The value of the pretreatment neutrophil lymphocyte ratio vs. platelet lymphocyte ratio in predicting the long-term survival in colorectal cancer

Azab, Basem; Mohammad, Farhan; Shah, Neeraj; Vonfrolio, Steven; Lu, Wenfu; Kedia, Shiksha; Bloom, Scott W.

doi:10.3233/cbm-140416

Cited by 48 publications

(45 citation statements)

References 30 publications

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“…Several studies, including one of 140 patients with resectable CRLM, have found PLR to exert independent significance in CRC [35,45]. Other groups, however, have found the NLR, not the PLR, to exert an independent association with poor prognosis in patients with CRC [46,47]. Additional studies are needed, therefore, to further examine the prognostic value of the platelet count, and indices derived thereof, in the context of CRC and CRLM.…”

Section: Discussionmentioning

confidence: 91%

Prognostic performance of inflammation-based prognostic indices in patients with resectable colorectal liver metastases

et al. 2015

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A range of prognostic cellular indices of the systemic inflammatory response, namely the neutrophil-lymphocyte ratio (NLR), derived NLR (dNLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), combination of platelet count and neutrophil-lymphocyte ratio (COP-NLR) and prognostic nutritional index (PNI), have been developed and found to have prognostic utility across varied malignancies. The current study is the first to examine the prognostic value of these six inflammatory scores in patients with resectable colorectal liver metastases (CRLM). Data from 302 consecutive patients undergoing surgery for resectable CRLM were evaluated. The prognostic influence of clinicopathological variables and the inflammatory scores NLR, dNLR, PLR, LMR, COP-NLR and PNI upon overall survival (OS) and cancer-specific survival (CSS) were determined by log-rank analysis and univariate and multivariate Cox regression analyses. High preoperative NLR was the only inflammatory variable independently associated with shortened OS (HR 1.769, 95 % CI 1.302-2.403, P < 0.001) or CSS (HR 1.927, 95 % CI 1.398-2.655, P < 0.001) following metastasectomy. When NLR was replaced by dNLR in analyses, high dNLR was independently associated with shortened OS (HR 1.932, 95 % CI 1.356-2.754, P < 0.001) and CSS (HR 1.807, 95 % CI 1.209-2.702, P = 0.004). The inflammatory scores PLR, LMR, COP-NLR and PNI demonstrated no independent association with either overall or cancer-specific survival in the study population. Our findings support high preoperative NLR and dNLR as independent prognostic factors for poor outcome in patients undergoing CRLM resection, with prognostic value superior to other cellular-based systemic inflammatory scores.

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Section: Discussionmentioning

confidence: 91%

Prognostic performance of inflammation-based prognostic indices in patients with resectable colorectal liver metastases

et al. 2015

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“…Twenty-eight studies contributed data to the analyses of overall survival [2-7, 9, 11-31]. Significant heterogeneity was found among studies (I 2 = 81%, p = 0.000, Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…The following studies confirmed this association [2, 3, 5, 6]. However, some other studies failed to demonstrate the association between pretreatment elevated platelet count and outcomes of colorectal cancer [11–16]. Considering the controversial evidence, we conduct a meta-analysis to evaluate whether pretreatment elevated platelet count is a prognostic marker of colorectal cancer.…”

Section: Introductionmentioning

confidence: 82%

Prognostic significance of pretreatment elevated platelet count in patients with colorectal cancer: a meta-analysis

Liu

Wang

Gao³

et al. 2016

Oncotarget

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BackgroundThe prognostic effect of pretreatment elevated platelet count remains controversial in colorectal cancer patients. We conducted this meta-analysis to evaluate the prognostic impact of it in these patients.MethodsPubMed, EMBASE and Cochrane Library were searched and studies on the prognostic significance of pretreatment elevated platelet count in colorectal patients were identified. We performed the meta-analysis, using overall survival and disease-free survival as outcomes and presenting data with hazard ratio and its 95% confidence interval. Heterogeneity among studies and publication bias were also evaluated.ResultsThirty studies were included in the meta-analysis. Compared with normal platelet count, pretreatment elevated platelet count was associated with poorer overall survival (Hazard ratio = 1.837, 95% confidence interval, 1.497 to 2.255, p = 0.000) and poorer disease-free survival (Hazard ratio = 1.635, 95% confidence interval, 1.237 to 2.160, p = 0.001) in patients with colorectal cancer. In subgroup analyses, pretreatment elevated platelet count was also associated with poorer overall survival and disease-free survival in most subgroups.ConclusionPretreatment elevated platelet count was an independent prognostic factor of overall survival and disease-free survival in colorectal cancer patients. Large-scale prospective studies and a validation study are warranted.

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“…The majority of reports have shown NLR to be a novel biomarker of survival in primary and metastatic colorectal cancers [30,31,32,33,34,35,36]. A meta-analysis combining results from 49 studies containing 14,282 patients showed that higher values of NLR were associated with poor disease-free [hazard ratio (HR): 1.99; 95% CI = 1.80-2.20; p < 0.001] and overall survival (HR: 1.92; 95% CI = 1.64-2.24; p < 0.001) in solid cancer patients [2].…”

Section: Discussionmentioning

confidence: 99%

The Neutrophil-to-Lymphocyte Ratio as a Marker of Lymph Node Status in Patients with Rectal Cancer

Khan

Akritidis²,

Pring³

et al. 2016

Oncology

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Aim: The aim of the study was to investigate the role of the neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker of rectal cancers. Methods: We undertook a retrospective review of patients with rectal cancer. Pre-treatment NLR was assessed for association and predictive values against clinicopathological staging and post-treatment outcomes. Results: A total of 140/180 cases were included in the final analysis [male:female 2:1; mean age 68 years (interquartile range 58-75)]. The pre-operative mean NLR was 5.4 ± 6.8. There was a strong positive correlation between NLR and C-reactive protein (Spearman's rho 64.3%, p < 0.001). A high NLR was associated with a positive nodal status on MRI (5.2 vs. 3.8, p = 0.03) and histopathological (4.8 vs. 3.8, p = 0.02) assessment. The NLR showed an average value for predicting MRI and pathological nodal status on receiver operating characteristic analysis [area under the curve = 0.72 (95% CI = 0.54-0.91), p = 0.031 and area under the curve = 0.64 (95% CI = 0.52-0.077), p = 0.021, respectively]. On multivariate analysis, the total lymph node retrieved at operation was the best predictor of pathological nodal involvement; NLR did not show any predictive value. Patients with an NLR >4 showed reduced recurrence-free (60 vs. 86 months, p = 0.52) and overall survival (57 vs. 84 months, p = 0.40) without statistical significance. Conclusion: Raised pre-treatment NLR may indicate nodal involvement in patients with rectal cancer.

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The value of the pretreatment neutrophil lymphocyte ratio vs. platelet lymphocyte ratio in predicting the long-term survival in colorectal cancer

Abstract: Elevated pretreatment NLR is an independent predictor of both worse overall and disease free survival in colorectal cancer, whereas PLR was not after adjusting for confounding variables.

Cited by 48 publications

References 30 publications

Prognostic performance of inflammation-based prognostic indices in patients with resectable colorectal liver metastases

Prognostic performance of inflammation-based prognostic indices in patients with resectable colorectal liver metastases

Prognostic significance of pretreatment elevated platelet count in patients with colorectal cancer: a meta-analysis

The Neutrophil-to-Lymphocyte Ratio as a Marker of Lymph Node Status in Patients with Rectal Cancer

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