The Effect of Monocyte Count on Disease-Free Survival in Esophageal Cancer Patients

Abstract

Objectives: Inflammation plays a pivotal role in cancer development and prognosis. Peripheral blood test is a use - ful parameter in the evaluation of systemic inflammatory response. The previous studies have shown a relationship between monocyte count and prognosis in some solid tumors. The aim of this study was to evaluate the relation- ship between the monocyte count assessed at diagnosis and disease-free survival (DFS) on prognosis in patients with esophageal cancer. Methods: The retrospective study included 145 patients with esophageal cancer who presented to Van Training and Research Hospital Medical Oncology outpatient clinic between January 2015 and September 2020. The effect of mono- cyte count assessed in the blood samples taken at the time of diagnosis before the initiation of the treatment on DFS was investigated. Results: The receiver operating characteristics curve analysis determined a cutoff value of 515/μL for the monocyte count assessed at the time of diagnosis. DFS was 17.3 months (95% CI: 8.4–26.2) in patients with a monocyte count ≥515/μL as opposed to 38.5 months (95% CI: 28. 8–48.1) in patients with a monocyte count <515/μL. Moreover, low monocyte count at diagnosis was associated with significantly higher DFS (p<0.001). Conclusion: It is considered that the proportional distribution of cells in peripheral blood count may reflect the severity of inflammation in the tumor microenvironment. Tumor-associated macrophages are a well-known component of the inflammatory infiltrate in the tumor microenvironment, originating from monocytes. Our findings showed that mono- cyte count is a prognostic factor affecting DFS in patients with esophageal cancer, regardless of histological subtype.