Significance of inflammation-based indices in the prognosis of patients with non-metastatic colorectal cancer
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Xiangping Song1, Hong Zhu2, Qian Pei1, Fengbo Tan1, Chenglong Li1, Zhongyi Zhou1, Yuan Zhou1, Nanhui Yu1, Yuqiang Li1, Haiping Pei1
1Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha, China
2Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
Haiping Pei, email: [email protected]
Keywords: colorectal cancer, prognostic factors, inflammation, survival, coNLR-PDW
Received: January 17, 2017 Accepted: March 21, 2017 Published: April 01, 2017
Previous studies demonstrated that several inflammation-based hematological indices are closely related to various malignancies, including colorectal cancer (CRC). In this study, the prognostic value of inflammation-based markers, including a combination index termed coNLR-PDW, comprising the preoperative neutrophil-to-lymphocyte ratio (NLR) and the platelet distribution width (PDW), was evaluated in 206 patients with non-metastatic CRC treated with surgery at a single medical center. The association of patient demographics, blood chemistry, and serum biochemical indices with recurrence-free survival (RFS) and overall survival (OS) were examined through univariate and multivariate analysis. Receiver operating characteristic curve analysis revealed the optimal cut-off values of the NLR and lymphocyte-to-monocyte ratio (LMR) to be, respectively, 2.0 and 3.32 for both RFS and OS. For PDW, cut-off values of 17.25% and 17.35% were defined for RFS and OS, respectively. On univariate analysis, lymph node involvement, stage, presence of intravascular emboli (IVE), carbohydrate antigen 199 (CA199) ≥ 35 kU/L, NLR ≥ 2.0, LMR ≤ 3.32, elevated PDW, a high coNLR-PDW score, high blood glucose, and high neutrophil and lymphocyte percentages correlated with poorer RFS and OS (P < 0.05). On multivariate analysis, lymph node involvement, IVE, CA199, PDW, and coNLR-PDW correlated with both RFS and OS (P < 0.05), while NLR correlated only with OS (P = 0.001). These results highlight the usefulness of the coNLR-PDW index as a prognostic marker of non-metastatic CRC outcome. In clinical practice, its assessment could contribute to establishing more personalized regimes for patients undergoing tumor resection surgery.
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