Clinical Implications of Systemic Inflammatory Response Markers as Independent Prognostic Factors in Colorectal Cancer Patients

Abstract

PurposeCancer-related inflammation affects many aspects of malignancy. We confirm the effects of early postoperative systemic inflammation on cancer prognosis.Materials and MethodsSix hundred consecutive patients underwent surgery for colorectal cancer from 2006 to 2009. Measurements of white blood cells, neutrophils, lymphocytes, monocytes, and platelet counts were performed preoperatively, daily until the fourth postoperative day, and subsequently every two days. Patients were divided into three groups based on the days spent on the leukocyte count to drop below 10,000/mm3 after surgery.ResultsPreoperative white blood cell (WBC) counts correlated with stage of disease. In univariate survival analyses, tumor, node, metastasis (TNM) stage, and monocyte count were associated with cancer-free survival. In addition, cancer-free survival outcomes were worse in patients who required more than four days for the normalization of WBC count. A TNM stage greater than II and the neutrophil lymphocyte ratio were associated with the duration of overall survival. In a multivariate analysis of these significant variables, TNM stage, an interval longer than four days for normalization of WBC counts and monocyte count independently associated with cancer-free survival.ConclusionPostoperative early inflammatory phase and preoperative monocyte count correlate with poor colon cancer prognosis. We can conclude that preoperative and postoperative inflammatory response and period unfavorably affect the metastatic microenvironment.

The prognostic and therapeutic role of hormones in colorectal cancer: a review

“…Although leptin's role in colonic tumorigenesis and proliferation has been well studied [21][22][23], only a few studies investigated its prognostic potential. Paik SS and colleagues showed that a low tissue leptin expression in CRC tissue samples is associated with more advanced disease whilst high tissue leptin expression is associated with a favorable OS and DFS [24]. Uddin et al [25] showed that tissue Ob-R expression is associated with better OS.…”

Prognostic role of pretreatment blood lymphocyte count in patients with solid tumors: a systematic review and meta-analysis

“…Numerous clinical studies have revealed that peripheral blood lymphopenia prior to initial treatment is associated with poor prognosis in various types of cancers, such as advanced carcinomas and sarcomas, cervical cancer, renal carcinoma, and bladder cancer [1,[7][8][9]. However, the inconsistent effect of pretreatment blood lymphocyte counts in patients with some publications cannot be ignored [10][11][12][13][14][15]. Moreover, the prognostic impact of lymphopenia in non-hematologic tumors has not been systematically analyzed.…”

Association of Body Composition with Long-Term Survival in Non-metastatic Rectal Cancer Patients

“…There is growing research interest in the correlation of sarcopenia or sarcopenic obesity (SO) with oncological outcomes, and a recent report has indicated that sarcopenia and systemic inflammation affect overall survival (OS) and recurrence-free survival (RFS) in CRC patients [10]. Studies reporting sarcopenic patients with colorectal cancer have higher levels of systemic inflammatory markers and increased systemic inflammation affects survival in these cases has furthered the interest in these parameters [11][12][13]. SO, in which excessive body fat is present alongside low muscle mass and quality, has also been shown to be associated with decreased survival in colorectal cancer [14][15][16].…”