Skip to main content
Log in

The mean corpuscular volume as a prognostic factor for colorectal cancer

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

The aim of the present study was to identify the factors investigated during routine blood examinations which can predict the disease outcome independent of the tumor stage.

Methods

Data from 1174 patients with stage I, II, and III CRC who underwent R0 resection were included. We investigated the correlations between the preoperative routine blood examination data, and clinicopathological factors, and disease-free survival (DFS) using univariate and multivariate analyses.

Results

The univariate analysis showed that tumor location, tumor stage, CRP, serum albumin, creatine kinase, neutrophil-to-lymphocyte ratio, red blood cell count, mean corpuscular volume (MCV), and the administration of postoperative adjuvant chemotherapy were significantly correlated with the DFS. The multivariate analysis of the factors associated with the DFS showed that stage and MCV were significant factors; an MCV of <80 fL was associated with a superior DFS in comparison to an MCV of 80–100 fL (hazard ratio: 0.31, 95% confidence interval: 0.13–0.61, p = 0.0003). The DFS in patients with an MCV of <80 fL was superior to that in patients with an MCV of ≥80 fL, irrespective of whether the patients underwent postoperative adjuvant chemotherapy.

Conclusion

MCV was a prognostic factor for the DFS, independent of the tumor stage, in CRC patients who underwent R0 resection.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008. Int J Cancer. 2010;127:2893–917.

    Article  CAS  PubMed  Google Scholar 

  2. Compton CC, Fielding LP, Burgart LJ, Conley B, Cooper HS, Hamilton SR, et al. Prognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med. 2000;124:979–94.

    CAS  PubMed  Google Scholar 

  3. Satomi A, Murakami S, Ishida K, Matsuki M, Hashimoto T, Sonoda M. Significance of increased neutrophils in patients with advanced colorectal cancer. Acta Oncol. 1995;34:69–73.

    Article  CAS  PubMed  Google Scholar 

  4. Monreal M, Fernandez-Llamazares J, Piñol M, Julian JF, Broggi M, Escola D, et al. Platelet count and survival in patients with colorectal cancer—a preliminary study. Thromb Haemost. 1998;79:916–8.

    CAS  PubMed  Google Scholar 

  5. Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 2005;91:181–4.

    Article  CAS  PubMed  Google Scholar 

  6. McMillan DC, Crozier JE, Canna K, Angerson WJ, McArdle CS. Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer. Int J Colorectal Dis. 2007;22:881–6.

    Article  PubMed  Google Scholar 

  7. Ishizuka M, Nagata H, Takagi K, Iwasaki Y, Kubota K. Combination of platelet count and neutrophil to lymphocyte ratio is a useful predictor of postoperative survival in patients with colorectal cancer. Br J Cancer. 2013;109:401–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. He W, Yin C, Guo G, Jiang C, Wang F, Qiu H, et al. Initial neutrophil lymphocyte ratio is superior to platelet lymphocyte ratio as an adverse prognostic and predictive factor in metastatic colorectal cancer. Med Oncol. 2013;30:439.

    Article  PubMed  Google Scholar 

  9. Son HJ, Park JW, Chang HJ, Kim DY, Kim BC, Kim SY, et al. Preoperative plasma hyperfibrinogenemia is predictive of poor prognosis in patients with nonmetastatic colon cancer. Ann Surg Oncol. 2013;20:2908–13.

    Article  PubMed  Google Scholar 

  10. Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.

    Article  CAS  PubMed  Google Scholar 

  11. Sobin L, Gospodarowicz ML, Wittekind Ch. TNM Classification of malignant tumors. New York: Wiley; 2010.

    Google Scholar 

  12. Jen J, Kim H, Piantadosi S, Liu ZF, Levitt RC, Sistonen P, et al. Allelic loss of chromosome 18q and prognosis in colorectal cancer. N Engl J Med. 1994;331:213–21.

    Article  CAS  PubMed  Google Scholar 

  13. Garrity MM, Burgart LJ, Mahoney MR, Windschitl HE, Salim M, Wiesenfeld M, et al. Prognostic value of proliferation, apoptosis, defective DNA mismatch repair, and p53 overexpression in patients with resected Dukes’ B2 or C colon cancer: a North Central Cancer Treatment Group Study. J Clin Oncol. 2004;22:1572–82.

    Article  CAS  PubMed  Google Scholar 

  14. Tennankore KK, Soroka SD, West KA, Kiberd BA. Macrocytosis may be associated with mortality in chronic hemodialysis patients: a prospective study. BMC Nephrol. 2011;12:19.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Myojo M, Iwata H, Kohro T, Sato H, Kiyosue A, Ando J, et al. Prognostic implication of macrocytosis on adverse outcomes after coronary intervention. Atherosclerosis. 2012;221:148–53.

