title: Elevated neutrophil to lymphocyte ratio predicts poor prognosis in advanced colorectal cancer patients receiving oxaliplatin-based chemotherapy.
abstract: BACKGROUND
  The aim of this study was to assess whether the neutrophil to lymphocyte ratio (NLR) and other laboratory markers may predict the prognosis of advanced colorectal cancer (CRC) patients receiving palliative chemotherapy.
  
  
  METHODS
  The study population included 50 patients with far advanced or recurrent unresectable CRC who received oxaliplatin-based combination chemotherapy as first-line treatment in our hospital between June 2005 and November 2010. Seven clinical variables and 7 laboratory indices before chemotherapy were evaluated retrospectively as the possible prognostic factors of overall and progression-free survival.
  
  
  RESULTS
  During the study period, 27 patients (54%) died of CRC. Elevated NLR (≥4.0) was observed in 15 patients (30%). By univariate analysis, elevated NLR, performance status and hypoalbuminemia were significantly associated with both poor overall and progression-free survivals. Multivariate analysis showed that elevated NLR (hazard ratio 4.39, 95% confidence interval 1.82-10.7; p = 0.0013) and thrombocytosis (hazard ratio 5.02, 95% confidence interval 1.69-13.4; p = 0.0066) were independently associated with overall survival.
  
  
  CONCLUSIONS
  Elevated NLR is a powerful predictor of poor response to oxaliplatin-based chemotherapy in patients with unresectable CRC. The ratio is a simply accessible and inexpensive but useful biomarker in CRC patients receiving chemotherapy.
authors.affiliation: Department of Surgical Oncology, Faculty of Medicine, University of Tokyo, Tokyo, Japan. m.kaneko @ fancy.ocn.ne.jp
authors.forename: Manabu
authors.initials: M
authors.lastname: Kaneko
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nozawa
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Sasaki
authors.forename: Kumiko
authors.initials: K
authors.lastname: Hongo
authors.forename: Masaya
authors.initials: M
authors.lastname: Hiyoshi
authors.forename: Noriko
authors.initials: N
authors.lastname: Tada
authors.forename: Koji
authors.initials: K
authors.lastname: Murono
authors.forename: Takako
authors.initials: T
authors.lastname: Nirei
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kawai
authors.forename: Eiji
authors.initials: E
authors.lastname: Sunami
authors.forename: Nelson H
authors.initials: NH
authors.lastname: Tsuno
authors.forename: Joji
authors.initials: J
authors.lastname: Kitayama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D009944:Organoplatinum Compounds / Q000627:therapeutic use*; D000077150:Oxaliplatin; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin