Preoperative neutrophil to lymphocyte ratio predicts survival in patients with T1-2N0 colorectal cancer.

Abstract

Neutrophil to lymphocyte ratio (NLR) is reported to be associated with prognosis of colorectal cancer. The aim of this study is to determine whether the NLR is a predictor of oncological outcomes in patients with stage I colorectal cancer who underwent curative surgery. Two hundred sixty-nine patients with stage I colorectal cancer who underwent surgical resection between December 2003 and December 2011 were retrospectively reviewed. The cutoff for NLR was defined as three by maximizing log-rank test statistics. We compared patients with a low NLR and those with a high NLR in terms of survival. The 5-year disease-free survival (DFS) and cancer-specific survival (CSS) rates were lower in patients with a high NLR compared to those with a low NLR in stage I colorectal cancer (89.5% vs. 97.4%, P = 0.006; 94.0% vs. 98.9%, P = 0.022). Cox multivariate analysis demonstrated that preoperative NLR was independently associated with DFS (HR, 5.216; 95%CI, 1.400-19.431; P = 0.014) and CSS (HR, 6.190; 95%CI, 1.034-37.047; P = 0.046) in patients with stage I colorectal cancer. The preoperative NLR is a prognostic factor predicting DFS and CSS in patients with stage I colorectal cancer who underwent curative surgery.