全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Neutrophil-Lymphocyte Ratio as a Prognostic Factor in Incurable Stage IV Colorectal Cancer

DOI: 10.4236/ojgas.2018.82005, PP. 45-56

Keywords: Colorectal Cancer, Neutrophil-Lymphocyte Ratio, Surgery, Prognosis, Metastasis

Full-Text   Cite this paper   Add to My Lib

Abstract:

Objectives: Our aim is investigating the predictive potential of these available and convenient laboratory dates in stage IV colorectal cancer (CRC) patients. Methods: We identified the cases of 114 consecutive patients who underwent the surgery at our Hospital between January 2006 and December 2012 by using the multivariate analysis, the Cox proportional-hazard regression model. Results: Multivariate analysis for the predictors of survival showed metastatic lesion resection [hazard ratio (HR) = 3.2, 95% confidence interval (CI) 1.6 - 6.6; p = 0.007] and only primary lesion resection (HR = 1.9, 95% CI 1.1 - 4.0; p = 0.045) remained independently significant prognostic factors. Therefore, we divided in 3 groups, 1) metastatic lesion resection group with primary lesion resection (n = 52 in the Met/Prim lesion group), 2) primary lesion resection without metastatic lesion resection (n = 38 in the Primary lesion group) and 3) palliative operation (n = 24 in the Palliative group). Age was the only independent risk factor in the Met/Prim lesion group. In the Primary lesion group, Neutrophil lymphocyte ratio (NLR) > 5, elevated Alanine aminotransferase and patients without chemotherapy were correlated with poor survival. In the Palliative group, NLR > 5 and patients who could not be treated with chemotherapy remained independent predictors of worse survival. Conclusions: NLR is not only simple and convenient for classification of patients, but also one of the important predictors of mortality for stage IV incurable CRC patients.

