edildi. Neoadjuvan tedavi öncesinde bakılan tam kan sayımında inflamatuvar biyobelirteçler çalışıldı.
Bulgular: Hastaların %20.5’inde patolojik tam yanıt saptandı. Nötrofil-lenfosit oranı, platelet-lenfosit oranı ve pan-immün inflamasyon değeri patolojik tam yanıt (+) grupta patolojik tam yanıt (-) gruptan anlamlı düşük bulundu. Pan-immün inflamasyon için cut-off ≤331.2 bulundu ve %90.4 ile en iyi tanısal test olarak saptandı.
Sonuç: Rektum kanserinde neoadjuvan kemoradyoterapi, sonrasında cerrahi ve adjuvan kemoterapi standart tedavi yaklaşımı olarak önemini korumaktadır. Patolojik tam yanıt onkolojik sonuçları iyileştirdiğinden; rektum kanserinde de patolojik tam yanıtı öngörecek biyobelirteçlerin bilinmesi önemlidir. Nötrofil-lenfosit oranı, platelet-lenfosit oranı ve pan-immün inflamasyon değeri patolojik tam yanıt (+) grupta anlamlı düşük saptandı ve pan-immün inflamasyon en iyi tanısal test olarak saptandı.
Anahtar Kelimeler
Rektum kanseri patolojik tam yanıt inflamatuvar biyobelirteçler pan-immün inflamasyon değeri
Destekleyen Kurum
yok
Proje Numarası
yok
Kaynakça
- Mazidimoradi A, Tiznobaik A, Salehiniya H. Impact of the covid-19 pandemic on colorectal cancer screening: a systematic review. J Gastrointest Cancer. 2022;53:730-44.
- Oronsky B, Reid T, Larson C, Knox SJ. Locally advanced rectal cancer: the past, present, and future. Semin Oncol. 2020;47:85-92.
- Bahadoer RR, Dijkstra EA, van Etten B, Marijnen CAM, Putter H, Kranenbarg EM et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. Lancet Oncol. 2021;22:29-42.
- Conroy T, Bosset JF, Etienne PL, Rio E, François É, Mesgouez-Nebout N et al. Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER-PRODIGE 23): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2021;22:702-15.
- Allegra CJ, Yothers G, O'Connell MJ, Beart RW, Wozniak TF, Pitot HC et al. Neoadjuvant 5-FU or capecitabine plus radiation with or without oxaliplatin in rectal cancer patients: a phase III randomized clinical trial. J Natl Cancer Inst. 2015;107:djv248.
- 6-Tang M, Gao X, Sun H, Tian S, Dong J, Liu Z et al. Neutrophil-lymphocyte ratio as a prognostic parameter in NSCLC patients receiving EGFR-TKIs: a systematic review and meta-analysis. J Oncol. 2021;2021:6688346.
- Li Q, Yu L, Yang P, Hu Q. Prognostic value of inflammatory markers in nasopharyngeal carcinoma patients in the intensity-modulated radiotherapy era. Cancer Manag Res. 2021;13:6799-6810.
- Timudom K, Akaraviputh T, Chinswangwatanakul V, Pongpaibul A, Korpraphong P, Petsuksiri J et al. Predictive significance of cancer related-inflammatory markers in locally advanced rectal cancer. World J Gastrointest Surg. 2020;12:390-396.
- Morrison L, Laukkanen JA, Ronkainen K, Kurl S, Kauhanen J, Toriola AT. Inflammatory biomarker score and cancer: a population-based prospective cohort study. BMC Cancer. 2016;16:80.
- Mandaliya H, Jones M, Oldmeadow C, Nordman II. Prognostic biomarkers in stage IV non-small cell lung cancer (NSCLC): neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR) and advanced lung cancer inflammation index (ALI). Transl Lung Cancer Res. 2019;8:886-94.
- Guven DC, Sahin TK, Erul E, Kilickap S, Gambichler T, Aksoy S. The association between the pan-immune-inflammation value and cancer prognosis: a systematic review and meta-analysis. Cancers (Basel). 2022;14:2675.
- Karakaya S, Karadağ İ, Yılmaz ME, Çakmak Öksüzoğlu ÖB. High neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and low lymphocyte levels are correlated with worse pathological complete response rates. Cureus. 2022;14:e22972.
- Khalfallah M, Dougaz W, Jerraya H, Nouira R, Bouasker I, Dziri C. Prognostic factors in rectal cancer: where is the evidence? Tunis Med. 2017;95:79-86.
- Garcia-Aguilar J, Chen Z, Smith DD, Li W, Madoff RD, Cataldo P et al. Identification of a biomarker profile associated with resistance to neoadjuvant chemoradiation therapy in rectal cancer. Ann Surg. 2011;254:486-92; discussion 492-3.
- Eraslan E, Adas YG, Yildiz F, Gulesen AI, Karacin C, Arslan UY. Systemic immune-inflammation index (SII) predicts pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer. J Coll Physicians Surg Pak. 2021;30:399-404.
