The Relationship Between Pre-Treatment Inflammatory Markers and Mandard Tumor Regression Scale in Operated Locally Advanced Rectal Adenocarcinoma Patients Treated with Neoadjuvant Chemoradiotherapy

Neoadjuvan Kemoradyoterapi ile Tedavi Edilen Lokal İleri Rektal Adenokarsinom Hastalarında Tedavi Öncesi Enflamatuar Belirteçler ile Mandard Tümör Regresyon Ölçeği Arasındaki İlişkiBackground: To evaluate the relationship between pre-treatment inflammatory markers and Mandard tumor regression grade in locally advanced rectal cancer (LARC) patients who underwent surgery after neoadjuvant chemoradiotherapy (nCRT). Materials and Methods:This single-center study included patients who underwent nCRT followed by curative surgery for rectal adenocarcinoma between 2015 and 2022.The relationship between pre-treatment neutrophil-to-lymphocyte ratio (NLR), plateletto-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), neutrophil-to-eosinophil ratio (NER), hemoglobin to red blood cell distribution width ratio (Hb/RDW), and derived NLR (dNLR) values and the Mandard tumor regression grade was analyzed using the Pearson correlation test.Results: Seventy-one patients with rectal adenocarcinoma who underwent curative surgery after nCRT between 2015 and 2022 were evaluated.Mean age was 56.6 ± 13.6 (20-82) years.Stage 3 disease was present in 88.7% of patients.Low anterior resection was performed in 60.6% of patients, and abdominoperineal resection was performed in 39.4%.A good response (Mandard grade 1, 2) was achieved in 52.1% of cases.Among inflammatory markers, only NLR showed a significant positive correlation with the Mandard grade (r = 0.320; p = 0.032).No significant correlation was found with PLR, LMR, NER, Hb/RDW, and dNLR. Conclusion:Lower NLR values are associated with improved pathological response.NLR may serve as a simple and inexpensive marker to predict treatment response in LARC patients operated on after nCRT. Keywords: Rectal cancer, neoadjuvant chemoradiotherapy, neutrophil-to-lymphocyte ratio, Mandard tumor regression gradeAmaç: Neoadjuvan kemoradyoterapi (nKRT) sonrası opere edilen lokal ileri evre rektum kanseri (LİERK) hastalarında tedavi öncesi nötrofil/lenfosit oranı (NLR) ile Mandard tümör regresyon skalası arasındaki ilişkiyi değerlendirmek amaçlandı.Gereç ve Yöntemler: Bu tek merkezli çalışma, 2015 ile 2022 yılları arasında rektal adenokarsinom için nCRT ve ardından küratif cerrahi uygulanan hastaları içermektedir.Tedavi öncesi, NLR, trombosit-lenfosit oranı (PLR), lenfosit-monosit oranı (LMR), nötrofileozinofil oranı (NER), hemoglobin-kırmızı kan hücrelerinin boyut genişliği oranı (Hb/RDW) ve derive NLR (dNLR) değerleri ile Mandard tümör regresyon skalası arasındaki ilişki Pearson korelasyon testi ile analiz edildi.