title: Preoperative neutrophil-to-lymphocyte ratio predicts clinical outcome in patients with stage II and III colon cancer.
abstract: AIM/ BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR), a combined indicator of inflammation and immunology, is as yet unidentified regarding the clinical outcome of stage II and III colon cancer patients. We evaluated the effect of NLR on time-to-recurrence (TTR) and overall survival (OS) in selected patients.
  
  
  METHODS
  A total of 504 patients with stage II and III colon cancer were included in this retrospective study. Preoperative NLR with a cut-off level of 4 was associated with TTR and OS.
  
  
  RESULTS
  In univariate analysis, elevated NLR was significantly associated with decreased TTR (p=0.001) and remained significant in multivariate analysis (p=0.006). Patients with NLR >4 showed a median TTR of 62.2 months. In contrast, patients with NLR ≤ 4 had a median TTR of 92.6 months.
  
  
  CONCLUSIONS
  This study suggests that preoperative NLR may be an independent prognostic marker for TTR in stage II and III colon cancer patients.
authors.affiliation: Priv.-Doz., Assoc.-Prof. Division of Clinical Oncology, Research Unit Genetic Epidemiology and Pharmacogenetics, Department of Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. armin.gerger@medunigraz.at.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Absenger
authors.forename: Joanna
authors.initials: J
authors.lastname: Szkandera
authors.forename: Michael
authors.initials: M
authors.lastname: Stotz
authors.forename: Ulrich
authors.initials: U
authors.lastname: Postlmayr
authors.forename: Martin
authors.initials: M
authors.lastname: Pichler
authors.forename: Anna Lena
authors.initials: AL
authors.lastname: Ress
authors.forename: Renate
authors.initials: R
authors.lastname: Schaberl-Moser
authors.forename: Hans
authors.initials: H
authors.lastname: Loibner
authors.forename: Hellmut
authors.initials: H
authors.lastname: Samonigg
authors.forename: Armin
authors.initials: A
authors.lastname: Gerger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009504:Neutrophils / Q000276:immunology*; D057234:Preoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Neutrophil-to-lymphocyte ratio; colon cancer