The lymphocyte–monocyte ratio predicts tumor response and survival in patients with locally advanced esophageal cancer who received definitive chemoradiotherapy

Figures & data

Table 1 Relationship between pretreatment LMR and clinicopathological parameters in patients with ESCC who received definitive chemoradiotherapy

Clinicopathological parameters	Cases (n=162)	LMR ≤4.02	LMR >4.02	P-value
Gender				1.000
Female	35 (21.6%)	18	17
Male	127 (78.4%)	63	64
Age, years				0.024
≤60	63 (38.9%)	24	39
>60	99 (61.1%)	57	42
Drinking history				0.090
Ever	51 (31.5%)	31	20
Never	111 (68.5%)	50	61
Smoking history				1.000
Ever	97 (59.9%)	49	48
Never	65 (40.1%)	32	33
Tumor location				0.735
Upper, mid	51 (31.5%)	24	27
Lower, GE junction	111 (68.5%)	57	54
cT status				0.228
T1–3	114 (70.4%)	53	61
T4	48 (29.6%)	28	20
cN status				0.176
N0	34 (21.0%)	13	21
N1–3	128 (79.0%)	68	60
Tumor stage				0.018
II	33 (20.4%)	10	23
III	129 (79.6%)	71	58
Tumor response				<0.001
CR	48 (29.6%)	12	36
Not CR	114 (70.4%)	69	45

Note: Bold values are significant (P<0.05).

Abbreviations: CR, complete response; ESCC, esophageal squamous cell carcinoma; GE, gastroesophageal; LMR, lymphocyte–monocyte ratio; cT, clinical tumor stage; cN, clinical node stage.

Table 2 Univariate and multivariate analyses for tumor response (CR and non-CR)

Parameters	Tumor response		Univariate analysis
	CR (n=48)	Non-CR (n=114)	P-value
cT status			0.053
T1–3	39	75
T4	9	39
cN status			0.523
N0	8	24
N1–3	40	90
Tumor stage			0.279
II	12	20
III	36	94
Neutrophils (×10^9/L)	3.97±1.27	4.30±1.52	0.187
Platelets (×10^9/L)	207.75±55.34	230.21±59.42	0.029
Monocytes (×10^9/L)	0.46±0.17	0.52±0.200	0.052
Lymphocytes (×10^9/L)	2.00±0.84	1.69±0.58	0.018
%Lymphocytes in WBC	29.83%±8.43%	26.01%±6.95%	0.004
LMR	4.89±1.17	3.87±1.29	<0.001

Note: Bold values are significant (P<0.05).

Abbreviations: CR, complete response; cT, clinical tumor stage; cN, clinical node stage; LMR, lymphocyte–monocyte ratio; WBC, white blood cell.

Table 3 Multivariate analysis for tumor response (CR and non-CR)

Parameters	Model 1		Model 2
	HR (95% CI)	P-value	HR (95% CI)	P-value
Platelets	1.01 (1.00–1.02)	0.051	1.01 (1.00–1.01)	0.160
Lymphocytes	0.59 (0.31–1.13)	0.112	–	–
%Lymphocytes in WBC	–	–	0.97 (0.92–1.03)	0.327
LMR	0.63 (0.46–0.87)	0.006	0.60 (0.43–0.82)	0.002

Note: Bold values are significant (P<0.05).

Abbreviations: CR, complete response; HR, hazard ratio; LMR, lymphocyte–monocyte ratio; WBC, white blood cell.

Figure 1 Kaplan–Meier curves for patients with low and high LMR.

Notes: (A) Kaplan–Meier curves for PFS and (B) Kaplan–Meier curves for OS.
Abbreviation: LMR, lymphocyte–monocyte ratio.

Table 4 Univariate analysis of factors associated with PFS and OS

Parameter	PFS		OS
	HR (95% CI)	P-value	HR (95% CI)	P-value
Gender (female/male)	1.20 (0.16–0.21)	0.347	1.83 (0.22–0.30)	0.264
Age (≤60/>60)	1.76 (0.15–0.22)	0.333	1.61 (0.26–0.32)	0.818
Drinking history (ever/never)	1.31 (0.57–0.74)	0.701	1.53 (0.29–0.41)	0.816
Smoking history (ever/never)	1.34 (0.16–0.21)	0.698	1.21 (0.26–0.31)	0.548
Tumor location (upper, mid/low, GE)	1.35 (0.68–1.57)	0.867	1.42 (0.28–0.35)	0.596
cT status (T1–3/T4)	1.33 (0.17–0.22)	<0.001	1.21 (0.28–0.33)	0.006
cN status (negative/positive)	2.03 (0.15–0.22)	0.730	2.26 (0.25–0.34)	0.873
Tumor stage (II, III)	2.27 (0.19–0.28)	0.013	2.20 (0.29–0.38)	0.017
Response (CR/not CR)	1.98 (0.21–0.29)	<0.001	1.59 (0.30–0.37)	<0.001
LMR (≤4.02/>4.02)	1.21 (0.10–0.15)	<0.001	1.25 (0.22–0.27)	<0.001

Note: Bold values are significant (P<0.05).

Abbreviations: CR, complete response; cT, clinical tumor stage; cN, clinical node stage; GE, gastroesophageal; HR, hazard ratio; LMR, lymphocyte–monocyte ratio; PFS, progress-free survival; OS, overall survival.

Table 5 Multivariate analysis of factors associated with PFS and OS

Parameters	PFS		OS
	HR (95% CI)	P-value	HR (95% CI)	P-value
cT status	0.58 (0.39–0.86)	0.007	0.70 (0.44–1.12)	0.137
Tumor stage	0.70 (0.41–1.21)	0.200	0.52 (0.28–0.97)	0.041
Tumor response	0.51 (0.32–0.81)	0.004	0.52 (0.31–0.88)	0.016
LMR	2.17 (1.46–3.23)	<0.001	2.02 (1.29–3.18)	0.002

Note: Bold values are significant (P<0.05).

Abbreviations: cT, clinical tumor stage; HR, hazard ratio; LMR, lymphocyte–monocyte ratio; PFS, progress-free survival; OS, overall survival.