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Published in: International Journal of Colorectal Disease 7/2019

01-07-2019 | Colorectal Cancer | Original Article

Prognostic impact of the combination of neutrophil-to-lymphocyte ratio and Glasgow prognostic score in colorectal cancer: a retrospective cohort study

Authors: Susumu Inamoto, Kenji Kawada, Ryosuke Okamura, Koya Hida, Yoshiharu Sakai

Published in: International Journal of Colorectal Disease | Issue 7/2019

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Abstract

Purpose

Although neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte count, and Glasgow prognostic score (GPS) are well-known prognostic markers in cancer, their prognostic importance is still controversial. We evaluated the prognostic value of NLR, PLR, monocyte count, and GPS in colorectal cancer (CRC).

Method

We retrospectively evaluated 448 CRC patients undergoing curative resection. We compared overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS) between dichotomized groups by the optimal cutoff point. Univariate and multivariate analyses were applied to identify prognostic factors.

Result

High NLR, high monocyte count, and high GPS exhibited significantly worse prognosis in OS, CSS, and DFS compared with low NLR, low monocyte count, and low GPS, respectively. In contrast, PLR was not significantly associated with OS, CSS, and DFS. The univariate and multivariate analyses indicated that poor OS was significantly associated with age ≥ 69 and high NLR; that poor CSS was significantly associated with age ≥ 69, M factor, high CA19-9, adjuvant chemotherapy, and high GPS; and that poor DFS was significantly associated with venous invasion, high NLR, and high GPS. When 448 patients were classified into three groups based on NLR and GPS, there was a significant difference in OS, CSS, and DFS between all the three groups. Patients with NLR ≥ 2.05 and GPS = 1/2 exhibited remarkably poorer prognosis, whereas those with both NLR < 2.05 and GPS = 0 exhibited remarkably better prognosis.

Conclusion

Combination of NLR and GPS can be a novel scoring system to effectively stratify outcome in CRC.
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Metadata
Title
Prognostic impact of the combination of neutrophil-to-lymphocyte ratio and Glasgow prognostic score in colorectal cancer: a retrospective cohort study
Authors
Susumu Inamoto
Kenji Kawada
Ryosuke Okamura
Koya Hida
Yoshiharu Sakai
Publication date
01-07-2019
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 7/2019
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-019-03316-z

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