Gastrointestinal (Colorectal) Cancer
Impact of a novel inflammation-based prognostic system on patients undergoing surgery for colorectal cancer: A retrospective study of 480 Japanese patients.
Background: Recent studies have demonstrated that the systemic inflammatory response (SIR), including reactive thrombocytosis and neutrophil to lymphocyte ratio (NLR), is associated with the postoperative survival of patients with several types of cancer. The aim of this study isto estimate the usefulness of a novel inflammation-based prognostic system, named combination of platelet count and neutrophil to lymphocyte ratio (COP-NLR), for predicting the postoperative survival of patients with colorectal cancer (CRC). Methods: The COP-NLR was calculated on the basis of data obtained on the day of admission as follows: patients with both an elevated platelet count (>30 x 104/mm3) and an elevated NLR (>3) were allocated a score of two, and patients showing one or neither were allocated a score of one or zero, respectively. Results: Four hundred eighty patients were enrolled. Multivariate analysis of clinical characteristics selected by univariate analysis such as the maximum tumor diameter (<40/>40, mm), serum levels of C-reactive protein (CRP), albumin, carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), the Glasgow Prognostic Score (GPS) and COP-NLR showed that the COP-NLR (0/1, 2) (odds ratio, 1.970; 95% C.I., 1.006 - 3.859; P = 0.048) had an association with cancer-specific survival, along with CEA (odds ratio, 1.004; 95% C.I., 1.001-1.008; P = 0.009) and CA19-9 (odds ratio, 1.001; 95% C.I., 1.000-1.001; P = 0.040). Kaplan-Meier analysis revealed that the COP-NLR was able to divide such patients into three independent groups (P < 0.001). Conclusions: The COP-NLR is considered to be a useful predictor of postoperative survival in patients with CRC.