References

[1]  Law, W.L., Fan, J.K., Poon, J.T., Choi, H. and Lo, O.S. (2008) Laparoscopic Bowel Resection in the Setting of Metastatic Colorectal Cancer. Annals of Surgical Oncology, 15, 1424-1428.
https://doi.org/10.1245/s10434-008-9820-6
[2]  Huh, J.W., Lee, J.H. and Kim, H.R. (2014) Pretreatment Expression of 13 Molecular Markers as a Predictor of Tumor Responses after Neoadjuvant Chemoradiation in Rectal Cancer. Annals of Surgery, 259, 508-515.
https://doi.org/10.1097/SLA.0b013e31829b3916
[3]  Lee, W.S., Baek, J.H., You, D.H. and Nam, M.J. (2013) Prognostic Value of Circulating Cytokines for Stage III Colon Cancer. Journal of Surgical Research, 182, 49-54.
https://doi.org/10.1016/j.jss.2012.08.051
[4]  Galizia, G., Orditura, M., Romano, C., Lieto, E., Castellano, P., et al. (2002) Prognostic Significance of Circulating IL-10 and IL-6 Serum Levels in Colon Cancer Patients Undergoing Surgery. Clinical Immunology, 102, 169-178.
https://doi.org/10.1006/clim.2001.5163
[5]  Kwon, K.A., Kim, S.H., Oh, S.Y., Lee, S., Han, J.Y., et al. (2010) Clinical Significance of Preoperative Serum Vascular Endothelial Growth Factor, Interleukin-6, and C-Reactive Protein Level in Colorectal Cancer. BMC Cancer, 10, 203.
https://doi.org/10.1186/1471-2407-10-203
[6]  Sideris, M. and Papagrigoriadis, S. (2014) Molecular Biomarkers and Classification Models in the Evaluation of the Prognosis of Colorectal Cancer. Anticancer Research, 34, 2061-2068.
[7]  Chua, W., Charles, K.A., Baracos, V.E. and Clarke, S.J. (2011) Neutrophil/Lymphocyte Ratio Predicts Chemotherapy Outcomes in Patients with Advanced Colorectal Cancer. British Journal of Cancer, 104, 1288-1295.
https://doi.org/10.1038/bjc.2011.100
[8]  McMillan, D.C., Crozier, J.E., Canna, K., Angerson, W.J. and McArdle, C.S. (2007) Evaluation of an Inflammation-Based Prognostic Score (GPS) in Patients Undergoing Resection for Colon and Rectal Cancer. International Journal of Colorectal Disease, 22, 881-886.
https://doi.org/10.1007/s00384-006-0259-6
[9]  Inoue, Y., Iwata, T., Okugawa, Y., Kawamoto, A., Hiro, J., et al. (2013) Prognostic Significance of a Systemic Inflammatory Response in Patients Undergoing Multimodality Therapy for Advanced Colorectal Cancer. Oncology, 84, 100-107.
https://doi.org/10.1159/000343822
[10]  Kishi, Y., Kopetz, S., Chun, Y.S., Palavecino, M., Abdalla, E.K., et al. (2009) Blood Neutrophil-to-Lymphocyte Ratio Predicts Survival in Patients with Colorectal Liver Metastases treated with Systemic Chemotherapy. Annals of Surgical Oncology, 16, 614-622.
https://doi.org/10.1245/s10434-008-0267-6
[11]  Walsh, S.R., Cook, E.J., Goulder, F., Justin, T.A. and Keeling, N.J. (2005) Neutrophil-Lymphocyte Ratio as a Prognostic Factor in Colorectal Cancer. Journal of Surgical Oncology, 91, 181-184.
https://doi.org/10.1002/jso.20329
[12]  Kaneko, M., Nozawa, H., Sasaki, K., Hongo, K., Hiyoshi, M., et al. (2012) Elevated Neutrophil to Lymphocyte Ratio Predicts Poor Prognosis in Advanced Colorectal Cancer Patients Receiving Oxaliplatin-Based Chemotherapy. Oncology, 82, 261-268.
https://doi.org/10.1159/000337228
[13]  Chiang, S.F., Hung, H.Y., Tang, R., Changchien, C.R., Chen, J.S., et al. (2012) Can Neutrophil-to-Lymphocyte Ratio Predict the Survival of Colorectal Cancer Patients Who Have Received Curative Surgery Electively? International Journal of Colorectal Disease, 27, 1347-1357.
https://doi.org/10.1007/s00384-012-1459-x
[14]  Hung, H.Y., Chen, J.S., Yeh, C.Y., Changchien, C.R., Tang, R., et al. (2011) Effect of Preoperative Neutrophil-Lymphocyte Ratio on the Surgical Outcomes of Stage II Colon Cancer Patients Who Do Not Receive Adjuvant Chemotherapy. International Journal of Colorectal Disease, 26, 1059-1065.
https://doi.org/10.1007/s00384-011-1192-x
[15]  Sobin, L.H., Gaspodarowicz, M. and Wittekind, C. (2009) TNM Classification of Malignant Tumours. 7th Edition, Wiley-Blackwell, New York.
[16]  Forrest, L.M., McMillan, D.C., McArdle, C.S., Angerson, W.J. and Dunlop, D.J. (2003) Evaluation of Cumulative Prognostic Scores Based on the Systemic Inflammatory Response in Patients with Inoperable Non-Small-Cell Lung Cancer. British Journal of Cancer, 89, 1028-1030.
https://doi.org/10.1038/sj.bjc.6601242
[17]  Mallappa, S., Sinha, A., Gupta, S. and Chadwick, S.J. (2013) Preoperative Neutrophil to Lymphocyte Ratio > 5 Is a Prognostic Factor for Recurrent Colorectal Cancer. Colorectal Disease, 15, 323-328.
https://doi.org/10.1111/codi.12008
[18]  Kato, T., Yasui, K., Hirai, T., Kanemitsu, Y., Mori, T., et al. (2003) Therapeutic Results for Hepatic Metastasis of Colorectal Cancer with Special Reference to Effectiveness of Hepatectomy: Analysis of Prognostic Factors for 763 Cases Recorded at 18 Institutions. Diseases of the Colon & Rectum, 46, S22-S31.
[19]  Tanoue, Y. (2010) Primary Site Resection Is Superior for Incurable Metastatic Colorectal Cancer. World Journal of Gastroenterology, 16, 3561-3566.
https://doi.org/10.3748/wjg.v16.i28.3561
[20]  Nordlinger, B., Sorbye, H., Glimelius, B., Poston, G.J., Schlag, P.M., et al. (2013) Perioperative FOLFOX4 Chemotherapy and Surgery versus Surgery Alone for Resectable Liver Metastases from Colorectal Cancer (EORTC 40983): Long-Term Results of a Randomised, Controlled, Phase 3 Trial. The Lancet Oncology, 14, 1208-1215.
https://doi.org/10.1016/S1470-2045(13)70447-9
[21]  Balkwill, F. and Mantovani, A. (2001) Inflammation and Cancer: Back to Virchow? The Lancet, 357, 539-545.
https://doi.org/10.1016/S0140-6736(00)04046-0
[22]  Biswas, S.K. and Mantovani, A. (2010) Macrophage Plasticity and Interaction with Lymphocyte Subsets: Cancer as a Paradigm. Nature Immunology, 11, 889-896.
https://doi.org/10.1038/ni.1937
[23]  Gabrilovich, D.I. and Nagaraj, S. (2009) Myeloid-Derived Suppressor Cells as Regulators of the Immune System. Nature Reviews Immunology, 9, 162-174.
https://doi.org/10.1038/nri2506

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133