The dynamic change of neutrophil to lymphocyte ratio can predict clinical outcome in stage I-III colon cancer

Li, Zhigui; Zhao, Rui; Cui, Yaping; Zhou, Yong; Wu, Xiaoting

doi:10.1038/s41598-018-27896-y

Cited by 69 publications

(58 citation statements)

References 37 publications

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“…Prior studies have reported a variety of inflammation markers as predictors for oncological outcomes in multiple types of cancer 4 – 24 . In NSCLC, preoperative NLR, PLR and PNI have been demonstrated to predict cancer recurrence or mortality after tumour resection 4 – 21 .…”

Section: Discussionmentioning

confidence: 99%

“…Our analyses have adjusted for a detailed list of covariates, and preoperative NLR remained significantly associated with cancer recurrence and all-cause mortality. Absolute change of lymphocyte count and dynamic change of NLR have also been reported to predict outcomes in liver cancer and colon cancer 22,24 . However, we did not confirm the prognostic values of these indexes in NSCLC.…”

Section: Continuous Nlrmentioning

confidence: 98%

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A comparison of inflammation markers for predicting oncological outcomes after surgical resection of non-small-cell lung cancer: a validated analysis of 2,066 patients

Chang

et al. 2020

Sci Rep

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Clinical and pathological predictors have proved to be insufficient in identifying high-risk patients who develop cancer recurrence after tumour resection. We aimed to compare the prognostic ability of various inflammation markers in patients undergoing surgical resection of lung cancer. We consecutively included 2,066 patients with stage I–III non-small-cell lung cancer undergoing surgical resection at the center between 2005 and 2015. We evaluated prognostic nutritional index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio along with their perioperative changes. We conducted stepwise backward variable elimination and internal validation to compare the selected markers’ predictive performance for postoperative recurrence-free survival and overall survival. Preoperative neutrophil-to-lymphocyte ratio independently predicts recurrence-free survival (HR: 1.267, 95% CI 1.064–1.509, p = 0.0079, on base-2 logarithmic scale) and overall survival (HR: 1.357, 95% CI 1.070–1.721, p = 0.0117, on base-2 logarithmic scale). The cut-off value is 2.3 for predicting both recurrence (sensitivity: 46.1% and specificity: 66.7%) and mortality (sensitivity: 84.2% and specificity: 40.4%). Advanced cancer stage, poor tumour differentiation, and presence of perineural infiltration were significantly correlated with higher preoperative neutrophil-to-lymphocyte ratio. We concluded that preoperative neutrophil-to-lymphocyte ratio is superior to prognostic nutritional index and platelet-to-lymphocyte ratio in predicting postoperative recurrence and mortality of patients undergoing surgical resection of non-small-cell lung cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Continuous Nlrmentioning

confidence: 98%

A comparison of inflammation markers for predicting oncological outcomes after surgical resection of non-small-cell lung cancer: a validated analysis of 2,066 patients

Chang

et al. 2020

Sci Rep

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“…Our results are in line with the study ( 32 ). Nonetheless, the post-NLR was previously reported to be an important prognostic factor in many cancers, including gastric cancer ( 33 ), hepatocellular carcinoma ( 34 ), renal cell carcinoma ( 35 ) and CRC ( 36 ), but it was noted that it could be affected by many factors. For example, a relatively high post-NLR was associated with surgery-related stress.…”

Section: Discussionmentioning

confidence: 99%

A persistent high neutrophil‑to‑lymphocyte ratio predicts poor prognosis in patients with colorectal cancer undergoing resection

Cui

Yan

2020

Mol Clin Oncol

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The prognostic role of the neutrophil-to-lymphocyte ratio (NLR) has been reported in colorectal cancer (CRC); however, its variation and corresponding predicative value in patients undergoing resection remain largely unknown. In the present study, data from 146 patients with CRC were retrospectively collected, optimal cutoff points for preoperative and postoperative low and high NLRs were set, and ΔNLR was calculated. Subsequently, patients were classified into low-low, low-high, high-low and high-high subgroups based on the cutoff points, and their progression-free survival (PFS) was determined. A Cox proportional hazard model was applied to calculate the prognostic value of all factors. The results demonstrated that both preoperative and postoperative NLRs (pre-NLR and post-NLR) but not ΔNLR could predict PFS with optimal cutoff points of 2.39 and 2.96, respectively. For predicting PFS, the pre-NLR had a sensitivity and specificity of 48.80 and 79.50%, respectively, and the post-NLR had a sensitivity and specificity of 63.20 and 56.20%, respectively. Significant differences were identified between low and high pre-NLRs in terms of histological grade (P<0.01) and tumor diameter (P<0.01); however, such differences were only found in terms of age (P<0.01) for low and high post-NLRs. The PFS of patients in the low-low, low-high, high-low and high-high subgroups was 50.30±21.36, 43.67±22.78, 31.06±25.56 and 29.87±24.13 months, respectively, and patients in the high-high subgroup had the worst PFS (P<0.01). Preoperative CEA level, invasive depth, node involvement, distant metastasis and preoperative NLR were independent prognostic factors. In conclusion, a persistently high NLR for patients with CRC undergoing resection was associated with poor prognosis.

