Research Papers:

Leukocytosis and neutrophilia predict outcome in locally advanced esophageal cancer treated with definitive chemoradiation

Antoine Schernberg, Laurence Moureau-Zabotto, Eleonor Rivin Del Campo, Alexandre Escande, Michel Ducreux, France Nguyen, Diane Goere, Cyrus Chargari and Eric Deutsch _

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Oncotarget. 2017; 8:11579-11588. https://doi.org/10.18632/oncotarget.14584

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Antoine Schernberg1, Laurence Moureau-Zabotto2, Eleonor Rivin Del Campo1, Alexandre Escande1, Michel Ducreux3,4, France Nguyen1, Diane Goere5, Cyrus Chargari1,6,7,8, Eric Deutsch1,3,6

1Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France

2Radiation Oncology Department, Institut Paoli-Calmettes, Marseille, France

3Université Paris Sud, Université Paris Saclay, Faculté de médecine du Kremlin-Bicetre, Le Kremlin-Bicetre, France

4Department of Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France

5Department of Surgery, Gustave Roussy, Université Paris-Saclay, Villejuif, France

6INSERM1030, Gustave Roussy Cancer Campus, Villejuif France

7French Military Health Services Academy, Ecole du Val-de-Grâce, Paris, France

8Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge, France

Correspondence to:

Eric Deutsch, email: [email protected]

Keywords: esophageal cancer, concurrent chemoradiation, prognostic factor, biomarker, leukocytosis

Received: November 09, 2016     Accepted: December 26, 2016     Published: January 10, 2017


Purpose: To investigate the prognostic value of leukocyte and neutrophil count as biomarkers in patients with locally advanced esophageal squamous cell carcinoma (SCC) undergoing exclusive chemoradiation.

Results: A total of 126 patients were identified. Respectively, 33% and 35% displayed baseline leukocytosis and neutrophilia. Estimated 3-year OS and PFS from chemoradiation completion were 31% and 25%, respectively. In univariate analysis, both leukocytosis and neutrophilia were associated with worse OS, PFS, and LRC (p < 0.01). In multivariate analysis, leukocytosis remained an independent risk factor associated with poorer OS, PFS and LRC (p < 0.05), independently from tumor stage and length, with higher prognostic value for OS compared with patients’ performance status (PS).

Materials and Methods: Bi-institutional clinical records from consecutive non-operable patients treated between 2003 and 2015 with definitive chemoradiation for locally advanced esophageal carcinoma were reviewed. Leukocytosis and neutrophilia were defined as a leukocyte or neutrophil count over 10 G/L and 7 G/L, respectively. These parameters were studied for their potential correlation with overall survival (OS), progression free survival (PFS), locoregional control (LRC) and distant metastases control (DMC).

Conclusions: Leukocytosis and neutrophilia were independent prognostic factors of poor OS, PFS, and LRC in this bi-institutional series of locally advanced esophageal SCC treated with definitive chemoradiation. Although prospective confirmation is warranted, it is suggested that the leukocyte and neutrophil count parameters might be clinically relevant biomarkers to be considered for further clinical investigations.

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