Can neutrophil-to-lymphocyte ratio predict the survival of colorectal cancer patients who have received curative surgery electively?
| Autor: | Sum-Fu Chiang, Reiping Tang, Jy-Ming Chiang, Yau-Tong You, Jr-Rung Lin, Jinn-Shiun Chen, Hsin-Yuan Hung, Chung Rong Changchien |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Oncology medicine.medical_specialty Neutrophils Colorectal cancer Kaplan-Meier Estimate Leukocyte Count Risk Factors Internal medicine medicine Humans In patient Lymphocytes Neutrophil to lymphocyte ratio Survival analysis Neoplasm Staging Proportional Hazards Models Rectal Neoplasms Proportional hazards model business.industry fungi Gastroenterology Middle Aged Hepatology Prognosis medicine.disease Survival Analysis Treatment Outcome ROC Curve Elective Surgical Procedures Multivariate Analysis Curative surgery Female Neoplasm staging Colorectal Neoplasms business |
| Zdroj: | International Journal of Colorectal Disease. 27:1347-1357 |
| ISSN: | 1432-1262 0179-1958 |
| Popis: | We evaluated the effect of neutrophil-to-lymphocyte ratio (NLR) on disease-free survival in patients with stages I to III colorectal cancer (CRC).There were 3857 patients identified from our database. We used receiver operating characteristic (ROC) analysis to identify the best cutoff value of NLR. A 5-year disease-free survival was used as end point. Survival analysis was used to assess the NLR effect, after stratification by several clinopathologic factors.In the ROC analysis, NLR = 3 had the highest sensitivity and specificity. Elevated NLR (3) in colon cancer seemed to accompany larger tumor size (~5 cm) and more advanced T stage. By multivariate analysis, elevated NLR in colon cancer was associated with an increased risk of disease progression or cancer death [hazard ratio (HR) 1.377, 95 % confidence interval 1.104-1.717, P = 0.014]. However, elevated NLR in rectal cancer lost its significance in multivariate analysis (HR 1.121, 95 % confidence interval 0.941-1.336, P = 0.200). Patients with elevated NLR had worse outcome, especially for colon cancer.Preoperative NLR influenced the disease-free survival in patients with stages I to III CRC. Elevated NLR (3) was associated with worse outcome (5-year disease-free survival 66.3 % vs. 78.9 % in colon cancer, P 0.001; 60. 5 % vs. 66.2 % in rectal cancer, P = 0.008). The difference was larger in colon cancer than in rectal cancer. NLR should be considered as a prognostic factor for stages I to III CRC patients after curative surgery. |
| Databáze: | OpenAIRE |
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