Prognostic significance of the neutrophil to lymphocyte ratio in patients with curative resection of esophageal cancer. A single center experience

AIM: In this study, we aimed to determine the clinical value and prognostic significance of the Neutrophil / LymphocyteRatio in patients undergoing curative surgery due to esophageal cancer.MATERIAL AND METHOD: Patients who underwent curative resection for esophageal cancer between 2015-2019 wereincluded in the study. Two groups, Group1 (low NLR) and Group2 (high NLR), were created. Demographic and clinical features, intraoperative and postoperative results, tumor characteristics and mean survival were compared in thegroups.RESULTS: A total of 48 patients participated in our study. Group 1 consisted of 18 patients and Group 2 consisted of30 patients. Male sex was dominant in both groups (66.7% vs 73.3%, p. 0.431). Preoperative CEA was higher inGroup 2 (3.97 vs 9.57, p. 0.032). Tumor diameter was larger in Group2 (3.33 vs 5.40 cm, p. 0.000). Adenocarcinomawas higher in Group 2 (33% vs 53.3%, p. 0.047), while squamous cell carcinoma was higher in Group 1 (66.7%vs 33.3%, p. 0.047). Lymph node positivity was higher in Group 2 (66.7% vs 93.3%, p. 0.024). The anastomosisleak was higher in Group 2 (0% vs 20%, p. 0.048). Postoperative hospital stay was longer in Group 2 (13.27 vs23.9 days, p. 0.009). 90-day readmission was higher in Group1 (33.3% vs 3.3%, p. 0.008). Survival duration wasshorter in Group 2 (29 vs 15 months, p. 0.005).CONCLUSION: This study revealed that preoperative high NLR was associated with poor survival, along with greatertumor diameter, increased lymph node metastasis rate, and increased anastomosis leakage in patients with esophagealcancer. These results suggest that modifying inflammatory responses and modulating the immune system may improve survival outcomes in patients with esophageal cancer.