Neutrophil-Lymphocyte Ratio as a Prognostic Factor in Incurable Stage IV Colorectal Cancer

• 作者: Hirohiko Kamiyama Kazuhiro Sakamoto Kiichi Sugimoto Kumpei Honjo Makoto Takahashi Masakazu Ouchi Masaya Kawai Shingo Kawano Shinya Munakata Yuichi Tomiki
• 来源期刊: 肠胃病学期刊(英文)
• 学科: 医学
• 关键词: COLORECTAL Cancer Neutrophil-Lymphocyte RATIO Surgery Prognosis METASTASIS
• 年，卷（期）: 2018,（2）
• 页码范围: 45-56
• 页数: 12页
• 分类号: R73

摘要

Objectives: Our aim is investigating the predictive potential of these available and convenient laboratory dates in stage IV colorectal cancer (CRC) patients. Methods: We identified the cases of 114 consecutive patients who underwent the surgery at our Hospital between January 2006 and December 2012 by using the multivariate analysis, the Cox proportional-hazard regression model. Results: Multivariate analysis for the predictors of survival showed metastatic lesion resection [hazard ratio (HR) = 3.2, 95% confidence interval (CI) 1.6 - 6.6;p = 0.007] and only primary lesion resection (HR = 1.9, 95% CI 1.1 - 4.0;p = 0.045) remained independently significant prognostic factors. Therefore, we divided in 3 groups, 1) metastatic lesion resection group with primary lesion resection (n = 52 in the Met/Prim lesion group), 2) primary lesion resection without metastatic lesion resection (n = 38 in the Primary lesion group) and 3) palliative operation (n = 24 in the Palliative group). Age was the only independent risk factor in the Met/Prim lesion group. In the Primary lesion group, Neutrophil lymphocyte ratio (NLR) > 5, elevated Alanine aminotransferase and patients without chemotherapy were correlated with poor survival. In the Palliative group, NLR > 5 and patients who could not be treated with chemotherapy remained independent predictors of worse survival. Conclusions: NLR is not only simple and convenient for classification of patients, but also one of the important predictors of mortality for stage IV incurable CRC patients.