The prognostic value of neutrophil‐to‐lymphocyte ratio in colorectal cancer: A systematic review

Haram, Abdelhamed; Boland, Michael R.; Kelly, Michael E.; Bolger, Jarlath; Waldron, Ronan; Kerin, Michael J.

doi:10.1002/jso.24523

Cited by 166 publications

(157 citation statements)

References 51 publications

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“…27,28 Previous studies, including a systematic review by Haram et al, have outlined such an impact in colorectal liver metastases, and we believe this paper may contribute to the body of evidence supporting the utilisation of NLR in the management of patients undergoing hepatic resection for CLM. 18,29 Although such previous work has demonstrated the use of NLR as a prognostic tool in colorectal liver metastasis, we have, for the first time, demonstrated its superior ability to detect major post-operative complications ahead of more conventionally used serum biomarkers.…”

Section: Discussionmentioning

confidence: 81%

Neutrophil: Lymphocyte ratio as a method of predicting complications following hepatic resection for colorectal liver metastasis

McCluney

Giakoustidis

Segler

et al. 2018

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 81%

Neutrophil: Lymphocyte ratio as a method of predicting complications following hepatic resection for colorectal liver metastasis

McCluney

Giakoustidis

Segler

et al. 2018

Journal of Surgical Oncology

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“…In this context, body composition parameters associated with fat and muscle distribution has gained increased attention [1,2]. Besides this, systemic inflammation is a speculated risk factor affecting the survival of cancer patients [3,4].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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Original ArticlePurpose We evaluated the association of body composition with long-term oncologic outcomes in non-metastatic rectal cancer patients. Materials and MethodsWe included 1,384 patients with stage(y)0-III rectal cancer treated at Asan Medical Center between January 2005 and December 2012. Body composition at diagnosis was measured using abdomino-pelvic computed tomography (CT). Sarcopenia, visceral obesity (VO), and sarcopenic obesity (SO) were defined using CT measured parameters such as skeletal muscle index (total abdominal muscle area, TAMA), visceral fat area (VFA), and VFA/TAMA. Inflammatory status was defined as a neutrophil-lymphocyte ratio of ! 3. Obesity was categorized by body mass index (! 25 kg/m 2 ). ResultsAmong the 1,384 patients, 944 (68.2%) had sarcopenia and 307 (22.2%) had SO. The 5-year overall survival (OS) rate was significantly lower in sarcopenic patients (no sarcopenia vs. sarcopenia; 84% vs. 78%, p=0.003) but the 5-year recurrence-free survival (RFS) rate was not different (77.3% vs. 77.9% p=0.957). Patients with SO showed lower 5-year OS (79.1% vs. 75.5% p=0.02) but no difference in 5-year RFS (p=0.957). Sarcopenia, SO, VO, and obesity were not associated with RFS. However, obesity, SO, age, sex, inflammatory status, and tumor stage were confirmed as independent factors associated with OS on multivariate analysis. In subgroup analysis, association of SO with OS was more prominent in patients with (y)p stage 0-2 and no inflammatory status. ConclusionThe presence of SO and a low body mass index at diagnosis are negatively associated with OS in non-metastatic rectal cancer patients.

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“…[34][35][36][37][38] NLR is derived from the absolute neutrophil and lymphocyte counts obtained from a CBC and has been evaluated as a marker of depression and other mood disorders. 39 High NLR is associated with worse cancer-related prognosis 40,41 and has been shown to be associated with a lower chance of benefit from immunotherapy. 42 These 2 markers provide a general measure of inflammation, reflecting both the innate and adaptive immune systems, and are easily adaptable to clinical care.…”

Section: Introductionmentioning

confidence: 99%

Tumor Mutation Burden and Depression in Lung Cancer: Association With Inflammation

McFarland

Jutagir

Miller

et al. 2020

Journal of the National Comprehensive Cancer Network

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Background: Patients with lung cancer with greater systemic inflammation have higher rates of depression. Tumor mutation burden (TMB) predicts immunotherapy response in patients with lung cancer and is associated with intratumoral inflammation, which may contribute to systemic inflammation and depression. This study evaluated whether higher TMB was associated with increased depression and systemic inflammation in patients with lung cancer. Patients and Methods: Patients with metastatic lung cancers were evaluated for depression severity using the Hospital Anxiety and Depression Scale. TMB was measured using the Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets. Inflammation was evaluated using C-reactive protein (CRP) level and neutrophilto-lymphocyte ratio (NLR). Results: A total of 96 patients with adequate TMB testing were evaluated. The average number of mutations (TMB) was 10.8 (SD, 10.9). A total of 19% of patients endorsed clinically significant depression symptoms. TMB was significantly correlated with depression severity (r 5 0.34; P5.001) and NLR (r 5 0.37; P5.002) but not CRP level (r 5 0.19; P5.07). TMB was also higher in patients receiving chemotherapy (mean, 12.0) and immunotherapy (mean, 14.4) versus targeted therapy (mean, 4.8). A multivariate model found that TMB (b 5 0.30; P5.01) and CRP level (b 5 0.31; P5.01) were independently associated with depression; there was no significant interaction effect of TMB 3 CRP and depression. A similar multivariate model showed no independent effect for NLR and depression (b 5 0.16; P5.17) after accounting for TMB. Conclusions: These data provide evidence for biologic depression risk in patients with lung cancer who have high levels of TMB. The underlying mechanism of the association is not clearly related to inflammation but warrants further analysis to broadly elucidate the mechanism of biologically derived depression in cancer.

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The prognostic value of neutrophil‐to‐lymphocyte ratio in colorectal cancer: A systematic review

Abstract: Elevated pre-operative NLR>5 is associated with poorer long-term survival in both patients with localized CRC and those with liver metastasis. NLR is a useful biomarker in delineating those patients with poorer prognosis and whom may benefit from adjuvant therapies.

Cited by 166 publications

References 51 publications

Neutrophil: Lymphocyte ratio as a method of predicting complications following hepatic resection for colorectal liver metastasis

Neutrophil: Lymphocyte ratio as a method of predicting complications following hepatic resection for colorectal liver metastasis

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

Tumor Mutation Burden and Depression in Lung Cancer: Association With Inflammation

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