- Kim TG, Park W, Kim H, Choi DH, Park HC, Kim SH et al. Baseline neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in rectal cancer patients following neoadjuvant chemoradiotherapy. Tumori. 2019;105:434-40.
- Ergen ŞA, Barlas C, Yıldırım C, Öksüz DÇ. Prognostic role of peripheral neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy. J Gastrointest Cancer. 2022;53:151-60.
- Shen L, Zhang H, Liang L, Li G, Fan M, Wu Y et al. Baseline neutrophil-lymphocyte ratio (≥2.8) as a prognostic factor for patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiation. Radiat Oncol. 2014;9:295.
- Hamid HKS, Emile SH, Davis GN. Prognostic significance of lymphocyte-to-monocyte and platelet-to-lymphocyte ratio in rectal cancer: a systematic review, meta-analysis, and meta-regression. Dis Colon Rectum. 2022;65:178-87.
- Yamamoto A, Toiyama Y, Okugawa Y, Oki S, Ide S, Saigusa S et al. Clinical implications of pretreatment: lymphocyte-to-monocyte ratio in patients with rectal cancer receiving preoperative chemoradiotherapy. Dis Colon Rectum. 2019;62:171-80.
- Wu QB, Wang M, Hu T, He WB, Wang ZQ. Prognostic role of the lymphocyte-to-monocyte ratio in patients undergoing resection for nonmetastatic rectal cancer. Medicine (Baltimore). 2016;95:e4945.
- Pérez-Martelo M, González-García A, Vidal-Ínsua Y, Blanco-Freire C, Brozos-Vázquez EM, Abdulkader-Nallib I et al. Clinical significance of baseline pan-immune-inflammation value and its dynamics in metastatic colorectal cancer patients under first-line chemotherapy. Sci Rep. 2022;12:6893.
- Yang XC, Liu H, Liu DC, Tong C, Liang XW, Chen RH. Prognostic value of pan-immune-inflammation value in colorectal cancer patients: a systematic review and meta-analysis. Front Oncol. 2022;12:1036890.
- Şahin AB, Cubukcu E, Ocak B, Deligonul A, Oyucu Orhan S, Tolunay S et al. Low pan-immune-inflammation-value predicts better chemotherapy response and survival in breast cancer patients treated with neoadjuvant chemotherapy. Sci Rep. 2021;11:14662
Öz
Purpose: Approximately half of rectal cancer cases are diagnosed at a locally advanced stage. It is important to identify biomarkers that can predict pathological complete response in patients undergoing surgery following neoadjuvant chemoradiotherapy.
Materials and Methods: This retrospective study included 205 patients with locally advanced rectal cancer who underwent surgery and adjuvant chemotherapy following neoadjuvant chemoradiotherapy. Inflammatory biomarkers were assayed in the complete blood count before neoadjuvant therapy.
Results: A pathological complete response was detected in 20.5% of the patients. The neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and pan-immune inflammation value were significantly lower in the pathological complete response (+) group than in the pathological complete response (-) group. The cut-off of the pan-immune inflammation value was ≤ 331.2, and this parameter had the best diagnostic performance of 90.4%.
Conclusion: Neoadjuvant chemoradiotherapy followed by surgery and adjuvant chemotherapy remains the standard treatment approach for rectal cancer. Since pathological complete response improves oncological outcomes, it is important to identify biomarkers that can predict pathological complete response in rectal cancer
Anahtar Kelimeler
rectal cancer pathological complete response inflammatory biomarkers pan-immune inflammation value
Proje Numarası
yok
Kaynakça
- Mazidimoradi A, Tiznobaik A, Salehiniya H. Impact of the covid-19 pandemic on colorectal cancer screening: a systematic review. J Gastrointest Cancer. 2022;53:730-44.
- Oronsky B, Reid T, Larson C, Knox SJ. Locally advanced rectal cancer: the past, present, and future. Semin Oncol. 2020;47:85-92.
- Bahadoer RR, Dijkstra EA, van Etten B, Marijnen CAM, Putter H, Kranenbarg EM et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. Lancet Oncol. 2021;22:29-42.
- Conroy T, Bosset JF, Etienne PL, Rio E, François É, Mesgouez-Nebout N et al. Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER-PRODIGE 23): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2021;22:702-15.
- Allegra CJ, Yothers G, O'Connell MJ, Beart RW, Wozniak TF, Pitot HC et al. Neoadjuvant 5-FU or capecitabine plus radiation with or without oxaliplatin in rectal cancer patients: a phase III randomized clinical trial. J Natl Cancer Inst. 2015;107:djv248.
- 6-Tang M, Gao X, Sun H, Tian S, Dong J, Liu Z et al. Neutrophil-lymphocyte ratio as a prognostic parameter in NSCLC patients receiving EGFR-TKIs: a systematic review and meta-analysis. J Oncol. 2021;2021:6688346.