    Article  CAS  PubMed  Google Scholar 

  16. Zheng YZ, Dai SQ, Li W, Cao X, Li Y, Zhang LJ, et al. Prognostic value of preoperative mean corpuscular volume in esophageal squamous cell carcinoma. World J Gastroenterol. 2013;19:2811–7.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Yokoyama A, Yokoyama T, Kumagai Y, Kato H, Igaki H, Tsujinaka T, et al. Mean corpuscular volume, alcohol flushing, and the predicted risk of squamous cell carcinoma of the esophagus in cancer-free Japanese men. Alcohol Clin Exp Res. 2005;29(10):1877–83.

    Article  PubMed  Google Scholar 

  18. Oh RC, Holt SN, Hitchcock K, Hoekzema G. How do you evaluate macrocytosis without anemia? J Fam Pract. 2008;57(8):548–50.

    PubMed  Google Scholar 

  19. Kaferle J, Strzoda CE. Evaluation of macrocytosis. Am Fam Physician. 2009;79(3):203–8.

    PubMed  Google Scholar 

  20. Lam AP, Gundabolu K, Sridharan A, Jain R, Msaouel P, Chrysofakis G, et al. Multiplicative interaction between mean corpuscular volume and red cell distribution width in predicting mortality of elderly patients with and without anemia. Am J Hematol. 2013;88(11):245–9.

    Article  CAS  PubMed  Google Scholar 

  21. Solak Y, Yilmaz MI, Saglam M, Demirbas S, Verim S, Unal HU, et al. Mean corpuscular volume is associated with endothelial dysfunction and predicts composite cardiovascular events in patients with chronic kidney disease. Nephrology (Carlton). 2013;18(11):728–35.

    Article  Google Scholar 

  22. Shen JG, Cheong JH, Hyung WJ, Kim J, Choi SH, Noh SH. Pretreatment anemia is associated with poorer survival in patients with stage I and II gastric cancer. J Surg Oncol. 2005;91(2):126–30.

    Article  CAS  Google Scholar 

  23. Stadler P, Becker A, Feldmann HJ, Hänsgen G, Dunst J, Würschmidt F, et al. Influence of the hypoxic subvolume on the survival of patients with head and neck cancer. Int J Radiat Oncol Biol Phys. 1999;44(4):749–54.

    Article  PubMed  Google Scholar 

  24. Qu X, Zhang T, Ma H, Sui P, Du J. Lower mean corpuscular hemoglobin concentration is associated with unfavorable prognosis of resected lung cancer. Future Oncol. 2014;10(14):2149–59.

    Article  CAS  PubMed  Google Scholar 

  25. Moullet I, Salles G, Ketterer N, Dumontet C, Bouafia F, Neidhart-Berard EM, et al. Frequency and significance of anemia in non-Hodgkin’s lymphoma patients. Ann Oncol. 1998;9(10):1109–15.

    Article  CAS  PubMed  Google Scholar 

  26. Inanc M, Duran AO, Karaca H, Berk V, Bozkurt O, Ozaslan E, et al. Haematologic parameters in metastatic colorectal cancer patients treated with capecitabine combination therapy. Asian Pac J Cancer Prev. 2014;15(1):253–6.

    Article  CAS  PubMed  Google Scholar 

  27. Jung HA, Kim HJ, Maeng CH, Park SH, Lee J, Park JO, et al. Changes in the mean corpuscular volume after capecitabine treatment are associated with clinical response and survival in patients with advanced gastric cancer. Cancer Res Treat. 2015;47(1):72–7.

    Article  PubMed  Google Scholar 

  28. Karlberg M, Ohrling K, Edler D, Hallström M, Ullén H, Ragnhammar P. Prognostic and predictive value of thymidylate synthase expression in primary colorectal cancer. Anticancer Res. 2010;30(2):645–51.

    Article  CAS  PubMed  Google Scholar 

  29. Takenoue T, Nagawa H, Matsuda K, Fujii S, Nita ME, Hatano K, et al. Relation between thymidylate synthase expression and survival in colon carcinoma, and determination of appropriate application of 5-fluorouracil by immunohistochemical method. Ann Surg Oncol. 2000;7(3):193–8.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Norihiro Yuasa.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest in association with the present study.

Funding source

The present study received no funding.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nagai, H., Yuasa, N., Takeuchi, E. et al. The mean corpuscular volume as a prognostic factor for colorectal cancer. Surg Today 48, 186–194 (2018). https://doi.org/10.1007/s00595-017-1575-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-017-1575-x

Keywords

Navigation