Abstract
Lymphocyte-to-monocyte ratio (LMR) has been reported as a biomarker for predicting the prognosis of colorectal cancer. However, the clinical usefulness of LMR requires detailed research, which can contribute to better therapeutic strategies. A cohort of 554 patients with resectable advanced colon cancer in our institution was analyzed retrospectively. An analysis of stages II and III resectable advanced colon cancer was performed. LMR was useful for predicting overall survival (OS) and relapse-free survival (RFS). The ROC curve revealed an LMR value of 2.77 as a cutoff for OS. A high LMR was an independent prognostic factor and was associated with a high hazard ratio (HR) in all cases for OS (HR = 0.530, 95% confidence interval (CI) = 0.334–0.842, p = 0.007). A high LMR was not an independent prognostic factor in stage II cases but was a predictor with the strongest association with prognosis in patients with stage III cases for OS (HR = 0.383, 95% CI = 0.160–0.915, p = 0.031). LMR is a strong predictor of prognosis in patients with stage III colon cancer and may be useful in postoperative treatment options.
Highlights
Colorectal cancer (CRC) is among the leading causes of cancer-related deaths worldwide, and 1.4 million CRC cases and nearly 700,000 deaths are reported per year [1]
Recurrences were classified into distant recurrence (DR) and local recurrence (LR)
DR was defined as all recurrences except LR and included recurrences of the liver, lungs, lymph nodes, and peritoneum
Summary
Colorectal cancer (CRC) is among the leading causes of cancer-related deaths worldwide, and 1.4 million CRC cases and nearly 700,000 deaths are reported per year [1]. CRC prognosis is based on the Union for International Cancer. Control (UICC) tumor node metastasis (TNM) classification; differences in outcomes have been reported among patients presenting with the same disease stage [2]. Various inflammatory biomarkers have been suggested as relevant survival predictors in this patient group [3, 4]. The lymphocyte-to-monocyte ratio (LMR) is a recently proposed biomarker that reflects the immune system function and may help predict outcomes. Previous studies that examined this association in CRC involved heterogeneous samples, including those of patients with varied disease location and stage, and few previous reports differentiated patients based on their clinical characteristics. CRC prognosis depends on disease stage and location, e.g., colon vs
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