Predictive and prognostic value of inflammatory markers in locally advanced rectal cancer (PILLAR) – A multicentric analysis by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Gastrointestinal Study Group

• DOI: 10.1016/j.ctro.2023.100579
• Publication Date: 2023-01-12T07:35:10Z
• Authors: Giuditta Chiloiro; Angela Romano; Silvia Mariani; Gabriella Macchia; Diana Giannarelli; Luciana Caravatta; Pierfrancesco Franco; Luca Boldrini; Alessandra Arcelli; Almalina Bacigalupo; Liliana Belgioia; Antonella Fontana; Elisa Meldolesi; Giampaolo Montesi; Rita Marina Niespolo; Elisa Palazzari; Cristina Piva; Vincenzo Valentini; Maria Antonietta ...
• Keywords: Chemoradiotherapy

Patients (pts) affected with locally advanced rectal cancer (LARC) may respond differently to neoadjuvant chemoradiotherapy (nCRT). The identification of reliable biomarkers able predict oncological outcomes could help in the development risk-adapted treatment strategies. It has been suggested that inflammation parameters have a role predicting tumor response nCRT and survival cancer, but no definitive conclusion can be drawn at present. aim current study is evaluate baseline inflammatory markers as prognostic predictive factors large multicentric Italian cohort LARC pts.Patients diagnosed from January 2002 December 2019 9 centers were retrospectively collected. underwent long-course RT chemotherapy based on fluoropyrimidine ± oxaliplatin followed by surgery. Inflammatory retrieved pre-treatment blood sample including HEI (hemo-eosinophils index), SII (systemic index inflammation), NLR (neutrophil-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio) MLR (monocyte-to-lymphocyte ratio). Outcomes interest pathological complete (pCR), disease-free (DFS), overall (OS).808 pts analyzed. pCR rate was 22 %, 5yOS 5yDFS 84.0% 63.1% respectively. Multivariate analysis identified cut-off value >1.2 >500 (p = 0.05 0.009 respectively). In addition age, extramesorectal nodes dose, >0.18 0.03) 3 0.05) independent for DFS. Finally, >0.35 0.028) 0.045) predictors OS.Higher values composite serve lower rates worse patients undergoing nCRT. More data prospective studies lead integration these inexpensive easy-to-derive tools into clinical practice.