Predictive Value Of LMR On Tumor Regression In Esophageal Squamous Cell Carcinoma Receiving Neoadjuvant Chemoradiotherapy

Aim:Preoperative neoadjuvant chemoradiotherapy combined with radical resection of esophageal cancer is the standard treatment for locally advanced esophageal squamous cell carcinoma(ESCC),but there is a lack of objective indicators to effectively predict tumor regression after neoadjuvant chemoradiotherapy.The lymphocyte/monocyte ratio(LMR)has been associated with the prognosis of patients with esophageal squamous cell carcinoma.The purpose of this study was to evaluate whether LMR can predict tumor regression in patients with locally advanced esophageal squamous cell carcinoma(ESCC)who accepted neoadjuvant chemoradiotherapy.Methods:In this study,77 patients with locally advanced esophageal squamous cell carcinoma who accepted neoadjuvant chemoradiotherapy in our hospital from January 2018 to December 2020 were analyzed retrospectively.Taking the good tumor regression as the state variable,the optimal cut off value of the continuous variable LMR was determined by the receiver operating characteristic curve(ROC).The main end point of the study was good tumor regression.Univariate and multivariate logistic regression were intended to analyze whether LMR and other factors were good independent predictors of tumor regression.Results:Of the 77 patients,54(70.1%)achieved good tumor regression.The area under the ROC curve of the LMR before neoadjuvant was 0.666(P=0.022),and the optional cut-off value was 2.3 8.Multi variate logistic regression analysis showed that the tumor regression effect of the preoperative interval of 6 to 8 weeks was significantly better than that of the treatment group with an interval of less than 6 weeks(P=0.007,OR=8.493,95%confidence interval:1.811—39.822).Univariate and multivariate logistic regression analysis revealed that patients with a high level of LMR(LMR>2.38)before neoadjuvant were more likely to have a good tumor regression(P=0.003,OR=6.29,95%confidence interval:1.907—20.747).Conclusion:LMR and preoperative interval are independent predictors of tumor regression in patients with esophageal squamous cell carcinoma.Patients with esophageal squamous cell carcinoma who has high LMR(>2.38)before neoadjuvant and received surgery within 6 to 8 weeks after the end of neoadjuvant chemoradiotherapy were more likely to achieve good tumor regression.