Skip to main content
SpringerLink
Log in

Prognostic Significance of Lymphocyte Counts in Colon Cancer Patients Treated with FOLFOX Chemotherapy

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Purpose

There is increasing interest in immune function in combination with chemotherapy for cancer treatment. However, the effects of chemotherapy on the human immune system remain to be determined. The aim of this study was to investigate the prognostic impact of lymphocyte and neutrophil counts in colon cancer patients who were treated with curative surgery and adjuvant chemotherapy.

Methods

Two hundred thirty-one patients with colon cancers who underwent curative surgery and FOLFOX adjuvant chemotherapy between November 2005 and December 2011 were included. Oncologic outcomes were analyzed with neutrophil count, lymphocyte count, and neutrophil-to-lymphocyte ratio (NLR) before and after chemotherapy.

Results

The 5-year DFS rate was lower in colon cancer patients with low lymphocyte count during chemotherapy (61.9 vs. 76.7%, P = 0.026). Cox multivariate analysis demonstrated that low lymphocyte count during chemotherapy was independently associated with poor disease-free survival (HR 1.829; 95% CI 1.096–3.050; P = 0.021) in colon cancer patients who underwent FOLFOX adjuvant chemotherapy.

Conclusion

Lymphocyte count during chemotherapy is a strong predictor of worse disease-free survival in colon cancer patients who have undergone FOLFOX adjuvant chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Hermanek P Jr, Wiebelt H, Riedl S, Staimmer D et al (1994) Long-term results of surgical therapy of colon cancer. Results of the Colorectal Cancer Study Group. Chirurg 65:287–297

    PubMed  Google Scholar 

  2. Andre T, Boni C, Mounedji-Boudiaf L et al (2004) Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 350:2343–2351

    Article  CAS  PubMed  Google Scholar 

  3. Nishijima TF, Muss HB, Shachar SS et al (2015) Prognostic value of lymphocyte-to-monocyte ratio in patients with solid tumors: a systematic review and meta-analysis. Cancer Treat Rev 41:971–978

    Article  PubMed  Google Scholar 

  4. Ray-Coquard I, Cropet C, Van Glabbeke M et al (2009) Lymphopenia as a prognostic factor for overall survival in advanced carcinomas, sarcomas, and lymphomas. Cancer Res 69:5383–5391

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Shin JS, Suh KW, Oh SY (2015) Preoperative neutrophil to lymphocyte ratio predicts survival in patients with T1-2N0 colorectal cancer. J Surg Oncol 112:654–657

    Article  CAS  PubMed  Google Scholar 

  6. Kitayama J, Yasuda K, Kawai K et al (2011) Circulating lymphocyte is an important determinant of the effectiveness of preoperative radiotherapy in advanced rectal cancer. BMC Cancer 11:1471–2407

    Article  Google Scholar 

  7. Kitayama J, Yasuda K, Kawai K et al (2010) Circulating lymphocyte number has a positive association with tumor response in neoadjuvant chemoradiotherapy for advanced rectal cancer. Radiat Oncol 5:5–47

    Article  Google Scholar 

  8. Ceze N, Thibault G, Goujon G et al (2011) Pre-treatment lymphopenia as a prognostic biomarker in colorectal cancer patients receiving chemotherapy. Cancer Chemother Pharmacol 68:1305–1313

    Article  CAS  PubMed  Google Scholar 

  9. Chu-Yuan H, Jing P, Yi-Sheng W et al (2013) The impact of chemotherapy-associated neutrophil/lymphocyte counts on prognosis of adjuvant chemotherapy in colorectal cancer. BMC Cancer 13:1471–2407

    Article  Google Scholar 

  10. Kobayashi N, Usui S, Kikuchi S et al (2012) Preoperative lymphocyte count is an independent prognostic factor in node-negative non-small cell lung cancer. Lung Cancer 75:223–227

    Article  PubMed  Google Scholar 

  11. Feng JF, Liu JS, Huang Y (2014) Lymphopenia predicts poor prognosis in patients with esophageal squamous cell carcinoma. Medicine 93:e257

    Article  PubMed  PubMed Central  Google Scholar 

  12. Clark EJ, Connor S, Taylor MA et al (2007) Preoperative lymphocyte count as a prognostic factor in resected pancreatic ductal adenocarcinoma. HPB 9:456–460

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Vicente Conesa MA, Garcia-Martinez E, Gonzalez Billalabeitia E et al (2012) Predictive value of peripheral blood lymphocyte count in breast cancer patients treated with primary chemotherapy. Breast 21:468–474

