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Abstract

Introduction: Multimodal management of rectal cancer, combining neoadjuvant Radio chemotherapy followed by total Mesorectal therapy (TME), has been shown to improve locoregional control. However, the histological response is variable independently of the initial tumor stage. Some recent data suggest the usefulness of the lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) in predicting the histological response to neoadjuvant therapy. This study aimed to investigate the correlation between the complete histological response (pCR) after neoadjuvant radio chemotherapy and biological parameters (LMR, NLR and PLR) in rectal cancer patients.

PATIENTS AND METHODS: This retrospective study was conducted in three Moroccan Oncology centers, between June 1, 2015 and June 30, 2019. The authors included 64 cases of rectal adenocarcinoma treated initially by neoadjuvant radio chemotherapy followed by radical surgery (TME). We report sociodemographic, biological and histological parameters. All data were extracted from the hospital medical records by two trained physicians.

RESULTS: The complete histological remission ypT0N0 was reached on nine cases (14 %), with either a normal appearance of the rectal mucosa or necrotic tissue in the tumor bed without perennial residue, while the rest of patients still had tumor mass with minimal to moderate size regression or as a high-grade dysplasia-like tumor residue. The lymphocyte-to-monocyte ratio was high in 33,3% of pCR versus 52,7% in the cases of no remission (p=0,28), neutrophil-lymphocyte ratio was high in 55,6% of pCR versus 49,1% (p=0,71). The platelet-lymphocyte ratio was high in 55,6% of pCR versus 85,5% (p-value=0.03). CONCLUSION: In this study, we did not detect any significant correlation between LMR, NLR and the histological response in rectal cancer patients. However, the high level of PLR was statistically associated with a poor response.

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This work is licensed under a Creative Commons Attribution 4.0 License.

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