title: Postoperative lymphocyte percentage influences the long-term disease-free survival following a resection for colorectal carcinoma.
abstract: OBJECTIVE
  The aim of this study is to examine the relationship between postoperative laboratory parameters of inflammation and the disease-free survival in patients undergoing resection for colorectal cancer.
  
  
  METHODS
  Six hundred seventy-five consecutive patients who underwent an elective resection for primary colorectal cancer from October 1999 to March 2004 were included in this study. We examined the associations between cancer recurrence and white blood cell count, lymphocyte percentage, neutrophil percentage and C-reactive protein.
  
  
  RESULTS
  Lymphocyte percentage on postoperative days 3 and 7 was significantly higher in patients without recurrence than in those with recurrence. Lymphocyte percentage on postoperative day 7 differed the most between the two groups. On postoperative day 7, Stage II patients with lymphocyte percentage >15% had significantly longer survival compared with the patients with lymphocyte percentage ≤ 15%. A multivariate analysis showed lymphocyte percentage ≤ 15% on postoperative day 7 to be an independent prognostic factor, along with lymph node metastases and serosal invasion. Logistic regression analysis showed that blood loss (>250 ml) and postoperative complications were significant independent predictors of lymphocyte percentage ≤ 15% on postoperative day 7.
  
  
  CONCLUSIONS
  Lymphocyte percentage ≤ 15% on postoperative day 7 is an independent prognostic factor for the patients undergoing a resection for colorectal cancer.
authors.affiliation: Department of Colorectal and Pelvic Surgery, National Cancer Center, Chiba-ken 277-8577, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yoneyama
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
authors.forename: Masanori
authors.initials: M
authors.lastname: Sugitou
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kobayashi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nishizawa
authors.forename: Norio
authors.initials: N
authors.lastname: Saito
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000276:immunology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein