Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Obstructing Colorectal Cancer Treated by Endoscopic Stenting as a Bridge to Surgery

Jiwei Guo; Aik Yong Chok; Hui Jun Lim; Wei Xuan Tay; Weng Kit Lye; Lasitha Bhagya Samarakoon; Emile John Tan; Ronnie Mathew

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저자정보: Jiwei Guo (Singapore General Hospital) Aik Yong Chok (Singapore General Hospital) Hui Jun Lim (Singapore General Hospital) Wei Xuan Tay (Yong Loo Lin School of Medicine National University of Singapore) Weng Kit Lye (Center for Quantitative Medicine Duke-NUS Graduate Medical School) Lasitha Bhagya Samarakoon (Singapore General Hospital) Emile John Tan (Singapore General Hospital) Ronnie Mathew (Singapore General Hospital)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.37 No.3

발행연도: 2021.1

수록면: 159 - 165 (7page)

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Purpose: Neutrophil-to-lymphocyte ratio (NLR) has been reported to predict adverse survival outcomes among patients with colorectal cancer (CRC). This study evaluates the prognostic value of NLR among patients with obstructing CRC who successfully underwent stenting before curative surgery. Methods: We retrospectively reviewed patients who underwent stenting before surgery. Patient demographics, tumor characteristics, perioperative outcomes, recurrence-free survival (RFS), and overall survival (OS) were analyzed. NLR was calculated from the differential white blood cell counts at least 4 days after successful stenting, before elective surgery. Op- timal cutoff to dichotomize NLR was obtained by maximizing log-rank test statistic with recursive partitioning of Kaplan- Meier RFS and OS curves. The optimal cutoff for high NLR was ≥ 5 at presentation before stenting, and ≥ 4 after stenting. Results: Fifty-seven patients with localized obstructing CRC underwent successful endoscopic stenting before curative sur- gery. High NLR was associated with lymphovascular invasion (P=0.006) and apical lymph node involvement (P=0.034). Major perioperative complication(s) (hazard ratio [HR], 11.34; 95% confidence interval [CI], 2.49 to 51.56; P<0.01) and high NLR (HR, 3.69; 95% CI, 1.46 to 9.35; P < 0.01) negatively impacted OS on univariate and multivariate analyses. High NLR negatively impacted RFS on univariate analysis (HR, 2.91; 95% CI, 1.29 to 6.60; P = 0.01). Conclusion: NLR of ≥ 4 after stenting is an independent prognostic factor among patients with obstructing localized CRC who are successfully decompressed by endoscopic stenting before curative surgery.

#Obstructing colorectal cancer #Neutrophil-to-lymphocyte ratio #Stents

참고문헌 (30)

참고문헌 신청

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백광열 / 2014 / Clinical Implications of Systemic Inflammatory Response Markers as Independent Prognostic Factors in Colorectal Cancer Patients / Cancer Research and Treatment 46(1):65~73

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Goh BK / 2016 / Blood neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are independent prognostic factors for surgically resected gastrointestinal stromal tumors / Surgery 159:1146~1156

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