Elevated preoperative neutrophil to lymphocyte ratio predicts risk of recurrence following curative resection for stage IIA colon cancer.
OBJECTIVE
Adjuvant chemotherapy for stage II colon cancer remains controversial but may be considered for patients with high-risk features. Recent studies have shown that elevated neutrophil to lymphocyte ratio (NLR) is a worse prognostic factor and a predictor of response to chemotherapy in patients with advanced colorectal cancer. The purpose of this study was to evaluate whether NLR predicts risk of recurrence in patients with stage IIA colon cancer undergoing curative resection without adjuvant chemotherapy.


METHODS
We retrospectively reviewed 141 consecutive patients with stage IIA colon cancer treated with curative surgery alone from 2002 to 2006. NLR, as well as demographics, clinical, histopathologic, and laboratory data were analyzed. Univariate and multivariate analyses were conducted to identify prognostic factors associated with recurrent-free survival (RFS).


RESULTS
Cox's regression analysis demonstrated that elevated NLR (>4) (hazard ratio, 4.88; P < 0.01) and less lymph node sampling (<15 lymph nodes; hazard ratio, 3.80; P < 0.05) were adverse prognostic factors for RFS. The 5-year RFS was 91.4% (95% CI, 88.6-94.2%) for patients with normal NLR and 63.8% (51.1-76.3%) for patients with elevated NLR. The 5-year RFS for patients with 0, 1, and 2 of the identified risk factors was 95.1%, 87.4%, and 33.3%, respectively (P < 0.001).


CONCLUSIONS
Elevated preoperative NLR is an independent predictor of worse RFS for patients with stage IIA colon cancer and a potential biomarker to identify candidates for adjuvant chemotherapy.
Ding
Pei-Rong
PR
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, People's Republic of China.
An
Xin
X
Zhang
Rong-Xin
RX
Fang
Yu-Jing
YJ
Li
Li-Ren
LR
Chen
Gong
G
Wu
Xiao-Jun
XJ
Lu
Zhen-Hai
ZH
Lin
Jun-Zhong
JZ
Kong
Ling-Heng
LH
Wan
De-Sen
DS
Pan
Zhi-Zhong
ZZ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001772:Blood Cell Count; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D055815:Young Adult
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