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“…Systemic inflammatory responses are thought to play a role in tumor progression by inducing angiogenesis and inhibiting apoptosis and DNA damage, tumor proliferation, and metastasis. 3,11,12 In addition to the high-risk factors associated with different tumor characteristics, the host's immune system also plays a role in the invasion or metastasis of colon cancer. 13 The host inflammatory response to cancer cells is also associated with tumor progression.…”

Section: Discussionmentioning

confidence: 99%

Clinical Value of Neutrophil/Lymphocyte Ratio in Predicting Postoperative Complications and Prognosis in Patients with Colorectal Cancer Undergoing Surgical Treatment

Yalav¹,

Topal²,

Ünal³

et al. 2020

tjcd

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Amaç: Son zamanlarda, preoperatif sistemik enflamatuar yanıtın kolorektal kanserli hastalarda (CRC) prognostik bir faktör olduğu bildirilmiştir. Bu bağlamda preoperatif nötrofil lenfosit oranı (NLO), prognoz için faydalı bir öngörü faktörü olarak öne sürülmüştür. Bu çalışmada nötrofil/ lenfosit oranının kolorektal kanser nedeniyle cerrahi tedavi uygulanan hastalarda postoperatif komplikasyonları öngörebilmedeki klinik değerini ve prognostik önemini saptamayı amaçladık. Yöntem: 2015-2019 yılları arasında kolorektal kanser nedeniyle cerrahi tedavi, uygulanan hastalar çalışmaya dahil edili. Grup 1 (NLO düşük) ve grup 2 (NLO yüksek) olmak üzere iki grup oluşturuldu. Gruplarda hastaların demografik ve klinik özellikleri intraoperatif ve postoperatif sonuçlarları ortalama sağkalımları karşılaştırıldı. NLO belirlenen cut off değerinde postoperatif komplikasyonları öngörebilmedeki değerine bakıldı. Bulgular: Hastalar 2,08 cutoff değerine göre iki gruba ayrıldı grup 1=56 hastadan grup 2=223 hastadan oluşuyordu Her iki grupta da erkek cinsiyet baskındı (%60 vs,%64 p=0,349), grup 2'deki hastalar daha çok neoadjuvant tedavi almıştı (%29,1 vs %12,5 p=0,007), intraoperatif komplikasyon ÖZ Aim: Recently, the preoperative systemic inflammatory response has been reported to be a prognostic factor in patients with colorectal cancer (CRC). In this context, the preoperative neutrophil/lymphocyte ratio (NLR) has been proposed as a useful predictor of prognosis. In this study, we aimed to determine the clinical value and prognostic significance of neutrophil/lymphocyte ratio in predicting postoperative complications in patients undergoing surgical treatment for colorectal cancer. Method: Patients who underwent surgical treatment for colorectal cancer between 2015-2019 were included in the study. group 1 (Low NLR) and group 2 (High NLR) were formed. Demographic and clinical characteristics, intraoperative and postoperative results, and mean survival were compared. The value of NLR in predicting postoperative complications at the determined cutoff value was examined. Results: Patients were divided into two groups according to the cutoff value of 2.08. Group 1 consisted of 56 patients, and group 2 consisted of 223 patients. Male sex was dominant in both groups (60% vs 64%, p=0.349), while patients in group 2 received more neoadjuvant treatment (29.1% vs 12.5%, p=0.007). Intraoperative complication rates were similar (1.8% vs 4%, p=0.369), pathological grade (p=0.031), and stage (p=0.113) were similar. Postoperative complications were more common in group 2 (24.7% vs 10.7%, p=0.015). Total survival was shorter in group 2 (46 months vs. 52 months, p=0.025). At the determined cutoff value, NLR predicted postoperative complications with 22.94% specificity and 90.6% sensitivity. Conclusion: High NLR was associated with postoperative complications and survival. Although it has a prognostic value, its value in predicting postoperative complications is limited and cannot be used alone.

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The dynamic change of neutrophil to lymphocyte ratio can predict clinical outcome in stage I-III colon cancer

Cited by 69 publications

References 37 publications

A comparison of inflammation markers for predicting oncological outcomes after surgical resection of non-small-cell lung cancer: a validated analysis of 2,066 patients

A comparison of inflammation markers for predicting oncological outcomes after surgical resection of non-small-cell lung cancer: a validated analysis of 2,066 patients

A persistent high neutrophil‑to‑lymphocyte ratio predicts poor prognosis in patients with colorectal cancer undergoing resection

Clinical Value of Neutrophil/Lymphocyte Ratio in Predicting Postoperative Complications and Prognosis in Patients with Colorectal Cancer Undergoing Surgical Treatment

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