• In Hee Lee, Soyoon Hwang, Soo Jung Lee, Byung Woog Kang, Dongwon Baek, Hye Jin Kim, Su Yeon Park, Jun Seok Park, Gyu Seog Choi, Jae Chul Kim, Seung Hyun Cho, and Jong Gwang Kim.
• Department of Oncology/Hematology, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Kyungpook National University Cancer Research Institute, Daegu, Republic of Korea.
• Anticancer Res. 2017 Mar 1; 37 (3): 1459-1465.

AimSystemic inflammatory response (SIR) has been reported to be an important determinant of disease progression and survival in patients with colorectal cancer. This study investigated the prognostic relevance of changes in the platelet count on survival and the predictive value of changes in platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) on the pathological tumor response to preoperative chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC).Patients And MethodsFrom 2006 to 2015, 291 consecutive patients with LARC who were treated with preoperative CRT followed by curative surgery at the Kyungpook National University Medical Center (Daegu, Korea) were retrospectively analyzed. A cut-off value of 370×103/μl for the platelet count was used and a PLR ≥235 was defined as high. Any change in the PLR or NLR was calculated based on subtracting the pre-CRT PLR or NLR from the post-CRT values.ResultsA total of 17.5% patients had stage II and 82.5% had stage III LARC. Initially high NLR and PLR were significantly associated with poor clinical outcomes. Patients who maintained a high platelet count after CRT also had an advanced pathological stage (p=0.028), low pathological complete response rate (p=0.048), and high relapse rate (p=0.021). For patients with an initially low PLR, the multiple logistic regression analysis revealed that a high PLR change (odds ratio (OR)=2.301, 95% confidence interval (CI)=1.269-4.174; p=0.006) and clinical stage II compared to stage III (OR=1.878, 95% CI=1.231-2.865; p=0.003) were significant independent markers predictive of a good response to CRT.ConclusionThe present results suggest that platelet and PLR change after preoperative CRT, along with the initial platelet count, can be used as prognostic and predictive markers for the oncological outcomes in patients with LARC.Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

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