Evidence map›Paper›PMID 40504413›Full record

ArticleJournal of gastrointestinal cancer2025

Response Prediction to Neoadjuvant Chemoradiotherapy in Rectal Cancer Based on Systemic Inflammatory Markers (NLR, PLR, and LMR).

Roger Beltrati Coser, Caio Sergio R Nahas, Alex Jones Flores Cassenote, Omar S T Ghani, Rafaela B B Pinheiro, Sergio Carlos Nahas, Carlos Frederico S Marques

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In one paragraph

Article in Journal of gastrointestinal cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Article
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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

7 authors.

Roger Beltrati CoserDepartment of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), Brazil. rogercos@hotmail.com.ORCID http://orcid.org/0000-0002-4548-0621
Caio Sergio R NahasDepartment of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Instituto do Câncer do Estado de São Paulo, São Paulo (SP), Brazil.
Alex Jones Flores CassenoteDepartment of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), Brazil.
Omar S T GhaniDepartment of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), Brazil.
Rafaela B B PinheiroHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Instituto do Câncer do Estado de São Paulo, São Paulo (SP), Brazil.
Sergio Carlos NahasDepartment of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Instituto do Câncer do Estado de São Paulo, São Paulo (SP), Brazil.
Carlos Frederico S MarquesDepartment of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Instituto do Câncer do Estado de São Paulo, São Paulo (SP), Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to evaluate whether systemic inflammatory markers-neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR)-can predict tumor response to neoadjuvant chemoradiotherapy (nCRT) in patients with rectal cancer.

methodsA retrospective, single-center study included 396 patients with biopsy-proven rectal cancer (clinical stage T2-4NxM0 or any T N + M0) treated with curative intent. All patients underwent standardized nCRT, followed by either radical surgery with total mesorectal excision (TME) or non-operative management in cases of sustained complete clinical response (cCR). Pre-treatment NLR, PLR, and LMR were calculated from baseline blood counts. Tumor response was categorized using tumor regression grade (TRG): TRG 0 (complete response), TRG 1 (almost complete), TRG 2 (partial), and TRG 3 (no response).

resultsIncomplete responders (TRG 1-3) had higher NLR (p < 0.001), PLR (p = 0.002), and carcinoembryonic antigen (CEA, p < 0.001), and were more frequently male (p = 0.021). Complete responders (TRG 0) were more associated with higher LMR (p < 0.001), elevated hemoglobin levels (p = 0.049), more comorbidities (p = 0.001), and greater use of antihypertensives (p = 0.012) and antiplatelet/anticoagulant drugs (p = 0.045). Risk estimates of incomplete response were as follows: NLR > 2.08 (RR 2.30, 95% CI 1.60-3.31), PLR > 129.36 (RR 1.79, 95% CI 1.25-2.05), and LMR > 2.67 (RR 0.42, 95% CI 0.26-0.66).

conclusionPre-treatment NLR, PLR, and LMR are predictors of response to nCRT in patients with rectal cancer. An NLR > 2.08 is an independent predictor of incomplete response to nCRT. These findings contribute a cost-effective and readily available tool to the rectal cancer management arsenal.

Indexed as

Blood PlateletsChemoradiotherapy, AdjuvantLymphocytesNeoadjuvant TherapyNeutrophilsRectal NeoplasmsAdultAgedBiomarkers, TumorFemaleHumansLymphocyte CountMaleMiddle AgedMonocytesPlatelet CountBiomarkers, TumorLymphocyte-to-monocyte ratio (LMR)Neoadjuvant therapyNeutrophil-to-lymphocyte ratio (NLR)Platelet-to-lymphocyte ratio (PLR)Rectal cancer

Identifiers

PMID40504413

What OpenQuestion holds

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Registered trials

None linked

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.