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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 12/2010

01-12-2010 | Original Article

Elevated preoperative neutrophil to lymphocyte ratio predicts risk of recurrence following curative resection for stage IIA colon cancer

Authors: Pei-Rong Ding, Xin An, Rong-Xin Zhang, Yu-Jing Fang, Li-Ren Li, Gong Chen, Xiao-Jun Wu, Zhen-Hai Lu, Jun-Zhong Lin, Ling-Heng Kong, De-Sen Wan, Zhi-Zhong Pan

Published in: International Journal of Colorectal Disease | Issue 12/2010

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Abstract

Background and Objectives

Adjuvant chemotherapy for stage II colon cancer remains controversial but may be considered for patients with high-risk features. Recent studies have shown that elevated neutrophil to lymphocyte ratio (NLR) is a worse prognostic factor and a predictor of response to chemotherapy in patients with advanced colorectal cancer. The purpose of this study was to evaluate whether NLR predicts risk of recurrence in patients with stage IIA colon cancer undergoing curative resection without adjuvant chemotherapy.

Methods

We retrospectively reviewed 141 consecutive patients with stage IIA colon cancer treated with curative surgery alone from 2002 to 2006. NLR, as well as demographics, clinical, histopathologic, and laboratory data were analyzed. Univariate and multivariate analyses were conducted to identify prognostic factors associated with recurrent-free survival (RFS).

Results

Cox’s regression analysis demonstrated that elevated NLR (>4) (hazard ratio, 4.88; P < 0.01) and less lymph node sampling (<15 lymph nodes; hazard ratio, 3.80; P < 0.05) were adverse prognostic factors for RFS. The 5-year RFS was 91.4% (95% CI, 88.6–94.2%) for patients with normal NLR and 63.8% (51.1–76.3%) for patients with elevated NLR. The 5-year RFS for patients with 0, 1, and 2 of the identified risk factors was 95.1%, 87.4%, and 33.3%, respectively (P < 0.001).

Conclusions

Elevated preoperative NLR is an independent predictor of worse RFS for patients with stage IIA colon cancer and a potential biomarker to identify candidates for adjuvant chemotherapy.
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Metadata
Title
Elevated preoperative neutrophil to lymphocyte ratio predicts risk of recurrence following curative resection for stage IIA colon cancer
Authors
Pei-Rong Ding
Xin An
Rong-Xin Zhang
Yu-Jing Fang
Li-Ren Li
Gong Chen
Xiao-Jun Wu
Zhen-Hai Lu
Jun-Zhong Lin
Ling-Heng Kong
De-Sen Wan
Zhi-Zhong Pan
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 12/2010
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-010-1052-0

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