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

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.

Pretreatment Neutrophil/Lymphocyte Ratio as a Prognostic Aid in Colorectal Cancer

“…That is why recent studies are focused on the other prognostic factors (including NLR), which may affect survival of CRC patients (Bolocan et al, 2012). The increase of knowledge in the field of inflammatory response, which generated by tumor cells, has led to the identification of some alternations in prognosis of CRC patients (Absenger et al, 2013).…”

Derived neutrophil/lymphocyte ratio predicts gemcitabine therapy outcome in unresectable pancreatic cancer

“…Although dNLR was revealed to be as useful as NLR in predicting the prognosis of patients with breast and colorectal cancer, the usefulness of dNLR as a marker for predicting the prognosis of patients with PDAC could not be verified in that study, due to the limited number of PDAC patients included in the heterogeneous population analyzed by the authors (19). Subsequently, Absenger et al performed an external validation study of the dNLR on a large cohort of patients with PDAC and confirmed that the pre-treatment dNLR was an independent prognostic factor for the clinical outcome of patients with PDAC (16). Based on the aforementioned results, the present study further focused on the role of the pre-treatment dNLR to predict response to gemcitabine in patients with unresectable PDAC.…”

“…Among various immunological processes, neutrophils and lymphocytes are reported to have a vital role in tumor inflammation and immunology. It has been demonstrated that the peripheral blood neutrophil-to-lymphocyte ratio (NLR), or more recently the derived NLR (dNLR), may be a reliable prognostic marker in various types of cancer, including PDAC (12)(13)(14)(15)(16)(17)(18), However, the use of the dNLR in predicting susceptibility to chemotherapy has not been evaluated. Therefore, the present study aimed to evaluate whether the dNLR is a reliable predictive marker for gemcitabine response in patients with unresectable PDAC.…”

Dietary Ziziphus jujuba Fruit Influence on Aberrant Crypt Formation and Blood Cells in Colitis-Associated Colorectal Cancer Mice

“…In colorectal cancer patients, tumorinfiltrating LYs has been shown to be independent prognostic factors of survival in all clinical stages. Furthermore, lymphocytosis is found to be significantly associated with increased overall survival in metastatic colorectal cancer patients (Absenger et al, 2013). ZJ decreased LY counts thus inhibited the proliferation and metastatic capacity of colon tumor.…”

“…Colon cancer is the third cause of cancer overall and the second leading cause of cancer-related death in Europe and the United States. Approximately 50% of colorectal cancer patients develop metastases; prognosis for these patients is poor, with 5-year survival rates of<10% (Absenger et al, 2013). CRC ranks the third place of cancer overall and the second leading cause of cancer-related death affecting both males and females in Europe (Siegel et al, 2013;Stotz et al, 2014).…”