Abstract
BackgroundRecently, a preoperative systemic inflammatory response has been reported to be a prognostic factor in patients with colorectal cancer (CRC). However, the prognostic significance of a systemic inflammatory response in the early stage after surgery in patients with CRC is unknown. The aim of this retrospective study was to evaluate the prognostic significance of a postoperative systemic inflammatory response in patients with CRC.MethodsTwo hundred and fifty-four patients who underwent potentially curative surgery for stage II/III CRC were enrolled in this study. Univariate and multivariate analyses were performed to evaluate the relationship between the prognosis and clinicopathological factors, including the neutrophil-to-lymphocyte ratio (NLR) and Glasgow Prognostic Score (GPS), which were measured within two weeks before operation and at the first visit after leaving the hospital.ResultsThe overall survival rates were significantly worse in the high preoperative NLR/preoperative GPS/postoperative NLR group. A multivariate analysis indicated that only preoperative GPS, postoperative NLR, and the number of lymph node metastases were independent prognostic factors for a poor survival.ConclusionsThe postoperative NLR is an independent prognostic factor in patients with CRC who underwent potentially curative surgery.
Highlights
A preoperative systemic inflammatory response has been reported to be a prognostic factor in patients with colorectal cancer (CRC)
As for the preoperative inflammatory status, an assessment of the prognosis showed that the overall survival rates were significantly worse in the high preoperative neutrophil-to-lymphocyte ratio (NLR)/Glasgow prognostic score (GPS) group (NLR, p = 0.0388; GPS, p = 0.0028) (Fig. 2)
As for the postoperative inflammatory status, the overall survival rates were significantly worse in the high postoperative NLR group (p = 0.0006), while there was no relationship between the postoperative GPS and mortality (Fig. 3)
Summary
A preoperative systemic inflammatory response has been reported to be a prognostic factor in patients with colorectal cancer (CRC). The markers of the systemic inflammatory response, such as the neutrophil-to-lymphocyte ratio (NLR) [2,3,4], serum C-reactive protein (CRP) level [5, 6], and Glasgow prognostic score (GPS) [4, 7, 8] have been reported to be associated with the prognosis in patients with CRC Most of these reports investigated the preoperative status, and there have been no reports on the relationship between the systemic inflammatory response in the early stage after surgery and the prognosis after potentially curative resection of CRC.
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