The Lymphocyte-to-Monocyte Ratio is a Superior Predictor of Overall Survival in Comparison to Established Biomarkers of Resectable Colorectal Cancer
نویسندگان
چکیده
OBJECTIVE The study aims to investigate the prognostic value of the lymphocyte-to-monocyte ratio (LMR) in patients with colorectal cancer (CRC) undergoing curative resection and to compare it to established biomarkers including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), modified Glasgow prognostic score (mGPS), and combined BRAF-mismatch repair (MMR) status. BACKGROUND The prognostic significance of systemic inflammatory markers in CRC such as the NLR, PLR, and mGPS has been well defined. Commonly used genetic markers such as combined BRAF-MMR status have also been found to be prognostic. Recent evidence, although limited, suggests that the preoperative LMR may be prognostic in CRC. METHODS Data from the Northern Sydney Local Health District from January 1998 to December 2012 were retrospectively collected. Of 3281 consecutive patients identified, 1623 patients who underwent curative resection were deemed eligible for inclusion. The relation between the LMR, clinicopathologic variables, and other biomarkers were analyzed in Kaplan-Meier log-rank survival analysis and then multivariate Cox regression models looking for association with overall survival (OS). RESULTS In multivariate analysis of all patients, elevated LMR was associated with better OS (hazard ratio 0.569, 95% confidence interval: 0.478-0.677, P < 0.001) independent of age (P < 0.001), T stage (P < 0.001), N stage (P < 0.001), and grade (P = 0.049). The NLR, PLR, and combined BRAF-MMR status were not independently significant. In multivariate subgroup analysis of 389 patients with mGPS, LMR remained the only independently significant biomarker (hazard ratio 0.620, 95% confidence interval: 0.437-0.880, P = 0.007). CONCLUSIONS The LMR is an independent predictor of OS in patients with CRC undergoing curative resection and appears to be superior to pre-existing biomarkers.
منابع مشابه
Role of Molecular Biomarkers in Colorectal Cancer
Colorectal cancer (CRC) is amongst the most widespread cancers and is a most common cause of cancer associated mortality universally. Since previous decades, it has been cleared that CRC develops owing to the buildup of a series of genetic and epigenetic changes in the normal colonic epithelium. Regardless of the current development in surgery and therapies, overall survival of end stage CRC pa...
متن کاملPrognostic Value of Lymph Node Ratio in comparison to Lymph Node Metastases in Stage III Colon Cancer
Background & Objectives: Colon cancer is currently of high incidence and mortality rate. Identifying the factors influencing its prognosis can be very beneficial to its clinical treatment. Recent studies have shown that lymph nodes ratio can be considered as an important prognostic factor. The aim of the present study is to investigate the effect of this factor on the prognosis of the ...
متن کاملPreoperative lymphocyte-to-monocyte ratio represents a superior predictor compared with neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios for colorectal liver-only metastases survival
Systemic inflammation was recognized as an essential factor contributing to the development of malignancies. This study aimed to investigate the prognostic value of pre-operative lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in patients with colorectal liver-only metastases (CLOM) undergoing hepatectomy. We retrospectively enrol...
متن کاملThe role of neutrophil-to-lymphocyte ratio (NLR) in predicting small bowel toxicity and outcome for rectal cancer patients who received chemoradiotherapy
Background: In this study, we explored the relationship between neutrophil-to-lymphocyte ratio (NLR) and grade 3 or higher treatment related small bowel toxicity and treatment outcome of patients with rectal cancer undergoing capecitabine and concurrent intensity modulated radiotherapy (IMRT). Materials and Methods: From the year of 2012 to 2013, 117 rectal cancer patients who ...
متن کاملThe monocyte to red blood cell count ratio is a strong predictor of postoperative survival in colorectal cancer patients: The Fujian prospective investigation of cancer (FIESTA) study
Background and Aims: We sought to evaluate the prognosis of preoperative blood routine parameters for the mortality of colorectal cancer patients after surgery by eliciting a subset of data from the ongoing Fujian prospective investigation of cancer (FIESTA) study. Methods: 1318 colorectal cancer patients with completed survival data were enrolled between 2000 and 2008. Effect-size estimates ar...
متن کامل