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. 2013 Jul 23;109(2):395-400.
doi: 10.1038/bjc.2013.346. Epub 2013 Jul 2.

A derived neutrophil to lymphocyte ratio predicts clinical outcome in stage II and III colon cancer patients

G Absenger  1 , J Szkandera, M Pichler, M Stotz, F Arminger, M Weissmueller, R Schaberl-Moser, H Samonigg, T Stojakovic, A Gerger
Affiliations

A derived neutrophil to lymphocyte ratio predicts clinical outcome in stage II and III colon cancer patients

G Absenger et al. Br J Cancer. .

Abstract

Background: Inflammation has a critical role in the pathogenesis and progression of cancer. Recently, the derived neutrophil to lymphocyte ratio (absolute count of neutrophils divided by the absolute white cell count minus the absolute count of neutrophils; dNLR) has been shown to influence clinical outcome in various cancer entities. In this study, we analysed the dNLR with clinical outcome in stage II and III colon cancer patients.

Methods: Three-hundred and seventy-two patients with stage II and III colon cancer were included in this retrospective study. Kaplan-Meier curves and multivariate Cox proportion analyses were calculated for time to recurrence (TTR) and overall survival (OS).

Results: In univariate analysis, the elevated preoperative dNLR was significantly associated with decreased TTR (hazard ratio (HR) 2.38, 95% confidence interval (CI) 1.57-3.6, P<0.001) and remained significant in multivariate analysis. Patients with dNLR >3 had a median TTR of 83 months, and patients with dNLR ≤ 3 showed a median TTR of 132 months. In OS analysis, a dNLR >2.2 was significantly associated with decreased OS in univariate (HR 1.85, 95% CI 1.11-3.08, P=0.018) and multivariate analysis. Patients with dNLR >2.2 showed a median OS of 121 months, and patients with dNLR ≤ 2.2 had a median OS of 147 months.

Conclusion: The dNLR may be an independent prognostic marker for TTR and OS in patients with stage II and III colon cancer. Independent validation of our findings is warranted.

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Figures

Figure 1
Figure 1
Preoperative dNLR and TTR in all colon cancer patients.
Figure 2
Figure 2
Preoperative dNLR and OS in all colon cancer patients.
Figure 3
Figure 3
Preoperative dNLR and TTR in colon cancer patients who underwent surgery alone.
Figure 4
Figure 4
Preoperative dNLR and TTR in colon cancer patients who underwent adjuvant chemotherapy.
See this image and copyright information in PMC

Comment in

References

    1. Boyle P, Ferlay J. Cancer incidence and mortality in Europe, 2004. Ann Oncol. 2005;16:481–488. - PubMed
    1. Chiang SF, Hung HY, Tang R, Changchien CR, Chen JS, You YT, Chiang JM, Lin JR. Can neutrophil-to-lymphocyte ratio predict the survival of colorectal cancer patients who have received curative surgery electively. Int J Colorectal Dis. 2012;27:1347–1357. - PubMed
    1. Chua W, Charles KA, Baracos VE, Clarke SJ. Neutrophil/lymphocyte ratio predicts chemotherapy outcomes in patients with advanced colorectal cancer. Br J Cancer. 2011;104:1288–1295. - PMC - PubMed
    1. Ding PR, An X, Zhang RX, Fang YJ, Li LR, Chen G, Wu XJ, Lu ZH, Lin JZ, Kong LH, Wan DS, Pan ZZ. Elevated preoperative neutrophil to lymphocyte ratio predicts risk of recurrence following curative resection for stage IIA colon cancer. Int J Colorectal Dis. 2010;25:1427–1433. - PubMed
    1. Ege H, Gertz MA, Markovic SN, Lacy MQ, Dispenzieri A, Hayman SR, Kumar SK, Porrata LF. Prediction of survival using absolute lymphocyte count for newly diagnosed patients with multiple myeloma: a retrospective study. Br J Haematol. 2008;141:792–798. - PubMed