title: Prognostic significance of systemic inflammatory response in stage II colorectal cancer.
abstract: It is considered that stage II colorectal cancers have heterogeneous oncological outcomes. It remains to be determined whether inflammatory markers can predict survival after curative surgery in these patients. The aim of this study was to investigate the prognostic impact of preoperative inflammatory markers after curative surgery in stage II colorectal cancers.
  
  
  
  Two hundred sixty-one patients with stage II colorectal cancers who underwent curative surgery between January 2006 and December 2011 were reviewed. Oncologic outcomes were analyzed with neutrophil count, lymphocyte count, monocyte count, neutrophil to lymphocyte ratio (NLR), and lymphocyte to monocyte ratio.
  
  
  
  Univariate analysis showed that high NLR (hazard ratio (HR), 3.506; 95% confidence interval [CI], 1.415-8.688; P = 0.007) and low LMR (HR, 2.436; 95% CI, 1.010-5.880; P = 0.048) were associated with worse disease-free survival (DFS), and high NLR (HR, 2.834; 95% CI, 1.419-5.662; P = 0.003) and low LMR (HR, 2.374; 95% CI, 1.188-4.742; P = 0.014) were associated with worse overall survival (OS) in stage II colorectal cancer. Cox multivariate analysis demonstrated that high NLR was independently associated with worse DFS (HR, 3.163; 95% CI, 1.058-9.455; P = 0.004) and OS (HR, 3.018; 95% CI, 1.467-6.207; P = 0.003) in stage II colorectal cancer.
  
  
  
  Among the systemic inflammatory markers, NLR is a strong predictor of worse DFS and OS in stage II colorectal cancer.
authors.affiliation: Department of Surgery, Ajou University School of Medicine, Suwon, Korea. Electronic address: kgsosy@ajou.ac.kr.
authors.forename: Seung Yeop
authors.initials: SY
authors.lastname: Oh
authors.affiliation: Department of Pathology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Young Bae
authors.initials: YB
authors.lastname: Kim
authors.affiliation: Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Kwang Wook
authors.initials: KW
authors.lastname: Suh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000150:complications / Q000276:immunology* / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011183:Postoperative Complications / Q000276:immunology*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology*
keywords: Colorectal cancer; Lymphocyte; Neutrophil; Prognosis