Prognostic Role Of Preoperative Inflammatory Markers In Postoperative Patients With Colorectal Cancer

Objective: Inflammatory response markers are prognostic factors for several cancers,but their role in postoperative colorectal cancer(CRC)is unclear.The purpose was to evaluate the role of preoperative Neutrophil-to-Lymphocyte ratio(NLR),Platelet-to-Lymphocyte-ratio(PLR),and Lymphocyte-to-monocyte ratio(LMR)in the prognosis of postoperative CRC patients.Methods: We retrospectively reviewed 448 CRC patients who had undergone surgical resection from December 2015 to December 2017 in our hospital.The plasma NLR,PLR,LMR,CEA,and CA19-9 were collected within 2 weeks before the operation.We recorded the clinical characteristics and survival data by reviewing medical records and phone calls.We analyzed preoperative inflammatory markers and clinical features using Pearson chi-squared tests or Fisher’s tests.Uni-and multivariate Cox regression analyses were performed,and overall survival(OS)was estimated with the Kaplan–Meier method.Results: A total of 123 of the 448 CRC patients in this study died during followup.NLR≥2.81 and PLR≥168.24 were associated with worse overall survival in postoperative CRC(HR = 2.140,95%CI =(1.488-3.078),p < 0.001;HR =1.820,95%CI =(1.271-2.605),p = 0.001).LMR≥5.46 was associated with improved overall survival in postoperative CRC(HR = 0.341,95%CI =(0.188-0.618),p < 0.001).In the multivariate regression analysis,the increase of NLR resulted in an increase in the risk of death(HR = 1.678,95%CI =(1.114-2.527),p = 0.013),and for the LMR,a reduction of the risk of death(HR = 0.480,95%CI =(0.256-0.902),p = 0.023).Moreover,TNM stage,the degree of differentiation,CA-199,CEA,nerve or vascular invasion(NVI)and adjuvant chemotherapy after surgery also were associated with worse overall survival in postoperative CRC.Conclusion: Current evidence indicates that preoperative inflammatory markers NLR,LMR,and PLR are associated with overall survival in postoperative patients with colorectal cancer.NLR≥2.81 is an independent risk factor,and LMR≥5.46 is an independent protective factor in CRC patients after surgery.