Combined use of preoperative lymphocyte counts and the post/preoperative lymphocyte count ratio as a prognostic marker of recurrence after curative resection of stage II colon cancer
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Seiichi Shinji1, Yoshibumi Ueda2,3, Takeshi Yamada1, Michihiro Koizumi1, Yasuyuki Yokoyama1, Goro Takahashi1, Masahiro Hotta1, Takuma Iwai1, Keisuke Hara1, Kohki Takeda1, Mikihiro Okusa1, Hayato Kan1 and Eiji Uchida1
1Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan
2Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
3AMED-PRIME, Japan Agency for Medical Research and Development, Tokyo, Japan
Seiichi Shinji, email: [email protected]
Keywords: lymphocyte count; post/preoperative lymphocyte count ratio; colon cancer; prognostic marker; stage II
Received: August 21, 2017 Accepted: December 11, 2017 Published: December 20, 2017
Purpose: Diagnostic markers for recurrence of colorectal cancer have not been established. The aim of the present study was to identify new diagnostic markers for recurrence after curative surgery of stage II colon cancer.
Materials and Methods: In this study, the prognostic values of the preoperative lymphocyte count and the post/preoperative lymphocyte count ratio (PPLR) were evaluated in 142 patients with localized colon cancer treated with surgery at a single medical center. The associations of patient demographics, blood chemistry, and serum biochemical indices with recurrence-free survival (RFS) and cancer-specific survival (CSS) were examined by univariate and multivariate analyses.
Results: Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off values of the lymphocyte count and PPLR were, respectively, 1555.2/μl and 1.151 for RFS. On univariate analysis, tumor depth of invasion, carbohydrate antigen 19-9 (CA19-9), and preoperative low lymphocyte count (≤1555.2/μl) were all correlated with poorer RFS (p < 0.05). On multivariate analysis, T4, low lymphocyte count, and low PPLR were independent predictors of poor RFS. Furthermore, the patients were categorized into four categories based on preoperative lymphocyte count high/low and PPLR high/low. Patients with a low preoperative lymphocyte count and low PPLR had the poorest RFS and CSS compared to the other patients.
Conclusion: The combination of the preoperative lymphocyte count and the PPLR appears to be a potential marker for predicting recurrence of stage II colon cancer.
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