- Li Q, Yu L, Yang P, Hu Q. Prognostic value of inflammatory markers in nasopharyngeal carcinoma patients in the intensity-modulated radiotherapy era. Cancer Manag Res. 2021;13:6799-6810.
- Timudom K, Akaraviputh T, Chinswangwatanakul V, Pongpaibul A, Korpraphong P, Petsuksiri J et al. Predictive significance of cancer related-inflammatory markers in locally advanced rectal cancer. World J Gastrointest Surg. 2020;12:390-396.
- Morrison L, Laukkanen JA, Ronkainen K, Kurl S, Kauhanen J, Toriola AT. Inflammatory biomarker score and cancer: a population-based prospective cohort study. BMC Cancer. 2016;16:80.
- Mandaliya H, Jones M, Oldmeadow C, Nordman II. Prognostic biomarkers in stage IV non-small cell lung cancer (NSCLC): neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR) and advanced lung cancer inflammation index (ALI). Transl Lung Cancer Res. 2019;8:886-94.
- Guven DC, Sahin TK, Erul E, Kilickap S, Gambichler T, Aksoy S. The association between the pan-immune-inflammation value and cancer prognosis: a systematic review and meta-analysis. Cancers (Basel). 2022;14:2675.
- Karakaya S, Karadağ İ, Yılmaz ME, Çakmak Öksüzoğlu ÖB. High neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and low lymphocyte levels are correlated with worse pathological complete response rates. Cureus. 2022;14:e22972.
- Khalfallah M, Dougaz W, Jerraya H, Nouira R, Bouasker I, Dziri C. Prognostic factors in rectal cancer: where is the evidence? Tunis Med. 2017;95:79-86.
- Garcia-Aguilar J, Chen Z, Smith DD, Li W, Madoff RD, Cataldo P et al. Identification of a biomarker profile associated with resistance to neoadjuvant chemoradiation therapy in rectal cancer. Ann Surg. 2011;254:486-92; discussion 492-3.
- Eraslan E, Adas YG, Yildiz F, Gulesen AI, Karacin C, Arslan UY. Systemic immune-inflammation index (SII) predicts pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer. J Coll Physicians Surg Pak. 2021;30:399-404.
- Kim TG, Park W, Kim H, Choi DH, Park HC, Kim SH et al. Baseline neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in rectal cancer patients following neoadjuvant chemoradiotherapy. Tumori. 2019;105:434-40.
- Ergen ŞA, Barlas C, Yıldırım C, Öksüz DÇ. Prognostic role of peripheral neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy. J Gastrointest Cancer. 2022;53:151-60.
- Shen L, Zhang H, Liang L, Li G, Fan M, Wu Y et al. Baseline neutrophil-lymphocyte ratio (≥2.8) as a prognostic factor for patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiation. Radiat Oncol. 2014;9:295.
- Hamid HKS, Emile SH, Davis GN. Prognostic significance of lymphocyte-to-monocyte and platelet-to-lymphocyte ratio in rectal cancer: a systematic review, meta-analysis, and meta-regression. Dis Colon Rectum. 2022;65:178-87.
- Yamamoto A, Toiyama Y, Okugawa Y, Oki S, Ide S, Saigusa S et al. Clinical implications of pretreatment: lymphocyte-to-monocyte ratio in patients with rectal cancer receiving preoperative chemoradiotherapy. Dis Colon Rectum. 2019;62:171-80.
- Wu QB, Wang M, Hu T, He WB, Wang ZQ. Prognostic role of the lymphocyte-to-monocyte ratio in patients undergoing resection for nonmetastatic rectal cancer. Medicine (Baltimore). 2016;95:e4945.
- Pérez-Martelo M, González-García A, Vidal-Ínsua Y, Blanco-Freire C, Brozos-Vázquez EM, Abdulkader-Nallib I et al. Clinical significance of baseline pan-immune-inflammation value and its dynamics in metastatic colorectal cancer patients under first-line chemotherapy. Sci Rep. 2022;12:6893.
- Yang XC, Liu H, Liu DC, Tong C, Liang XW, Chen RH. Prognostic value of pan-immune-inflammation value in colorectal cancer patients: a systematic review and meta-analysis. Front Oncol. 2022;12:1036890.
- Şahin AB, Cubukcu E, Ocak B, Deligonul A, Oyucu Orhan S, Tolunay S et al. Low pan-immune-inflammation-value predicts better chemotherapy response and survival in breast cancer patients treated with neoadjuvant chemotherapy. Sci Rep. 2021;11:14662
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma |
| Yazarlar | |
| Proje Numarası | yok |
| Erken Görünüm Tarihi | 10 Temmuz 2023 |
| Yayımlanma Tarihi | 2 Temmuz 2023 |
| Kabul Tarihi | 27 Mayıs 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 48 Sayı: 2 |
