The Postoperative Lymphocyte to Monocyte Ratio Change Predicts Poor Clinical Outcome in Patients with Esophageal Squamous Cell Carcinoma Undergoing Curative Resection

Abstract

Background. Postoperative lymphocyte to monocyte ratio (post-LMR) change (LMRc) reflects the dynamic change of balance between inflammatory reaction and immune reaction after curative operation. An elevated preoperative LMR (pre-LMR) has been shown to be a prognostic factor in patients with esophageal squamous cell carcinoma (ESCC), but the clinical value of the LMRc remains unknown. Methods. 674 patients in ESCC undergoing curative operation were enrolled in this study. LMRc (LMRc=pre-LMR-post-LMR) was counted on the basis of data within one week before and after operation. The median of LMRc was chosen to be the optimal cut-off value to evaluate the prognostic value of LMRc. Results. Kaplan-Meier curves revealed that LMRc≤1.59 was significantly associated with worse overall survival (OS) (P=0.003) and disease-free survival (DFS) (P=0.008). Multivariate analysis suggested that LMRc could serve as an independent prognostic predictor for both OS (P=0.006, HR=0.687, 95% CI 0.526-0.898) and DFS (P=0.003, HR=0.640, 95% CI 0.476-0.859). Conclusions. LMRc is a promising prognostic predictor for predicting the worse clinical outcome in patients with ESCC undergoing curative operation.