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Preoperative lymphocyte-to-monocyte ratio predicts postoperative infectious complications after laparoscopic colorectal cancer surgery

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International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Background and aim

Postoperative infectious complications (POI), which can increase length of hospital stay, medical cost, and worsen overall survival, are a concern in minimally invasive colorectal cancer (CRC) surgeries. Recent reports showed that relatively new inflammation-based score, lymphocyte-to-monocyte ratio (LMR) is an independent predictor of long-term outcomes after CRC surgeries. In this study, LMR was evaluated as a predictor of short-term postoperative outcomes.

Patients and methods

This was a single-institutional retrospective study of 211 consecutive patients who had undergone laparoscopic CRC surgery with primary tumor resection from January 2014 to August 2015 at Nippon Medical School Chiba Hokusoh Hospital. The patients were divided into two groups (no POI; n = 176 and POI; n = 35). The associations between inflammation-based scores, namely neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and LMR, and the occurrence of POI were investigated. Receiving operator characteristic curve analysis was used to determine the cutoff point of preoperative LMR.

Results

Low LMR (cut-off 3.46), long operative time, and smoking were found to be independent predictors of POI in a multivariate analysis (LMR: Odds ratio 5.61, 95% confidence interval 1.98–15.9, P = 0.001). Patients with low LMR also appeared to have more advanced and aggressive tumours.

Conclusion

This is the first study to report that the lower LMR is a predictive factor of POI after laparoscopic CRC surgery, and it may provide additional information for treatment decisions to prevent POI.

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Acknowledgements

This study was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (15K10037: Matsuda A). We thank Dr. Trish Reynolds, MBBS, FRACP, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

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Author notes

  1. Tunyaporn Kamonvarapitak and Akihisa Matsuda have contributed equally in this work.

Authors and Affiliations

  1. Department of Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan

    Tunyaporn Kamonvarapitak, Akihisa Matsuda, Satoshi Matsumoto, Supaschin Jamjittrong, Nobuyuki Sakurazawa, Youichi Kawano, Hideyuki Suzuki & Masao Miyashita

  2. Department of Surgery, Queen Savang Vadhana Memorial Hospital, 290 Jermjompol Road, Sri Racha, Chonburi, 20110, Thailand

    Tunyaporn Kamonvarapitak & Supaschin Jamjittrong

  3. Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan

    Takeshi Yamada & Hiroshi Yoshida

Authors
  1. Tunyaporn Kamonvarapitak
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  2. Akihisa Matsuda
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Contributions

Study concept and design: MA and MS. Acquisition of data: MA, SN, and KY. Analysis and interpretation of data: MA, YT, MS, JS and SH. Drafting of the manuscript: KT and MA. Study supervision: MM and YH.

Corresponding author

Correspondence to Akihisa Matsuda.

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Kamonvarapitak, T., Matsuda, A., Matsumoto, S. et al. Preoperative lymphocyte-to-monocyte ratio predicts postoperative infectious complications after laparoscopic colorectal cancer surgery. Int J Clin Oncol 25, 633–640 (2020). https://doi.org/10.1007/s10147-019-01583-y

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  • DOI: https://doi.org/10.1007/s10147-019-01583-y

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