Prognostic value of neutrophil-to-lymphocyte ratios pre- and post-surgery in stage III CRC: a study of 2,742 patients.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY International Journal of Colorectal Disease Pub Date : 2024-12-20 DOI:10.1007/s00384-024-04789-3

Yun Lee, Kung-Chuan Cheng, Yueh-Ming Lin, Chien-Chang Lu, Ko-Chao Lee

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Abstract

Purpose: Stage III colorectal cancer (CRC) is typically treated with surgery; however, it has a high recurrence rate and inconsistent benefits from postoperative chemotherapy. Inflammatory markers like the neutrophil-to-lymphocyte ratio (NLR) have shown prognostic value in various cancers. However, the prognostic significance of NLR measured before and after CRC surgery is not clear. This study aims to clarify the prognostic value of the combination of pre- and post-surgery NLR in stage III CRC patients.

Methods: Patients with stage III CRC treated between 2001 and 2022 were retrospectively analyzed using data from the Chang Gung Medical Research Database. Patients were categorized into 4 groups based on their pre- and post-operative NLR levels. Kaplan-Meier survival analysis and Cox proportional hazard models were used to assess the associations between NLR levels and overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS).

Results: Data from 2,742 patients, median age of 62 years and 54% male, were analyzed. After adjustment, patients in Group IV, with high NLR values both before and after surgery, had greater risks of worse DFS (adjusted hazard ratio [aHR] = 1.30, 95% confidence interval [CI]: 1.13-1.50), OS (aHR = 1.36, 95% CI: 1.14-1.63), and CSS (aHR = 1.27, 95% CI: 1.04-1.55) compared to Group I.

Conclusions: High NLR levels before and after surgery is a strong predictor of poor outcomes in stage III CRC patients. The findings suggest that monitoring NLR at both time points can be a valuable prognostic tool, guiding postoperative care and treatment strategies to improve patient outcomes.

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目的：III 期结直肠癌（CRC）通常采用手术治疗，但其复发率较高，术后化疗的疗效也不稳定。中性粒细胞与淋巴细胞比值（NLR）等炎症指标在各种癌症中都显示出预后价值。然而，在 CRC 手术前后测量的 NLR 的预后意义尚不明确。本研究旨在明确手术前后 NLR 组合对 III 期 CRC 患者的预后价值：方法：利用长庚医学研究数据库中的数据，对 2001 年至 2022 年间接受治疗的 III 期 CRC 患者进行回顾性分析。根据患者术前和术后的 NLR 水平将其分为 4 组。研究采用Kaplan-Meier生存分析和Cox比例危险模型评估NLR水平与总生存期（OS）、无病生存期（DFS）和癌症特异性生存期（CSS）之间的关系：分析了2742名患者的数据，其中中位年龄为62岁，54%为男性。经调整后，与第一组相比，手术前后NLR值均较高的第四组患者DFS（调整后危险比[aHR] = 1.30，95%置信区间[CI]：1.13-1.50）、OS（aHR = 1.36，95% CI：1.14-1.63）和CSS（aHR = 1.27，95% CI：1.04-1.55）恶化的风险更大：结论：手术前后的高 NLR 水平是预测 III 期 CRC 患者不良预后的重要指标。研究结果表明，监测两个时间点的 NLR 可以作为一种有价值的预后工具，指导术后护理和治疗策略，改善患者预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Colorectal Disease 医学-外科

CiteScore

4.90

自引率

3.60%

发文量

206

审稿时长

3-8 weeks

期刊介绍： The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.