Cox S, et al. - The prognostic value of derived neutrophil–lymphocyte ratio (dNLR) in patients recruited to the SCOPE1 trial was examined. For overall survival (OS) and progression free survival (PFS) in oesophageal cancer patients treated with definitive chemoradiotherapy (dCRT), an elevated pre-treatment dNLR could be an independent prognostic biomarker. Data emphasized dNLR as a simple, inexpensive and readily available tool for risk-stratification, and suggested to consider its use in future oesophageal cancer clinical trials.

Methods

• Experts randomised 258 patients to receive dCRT±cetuximab.
• They measured Kaplan–Meier’s curves and both univariable and multivariable Cox regression models for overall survival (OS), progression free survival (PFS), local PFS inside the radiation volume (LPFSi), local PFS outside the radiation volume (LPFSo), and distant PFS (DPFS).

Results

• A significant link was noticed between an elevated pre-treatment dNLR≥2 and decreased OS in univariable (HR 1.74 [95% CI 1.29–2.35], p<0.001) and multivariable analyses (HR 1.64 [1.17–2.29], p=0.004).
• If dNLR<2, median OS was 36months (95% CI 27.8–42.4) and 18.4 months (95% CI 14.1–24.9) if dNLR≥2.
• With an elevated dNLR, all measures of PFS were also significantly reduced.
• Data displayed dNLR as prognostic for OS in cases of squamous cell carcinoma with a non-significant trend for adenocarcinoma/undifferentiated tumours.