Prognostic significance of inflammatory-related parameters in patients with anal canal cancer

Int J Colorectal Dis. 2019 Mar;34(3):519-525. doi: 10.1007/s00384-018-03225-7. Epub 2019 Jan 7.

Abstract

Purpose: To investigate the correlation between inflammatory-related parameters and overall survival (OS) and disease-free survival (DFS) in anal canal cancer population.

Methods and materials: Patients diagnosed with anal canal carcinoma and treated with curative intent chemoradiotherapy (CRT) were included. Data about pre-treatment complete blood count were collected. Neutrophil to lymphocyte ratio (NLR), fibrinogen (F), and a combination of these (F-NLR score) were correlated with OS.

Results: A total of 58 patients were enrolled. In multivariate analysis, the strongest OS prognostic factor was NLR, with a hazard ratio (HR) for low NLR compared to high NLR of 1.30 (95% confidence interval 1.01-14.12). Kaplan-Meier survival analysis showed that patients with high NLR, F, and F-NLR had significantly shorter OS and DFS.

Conclusion: To our knowledge, this is the first study providing evidence that elevated pre-treatment NLR, F, and F-NLR score significantly correlate with worse survival outcomes in patients with anal canal carcinoma. In view of our findings, future clinical trials in anal canal cancer patients are warranted to verify our results.

Keywords: Anal carcinoma; Fibrinogen; Lymphocyte; Neutrophil; Radiotherapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anus Neoplasms / diagnosis*
  • Anus Neoplasms / surgery*
  • Disease-Free Survival
  • Female
  • Fibrinogen / metabolism
  • Humans
  • Inflammation / pathology*
  • Lymphocytes / pathology
  • Male
  • Middle Aged
  • Neutrophils / pathology
  • Prognosis
  • Survival Analysis

Substances

  • Fibrinogen

Supplementary concepts

  • Anal Canal Carcinoma