Evidence map›Paper›PMID 31277604›Full record

ArticleBMC cancer2019

Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as predictive and prognostic markers in patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation.

Shaan Dudani, Horia Marginean, Patricia A Tang, Jose G Monzon, Soundouss Raissouni, Timothy R Asmis, Rachel A Goodwin, Joanna Gotfrit, Winson Y Cheung, Michael M Vickers

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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  19. The Crying Need for a Better Response Assessment in Rectal Cancer.Current treatment options in oncology · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Shaan DudaniThe Ottawa Hospital Cancer Centre/University of Ottawa, Ottawa, Ontario, Canada. shaan.dudani@gmail.com.ORCID http://orcid.org/0000-0003-4958-381X
Horia MargineanThe Ottawa Hospital Cancer Centre/University of Ottawa, Ottawa, Ontario, Canada.
Patricia A TangAlberta Health Services/University of Calgary, Calgary, Alberta, Canada.
Jose G MonzonAlberta Health Services/University of Calgary, Calgary, Alberta, Canada.
Soundouss RaissouniAlberta Health Services/University of Calgary, Medicine Hat, Alberta, Canada.
Timothy R AsmisThe Ottawa Hospital Cancer Centre/University of Ottawa, Ottawa, Ontario, Canada.
Rachel A GoodwinThe Ottawa Hospital Cancer Centre/University of Ottawa, Ottawa, Ontario, Canada.
Joanna GotfritThe Ottawa Hospital Cancer Centre/University of Ottawa, Ottawa, Ontario, Canada.
Winson Y CheungBritish Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Michael M VickersThe Ottawa Hospital Cancer Centre/University of Ottawa, Ottawa, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA standard therapy for locally advanced rectal cancer (LARC) includes fluoropyrimidine (FP)-based neoadjuvant chemoradiation (nCRT). Previous studies have inconsistently demonstrated that baseline neutrophil- and platelet-to-lymphocyte ratios (NLR and PLR) are predictive of response to nCRT or prognostic of outcomes in LARC.

methodsWe reviewed patients with LARC undergoing nCRT followed by surgery from 2005 to 2013 across 8 Canadian cancer centres. Outcome measures of interest were pathological complete response (pCR), disease-free survival (DFS) and overall survival (OS). Logistic regression and Cox proportional hazard models were used to assess for associations between baseline hematologic variables and outcomes.

resultsOf 1527 identified patients, 1237 (81%) were included in the DFS/OS analysis. Median age was 62 (range 23-88), 69% were male, and 80% had performance status (PS) 0-1. Twenty-six percent had elevated NLR (≥ 4), and 66% had elevated PLR (≥ 150). Ninety-seven percent of patients received FP-based nCRT, with 96% receiving ≥44 Gy. 81% completed neoadjuvant chemotherapy and 95% completed neoadjuvant radiotherapy, with a pCR rate of 18%. After a median follow-up time of 71 months, 8% developed local recurrence, 22% developed distant recurrence and 24% died. 5-year DFS and OS were 69% (95% CI 66-72%) and 79% (95% CI 77-82%), respectively. In multivariate analyses, elevated baseline NLR and PLR were neither prognostic for DFS and OS nor predictive of pCR.

conclusionsNLR and PLR were not found to be independently prognostic for DFS or OS and did not predict for pCR in patients with LARC undergoing nCRT followed by surgery.

Indexed as

Blood PlateletsChemoradiotherapy, AdjuvantLymphocytesNeoadjuvant TherapyNeutrophilsAdultAgedAged, 80 and overBiomarkers, TumorCanadaDisease-Free SurvivalFemaleFollow-Up StudiesHumansLogistic ModelsLymphocyte Count5-fluoropyrimidineBiomarkers, TumorPyrimidinesBiomarkersInflammatory responsePathologic complete responsePersonalized medicineSurvival

Identifiers

PMID31277604
PMCPMC6612202

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.