International Journal of Colorectal Disease

, Volume 34, Issue 3, pp 519–525 | Cite as

Prognostic significance of inflammatory-related parameters in patients with anal canal cancer

  • Francesca De FeliceEmail author
  • Filippo Lorenzo Rubini
  • Luca Romano
  • Nadia Bulzonetti
  • Rossella Caiazzo
  • Daniela Musio
  • Vincenzo Tombolini
Original Article



To investigate the correlation between inflammatory-related parameters and overall survival (OS) and disease-free survival (DFS) in anal canal cancer population.

Methods and materials

Patients diagnosed with anal canal carcinoma and treated with curative intent chemoradiotherapy (CRT) were included. Data about pre-treatment complete blood count were collected. Neutrophil to lymphocyte ratio (NLR), fibrinogen (F), and a combination of these (F-NLR score) were correlated with OS.


A total of 58 patients were enrolled. In multivariate analysis, the strongest OS prognostic factor was NLR, with a hazard ratio (HR) for low NLR compared to high NLR of 1.30 (95% confidence interval 1.01–14.12). Kaplan-Meier survival analysis showed that patients with high NLR, F, and F-NLR had significantly shorter OS and DFS.


To our knowledge, this is the first study providing evidence that elevated pre-treatment NLR, F, and F-NLR score significantly correlate with worse survival outcomes in patients with anal canal carcinoma. In view of our findings, future clinical trials in anal canal cancer patients are warranted to verify our results.


Anal carcinoma Radiotherapy Neutrophil Lymphocyte Fibrinogen 


Compliance with ethical standards

The protocol was reviewed and approved by the institutional review board and the scientific review committee. Written informed consent was obtained from all patients before the initiation of therapy.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Radiotherapy, Policlinico Umberto I“Sapienza” University of RomeRomeItaly

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