International Journal of Colorectal Disease

, Volume 25, Issue 12, pp 1427–1433

Elevated preoperative neutrophil to lymphocyte ratio predicts risk of recurrence following curative resection for stage IIA colon cancer

  • Pei-Rong Ding
  • Xin An
  • Rong-Xin Zhang
  • Yu-Jing Fang
  • Li-Ren Li
  • Gong Chen
  • Xiao-Jun Wu
  • Zhen-Hai Lu
  • Jun-Zhong Lin
  • Ling-Heng Kong
  • De-Sen Wan
  • Zhi-Zhong Pan
Original Article

Abstract

Background and Objectives

Adjuvant chemotherapy for stage II colon cancer remains controversial but may be considered for patients with high-risk features. Recent studies have shown that elevated neutrophil to lymphocyte ratio (NLR) is a worse prognostic factor and a predictor of response to chemotherapy in patients with advanced colorectal cancer. The purpose of this study was to evaluate whether NLR predicts risk of recurrence in patients with stage IIA colon cancer undergoing curative resection without adjuvant chemotherapy.

Methods

We retrospectively reviewed 141 consecutive patients with stage IIA colon cancer treated with curative surgery alone from 2002 to 2006. NLR, as well as demographics, clinical, histopathologic, and laboratory data were analyzed. Univariate and multivariate analyses were conducted to identify prognostic factors associated with recurrent-free survival (RFS).

Results

Cox’s regression analysis demonstrated that elevated NLR (>4) (hazard ratio, 4.88; P < 0.01) and less lymph node sampling (<15 lymph nodes; hazard ratio, 3.80; P < 0.05) were adverse prognostic factors for RFS. The 5-year RFS was 91.4% (95% CI, 88.6–94.2%) for patients with normal NLR and 63.8% (51.1–76.3%) for patients with elevated NLR. The 5-year RFS for patients with 0, 1, and 2 of the identified risk factors was 95.1%, 87.4%, and 33.3%, respectively (P < 0.001).

Conclusions

Elevated preoperative NLR is an independent predictor of worse RFS for patients with stage IIA colon cancer and a potential biomarker to identify candidates for adjuvant chemotherapy.

Keywords

Neutrophil to lymphocyte ratio Colon cancer Stage IIA 

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Pei-Rong Ding
    • 1
    • 2
  • Xin An
    • 1
    • 3
  • Rong-Xin Zhang
    • 1
    • 2
  • Yu-Jing Fang
    • 1
    • 2
  • Li-Ren Li
    • 1
    • 2
  • Gong Chen
    • 1
    • 2
  • Xiao-Jun Wu
    • 1
    • 2
  • Zhen-Hai Lu
    • 1
    • 2
  • Jun-Zhong Lin
    • 1
    • 2
  • Ling-Heng Kong
    • 1
    • 2
  • De-Sen Wan
    • 1
    • 2
  • Zhi-Zhong Pan
    • 1
    • 2
  1. 1.State Key Laboratory of Oncology in South ChinaGuangzhouPeople’s Republic of China
  2. 2.Department of Colorectal SurgeryCancer Center, Sun Yat-sen UniversityGuangzhouPeople’s Republic of China
  3. 3.Department of Medical OncologyCancer Center, Sun Yat-sen UniversityGuangzhouPeople’s Republic of China

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