Preoperative neutrophil to lymphocyte ratio predicts survival in patients with T1-2N0 colorectal cancer

PurposeNeutrophil to lymphocyte ratio (NLR) is reported to be associated with prognosis of colorectal cancer. The aim of this study is to determine whether the NLR is a predictor of oncological outcomes in patients with stage I colorectal cancer who underwent curative surgery. MethodsTwo hundred sixty-nine patients with stage I colorectal cancer who underwent surgical resection between December 2003 and December 2011 were retrospectively reviewed. The cutoff for NLR was defined as three by maximizing log-rank test statistics. We compared patients with a low NLR and those with a high NLR in terms of survival. ResultsThe 5-year disease-free survival (DFS) and cancer-specific survival (CSS) rates were lower in patients with a high NLR compared to those with a low NLR in stage I colorectal cancer (89.5% vs. 97.4%, P=0.006; 94.0% vs. 98.9%, P=0.022). Cox multivariate analysis demonstrated that preoperative NLR was independently associated with DFS (HR, 5.216; 95%CI, 1.400-19.431; P=0.014) and CSS (HR, 6.190; 95%CI, 1.034-37.047; P=0.046) in patients with stage I colorectal cancer. ConclusionThe preoperative NLR is a prognostic factor predicting DFS and CSS in patients with stage I colorectal cancer who underwent curative surgery. J. Surg. Oncol. 2015;112:654-657. (c) 2015 Wiley Periodicals, Inc.