Prognostic significance of the preoperative lymphocyte-to-monocyte ratio in patients with colorectal cancer

Abstract

Abstract.A correlation between the lymphocyte-to-monocyte ratio (LMR) and the survival of patients with hematological malignancies has been reported previously. However, there have been few studies investigating the prognostic significance of LMR in patients with solid tumors. The aim of the present study was to evaluate the prognostic significance of preoperative LMR in patients with colorectal cancer (CRC). A total of 189 patients undergoing potentially curative surgery for CRC were enrolled. The LMR was calculated from preoperative blood samples by dividing absolute lymphocyte count by absolute monocyte count. A cut-off value of 4.8 was set based on the receiver operating characteristic curve; 116 patients were classified as high-LMR, and 73 patients classified as low-LMR. The high-LMR group exhibited significantly better relapse-free survival (P=0.0018) and overall survival (P=0.0127) rates than the low-LMR group. According to the multivariate analysis of survival, preoperative LMR was identified as an independent prognostic factor for relapse-free survival (P=0.041) and overall survival (P=0.031). Therefore, preoperative LMR is a useful prognostic marker in patients with CRC. IntroductionColorectal cancer (CRC) is the third most common cancer and fourth leading cause of cancer-associated mortality worldwide (1). Despite advances in surgical procedures and adjuvant chemotherapy, 20-25% of patients still experience relapse following curative surgery (2). The Union for International Cancer Control (UICC) tumor node metastasis (TNM) staging system (3) is currently the most reliable indicator of patient prognosis and is widely used amongst practitioners. However, there are differences in patient prognosis even within the same TNM stage. Therefore, more reliable markers are required to improve predictions of cancer recurrence and patient survival.It has previously been reported that inflammation is important in determining cancer progression (4,5). Inflammation-based indices, such as the C-reactive protein level, Glasgow prognostic score, and neutrophil-to-lymphocyte ratio; are useful for predicting the prognosis of patients with CRC as well as various other types of cancer (6-9). Recent studies investigating various types of malignancies have demonstrated a correlation between the lymphocyte-to-monocyte ratio (LMR), which also reflects the degree of systemic inflammation, and patient survival (10-14). However, the prognostic value of the LMR has mainly been investigated in patients with hematological malignancies, with few reports focusing on patients with solid tumors. Therefore, the aim of this retrospective study was to evaluate the prognostic significance of preoperative LMR in patients with CRC who are able to undergo potentially curative surgery. Materials and methods Patients.A total of 189 patients with CRC were enrolled. All patients underwent potentially curative surgery for CRC in the Department of Surgical Oncology, Osaka City University, between January 2007 and December 2009. Patients who received ...

Pretreatment C‐reactive protein/albumin ratio is associated with poor survival in patients with stage IB‐IIA cervical cancer

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Prediction of outcome after curative surgery for colorectal cancer: preoperative haemoglobin, C‐reactive protein and albumin

“…As expected, risk factors for recurrence were more advanced disease and site (left‐sided or rectal) . The association between the modified Glasgow Prognostic Score (1 if CRP > 10 mg/l and 2 if CRP > 10 mg/l and albumin < 35 g/l) and risk for recurrence was also calculated; this was not statistically significant (data not shown). Recurrence‐free survival has been reported to be reduced in colorectal cancer patients with a CRP above 30 mg/l or a CRP/albumin ratio above 0.0271 .…”

“…Low albumin and elevated CRP have been studied, separately or in combination as a score or ratio, to see if they can predict outcomes following the diagnosis of colorectal cancer . A cut‐off level of 10 mg/l for CRP has been used in several previous studies addressing the impact of elevated CRP on cancer outcome.…”

C‐reactive protein/albumin ratio is a predictive factor for prognosis in patients with metastatic renal cell carcinoma

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