title: The elevated preoperative platelet to lymphocyte ratio predicts decreased time to recurrence in colon cancer patients.
abstract: BACKGROUND
  Recent evidence indicates that tumor progression involves factors of systemic inflammation, such as platelets and lymphocytes. In this study, we investigated the prognostic relevance of the preoperative platelet to lymphocyte (P/L) ratio on time to recurrence (TTR) and overall survival (OS) in patients with stage II and III colon cancer (CC) who underwent curative resection.
  
  
  METHODS
  In this retrospective study, 372 CC patients were included. Kaplan-Meier curves and multivariate Cox proportional models were calculated for TTR and OS.
  
  
  RESULTS
  In univariate analysis, the elevated P/L ratio was significantly associated with decreased TTR (HR = 1.60, 95% CI = 1.02 to 2.51, P = .040) and remained significant in multivariate analysis (HR = 1.65, 95% CI = 1.05 to 2.58, P = .030), where HR and CI represent Hazard ratio and confidence interval, respectively. Patients with elevated P/L ratio showed a median TTR of 116 months. In contrast, patients with low P/L ratio had a median TTR of 132 months. In OS analysis, the elevated P/L ratio showed a trend toward decreased OS in univariate analysis (HR = 1.54, 95% CI = .95 to 2.48, P = .079).
  
  
  CONCLUSIONS
  In this study, we identified the preoperative P/L ratio as a prognostic marker for TTR in stage II and III CC patients.
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria; Research Unit: Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Joanna
authors.initials: J
authors.lastname: Szkandera
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Pichler
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria; Research Unit: Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Absenger
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Stotz
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Franziska
authors.initials: F
authors.lastname: Arminger
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Melanie
authors.initials: M
authors.lastname: Weissmueller
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Renate
authors.initials: R
authors.lastname: Schaberl-Moser
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Hellmut
authors.initials: H
authors.lastname: Samonigg
authors.affiliation: Division of General Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Kornprat
authors.affiliation: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Stojakovic
authors.affiliation: Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Avian
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria; Research Unit: Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria. Electronic address: armin.gerger@medunigraz.at.
authors.forename: Armin
authors.initials: A
authors.lastname: Gerger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D010976:Platelet Count; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
keywords: Colon cancer; Platelet to lymphocyte ratio; Prognostic factor; Systemic inflammation