Cumulative perioperative lymphocyte/C-reactive protein ratio as a predictor of the long-term outcomes of patients with colorectal cancer.

Publisher: Springer International Country of Publication: Japan NLM ID: 9204360 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1436-2813 (Electronic) Linking ISSN: 09411291 NLM ISO Abbreviation: Surg Today Subsets: MEDLINE

Original Publication: Tokyo : Springer International, c1992-

C-Reactive Protein* ; Lymphocyte Count*; Colorectal Neoplasms/*diagnosis; Adult ; Aged ; Aged, 80 and over ; Biomarkers/blood ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/pathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Perioperative Period ; Predictive Value of Tests ; Prognosis ; Risk ; Survival Rate

Purpose: Systemic inflammatory response influences cancer development and perioperative surgical stress can affect the survival of patients with colorectal cancer (CRC). We developed a system to cumulatively assess perioperative inflammatory response and compare the prognostic value of various cumulative inflammatory and nutritional markers in patients with CRC.
Methods: We assessed perioperative cumulative markers using the trapezoidal area method in 307 patients who underwent surgery for CRC and analyzed the results statistically.
Results: The cumulative lymphocyte to C-reactive protein (CRP) ratio (LCR) predicted survival more accurately than other well-established markers (sensitivity: 80.0%, specificity: 69.3%; area under the curve (AUC): 0.779; P  <  0.001). A low cumulative LCR was correlated with factors associated with disease development, including undifferentiated histology, advanced T stage, lymph node metastasis, distant metastasis, and advanced TNM stage classification. A decreased cumulative LCR was an independent prognostic factor for both overall survival (OS) (Hazard Ratio (HR):5.21, 95% confidence interval [CI] 2.42-11.2; P  <  0.0001) and disease-free survival (DFS) (HR: 1.88, 95% CI 1.07-3.31; P  =  0.02), and its prognostic significance was verified in a different clinical setting. The cumulative LCR was correlated negatively with the intraoperative bleeding volume (P  <  0.0001, R  =  ^- 0.4). Combined analysis of cumulative and preoperative LCR could help stratify risk for the oncological outcomes of CRC patients.
Conclusions: The findings of this study demonstrate the value of the cumulative LCR in the postoperative management of patients with CRC.
(© 2021. Springer Nature Singapore Pte Ltd.)

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Keywords: Colorectal cancer; Lymphocyte-C-reactive protein ratio; Perioperative cumulating of systemic inflammation; Prognosis

0 (Biomarkers)
9007-41-4 (C-Reactive Protein)

Date Created: 20210506 Date Completed: 20211229 Latest Revision: 20211229

20240104

10.1007/s00595-021-02291-9

33954875