    Article  PubMed  Google Scholar 

  14. Sica A, Saccani A, Bottazzi B et al (2000) Autocrine production of IL-10 mediates defective IL-12 production and NF-kappa B activation in tumor-associated macrophages. J Immunol 164:762–767

    Article  CAS  PubMed  Google Scholar 

  15. Formenti SC, Demaria S (2008) Effects of chemoradiation on tumor-host interactions: the immunologic side. J Clin Oncol 26:1562–1563 (author reply 1563)

    Article  PubMed  Google Scholar 

  16. Menard C, Martin F, Apetoh L et al (2008) Cancer chemotherapy: not only a direct cytotoxic effect, but also an adjuvant for antitumor immunity. Cancer Immunol Immunother 57:1579–1587

    Article  CAS  PubMed  Google Scholar 

  17. Swann JB, Smyth MJ (2007) Immune surveillance of tumors. J Clin Invest 117:1137–1146

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Sakaguchi S, Yamaguchi T, Nomura T et al (2008) Regulatory T cells and immune tolerance. Cell 133:775–787

    Article  CAS  PubMed  Google Scholar 

  19. Sunaga T, Suzuki S, Kogo M et al (2014) The association between neutropenia and prognosis in stage III colorectal cancer patients receiving adjuvant chemotherapy. Eur J Cancer Care 23:394–400

    Article  CAS  Google Scholar 

  20. McCoy MJ, Lake RA, van der Most RG et al (2012) Post-chemotherapy T-cell recovery is a marker of improved survival in patients with advanced thoracic malignancies. Br J Cancer 107:1107–1115

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Tartour E, Blay JY, Dorval T et al (1996) Predictors of clinical response to interleukin-2-based immunotherapy in melanoma patients. J Clin Oncol 14:1697–1703

    Article  CAS  PubMed  Google Scholar 

  22. Mackall CL, Hakim FT, Gress RE (1997) Restoration of T-cell homeostasis after T-cell depletion. Semin Immunol 9:339–346

    Article  CAS  PubMed  Google Scholar 

  23. Schluns KS, Kieper WC, Jameson SC et al (2000) Interleukin-7 mediates the homeostasis of naive and memory CD8 T cells in vivo. Nat Immunol 1:426–432

    Article  CAS  PubMed  Google Scholar 

  24. Tan JT, Ernst B, Kieper WC et al (2002) Interleukin (IL)-15 and IL-7 jointly regulate homeostatic proliferation of memory phenotype CD8+ cells but are not required for memory phenotype CD4+ cells. J Exp Med 195:1523–1532

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Coleman S, Clayton A, Mason MD et al (2005) Recovery of CD8+ T-cell function during systemic chemotherapy in advanced ovarian cancer. Cancer Res 65:7000–7006

    Article  CAS  PubMed  Google Scholar 

  26. Bellone G, Novarino A, Vizio B et al (2009) Impact of surgery and chemotherapy on cellular immunity in pancreatic carcinoma patients in view of an integration of standard cancer treatment with immunotherapy. Int J Oncol 34:1701–1715

    Article  CAS  PubMed  Google Scholar 

  27. Lissoni P, Brivio F, Fumagalli L et al (2005) Enhancement of the efficacy of chemotherapy with oxaliplatin plus 5-fluorouracil by pretreatment with il-2 subcutaneous immunotherapy in metastatic colorectal cancer patients with lymphocytopenia prior to therapy. In Vivo 19:1077–1080

    CAS  PubMed  Google Scholar 

Download references

Authors’ contribution

SYO and OKN have contributed to design of this paper, analysis of data, revising this paper and final approval. YBK and KWS have contributed to revising this paper and final approval.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea

    O Kyu Noh

  2. Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea

    O Kyu Noh

  3. Department of Surgery, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, 443-721, Korea

    Seung Yeop Oh & Kwang Wook Suh

  4. Department of Pathology, Ajou University School of Medicine, Suwon, Korea

    Young Bae Kim

Authors
  1. O Kyu Noh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seung Yeop Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Young Bae Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kwang Wook Suh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seung Yeop Oh.

Ethics declarations

Conflict of interest

The authors do not have any conflicts of interest to declare.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Noh, O.K., Oh, S.Y., Kim, Y.B. et al. Prognostic Significance of Lymphocyte Counts in Colon Cancer Patients Treated with FOLFOX Chemotherapy. World J Surg 41, 2898–2905 (2017). https://doi.org/10.1007/s00268-017-4104-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-017-4104-6

Search

Navigation