Leukocytosis and neutrophilia predicts outcome in anal cancer

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• 作者：Antoine Schernberg^a ; Alexandre Escande^a ; Eleonor Rivin Del Campo^a ; Michel Ducreux^b ; ^c ; France Nguyen^a ; Diane Goere^d ; Cyrus Chargari^a ; ^e ; ^f ; ^g ; Eric Deutsch^a ; ^b ; ^e ; ^{eric.deutsch@gustaveroussy.fr}
• 关键词：5FU ; 5-fluorouracil ; AJCC ; American Joint Committee on Cancer ; CRP ; C &ndash ; reactive protein ; DFS ; distant failure free survival ; CTV ; clinical target volume ; EBRT ; external beam radiotherapy ; G-CSF ; granulocyte colony-stimulating factor ; GTV ; growth tumor volume ; Gy ; gray ; HIV ; Human Immunodeficiency Virus ; HPV ; human papillomavirus ; IMRT ; intensity-modulated radiotherapy ; LFS ; locoregional failure free survival ; MRI ; magnetic-resonance imaging ; MV ; mega voltage ; NLR ; neutrophils to lymphocyt
• 刊名：Radiotherapy and Oncology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：122
• 期：1
• 页码：137-145
• 全文大小：932 K
• 卷排序：122

文摘

Leukocytosis and neutrophilia could be the tip of the iceberg in the inflammatory tumor microenvironment. We aimed to validate their prognostic significance in a cohort of patients treated with definitive chemoradiation for anal squamous cell carcinoma (SCC).Materials & methodsClinical records from all consecutive patients treated in a single institution between 2006 and 2016 with curative-intent radiotherapy were retrospectively analyzed. Leukocytosis and neutrophilia, defined as leukocyte or neutrophil count over 10,000 and 7500/mm3, respectively, were studied in terms of overall survival (OS), progression (PFS), locoregional (LFS) and distant (DFS)-free survival.ResultsWe identified 103 non-metastatic HIV-negative patients, with concurrent chemotherapy use in 78%. Twelve and 8% displayed baseline leukocytosis and neutrophilia, respectively. Estimated 3-year OS and PFS were 88% and 67%, respectively. In univariate analysis, both leukocytosis and neutrophilia were strongly associated with inferior OS, PFS, LFS and DFS (p < 0.01). In multivariate analysis, leukocytosis and neutrophilia remained strongly associated with patient outcome (p < 0.01), independently from tumor T and N-stage. Anemia was an independent predictor of worse OS and PFS, while chemoradiation overall treatment time below 50 days improved PFS.ConclusionLeukocytosis and neutrophilia are strong prognostic factors for OS, PFS, LFS and DFS in anal cancer treated with chemoradiation. These biomarkers could help identify patients with higher risk of tumor relapse that require treatment intensification.