title: Clinical implications of systemic inflammatory response markers as independent prognostic factors in colorectal cancer patients.
abstract: OBJECTIVE
  Cancer-related inflammation affects many aspects of malignancy. We confirm the effects of early postoperative systemic inflammation on cancer prognosis.
  
  
  METHODS
  Six hundred consecutive patients underwent surgery for colorectal cancer from 2006 to 2009. Measurements of white blood cells, neutrophils, lymphocytes, monocytes, and platelet counts were performed preoperatively, daily until the fourth postoperative day, and subsequently every two days. Patients were divided into three groups based on the days spent on the leukocyte count to drop below 10,000/mm(3) after surgery.
  
  
  RESULTS
  Preoperative white blood cell (WBC) counts correlated with stage of disease. In univariate survival analyses, tumor, node, metastasis (TNM) stage, and monocyte count were associated with cancer-free survival. In addition, cancer-free survival outcomes were worse in patients who required more than four days for the normalization of WBC count. A TNM stage greater than II and the neutrophil lymphocyte ratio were associated with the duration of overall survival. In a multivariate analysis of these significant variables, TNM stage, an interval longer than four days for normalization of WBC counts and monocyte count independently associated with cancer-free survival.
  
  
  CONCLUSIONS
  Postoperative early inflammatory phase and preoperative monocyte count correlate with poor colon cancer prognosis. We can conclude that preoperative and postoperative inflammatory response and period unfavorably affect the metastatic microenvironment.
authors: Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors: Kwang Yeol
authors: KY
authors: Paik
authors: Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors: In Kyu
authors: IK
authors: Lee
authors: Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors: Yoon Suk
authors: YS
authors: Lee
authors: Department of Biostatistics and Computing, Yonsei University College of Medicine, Seoul, Korea.
authors: Na Young
authors: NY
authors: Sung
authors: Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors: Taek Soo
authors: TS
authors: Kwon
keywords: Colorectal neoplasms; Inflammation; Perioperative period; Prognosis