Abstract
Whether the dynamic change of neutrophil to lymphocyte ratio (delta-NLR) can predict the outcome in various malignancies remained controversial. The delta-NLR has not been evaluated in colon cancer. Thus, we conducted the study to evaluate the predictive value of the delta-NLR in patients with colon cancer who underwent curative resection. Three-hundred and fifty-four patients with stage I-III colon cancer were retrospectively analysed. Clinicopathological features, preoperative NLR and postoperative NLR were collected. Prognostic factors were evaluated by univariate and multivariate analysis. The one, three and five-year overall survival rate in the delta-NLR < 0 group was 98.2%, 90.7% and 83.6%, respectively; and in the delta-NLR ≥ 0 group was 98.4%, 96.9% and 95.3%, respectively (log-rank test, P = 0.002). Univariate and multivariate analysis showed that there was a strong relationship between delta-NLR and overall survival. In conclusion, the delta-NLR was an independent prognostic factor for overall survival in early stage colon cancer. Patients with increased delta-NLR had an favourable clinical outcome.
Highlights
Colon cancer remained one of the most common cancer and the leading cause of cancer-related mortality worldwide, with an increased incidence[1,2,3]
Whether the delta-neutrophil to lymphocyte ratio (NLR) was an independent prognosis in colon cancer remained unclear
A cohort study of 2536 patients conducted by Rashtak et al.[23] demonstrated that NLR was no statistically significantly associated with overall survival (OS) and progression-free survival (PFS) in rectal cancer
Summary
Colon cancer remained one of the most common cancer and the leading cause of cancer-related mortality worldwide, with an increased incidence[1,2,3]. The prognosis of patients with colon cancer mainly relied on clinical stage at the time of diagnosis, but which was not entirely reliable. Systemic inflammatory responses are thought to take part in tumor progression through inducing angiogenesis and repairing DNA damage, tumor proliferation and metastasis, inhibition of apoptosis[8,9,10,11], which caused the changes of haematological components, like neutrophils, lymphocytes, monocytes. The dynamic change of preoperative and postoperative NLR (delta-NLR) has been rarely studied in colon cancer. The aim of this study was to evaluate the predictive value of delta-NLR in patients with stage I-III colon cancer who underwent curative resection
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