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Cancer Invest. 2016;34(9):440-451. Epub 2016 Oct 14.

Neutrophil to Lymphocyte Ratio (NLR) and Derived Neutrophil to Lymphocyte Ratio (d-NLR) Predict Non-Responders and Postoperative Complications in Patients Undergoing Radical Surgery After Neo-Adjuvant Radio-Chemotherapy for Rectal Adenocarcinoma.

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a Department of General Surgery , University Campus Bio-Medico di Roma , Rome , Italy.
b International PhD Programme in Endocrinology and Metabolic Diseases, University Campus Bio-Medico di Roma , Rome , Italy.
c Department of Radiation Oncology , University Campus Bio-Medico di Roma , Rome , Italy.


In order to evaluate neutrophil-to-lymphocyte ratio (NLR) and derived neutrophil-to-lymphocyte ratio (d-NLR) in predicting response and complications in rectal cancer patients who underwent surgery after neo-adjuvant radio-chemotherapy, 87 patients were evaluated. Cutoffs before and after radio-chemotherapy were respectively 2.8 and 3.8 for NLR, and 1.4 and 2.3 for d-NLR. They were analyzed in relation to clinical and pathological outcomes. Patients with preoperative NLR and d-NLR higher than cutoffs had significantly higher rates of tumor regression grade response (TRG ≥ 4) and postoperative complications. Elevated NLR and d-NLR after radio-chemotherapy are associated with worse pathological and clinical outcome.


colorectal and anal cancer; detection/diagnosis; prognosis and response predictions

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