title: Impact of the perioperative neutrophil-to-lymphocyte ratio on the long-term survival following an elective resection of colorectal carcinoma.
abstract: OBJECTIVE
  The present study was designed to evaluate the prognostic value of the perioperative neutrophil-to-lymphocyte ratio (NLR) for the long-term survival in patients with colorectal cancer.
  
  
  METHODS
  This was a retrospective study of 524 patients with histologically proven stage II or III colorectal cancer who underwent curative colorectal resection. We classified patients into a low NLR group or high NLR group base on their NLR values at three time points (before surgery (Pre), on the first postoperative day (POD1), and on the third or fourth postoperative day (POD3)) and evaluated the survival according to the group.
  
  
  RESULTS
  The cancer-specific survival was significantly longer in the groups with a low NLR on POD3. The disease-free survival was significantly longer in the group with a low NLR on Pre. We subsequently allocated a score of 1 to patients with a high NLR at each point and reclassified patients into those with a low perioperative NLR group (score of 0 or 1) and high perioperative NLR group (score of 2 or 3). Both the cancer-specific survival and disease-free survival rates were significantly different between the two perioperative NLR groups. Both univariate and multivariate analyses demonstrated that being in the high perioperative NLR group was an independent risk factor for both the cancer-specific survival and disease-free survival.
  
  
  CONCLUSIONS
  Not only the preoperative but also the postoperative NTR is thus considered to be a predictor of the long-time survival in patients with colorectal cancer.
authors.affiliation: Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan, drs1020@ndmc.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Kubo
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.forename: Hideki
authors.initials: H
authors.lastname: Ueno
authors.forename: Eiji
authors.initials: E
authors.lastname: Shinto
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hase
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009504:Neutrophils / Q000378:metabolism*; D059035:Perioperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents