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Ann Surg Oncol. 2009 Mar;16(3):614-22. doi: 10.1245/s10434-008-0267-6. Epub 2009 Jan 8.

Blood neutrophil-to-lymphocyte ratio predicts survival in patients with colorectal liver metastases treated with systemic chemotherapy.

Author information

1
Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030-4009, USA.

Abstract

BACKGROUND:

Whether neutrophil-to-lymphocyte ratio (NLR) predicts survival of patients with colorectal liver metastases (CLM) treated with systemic chemotherapy remains unclear.

METHODS:

Clinicopathologic data were reviewed for patients with CLM treated with chemotherapy and resection (n=200) or chemotherapy only (n=90). Univariate and multivariate analyses for prognostic factors were performed. In the resection group, whether chemotherapy normalizes high NLR and the effect of NLR normalization on survival were evaluated.

RESULTS:

In the resection group, patients with preoperative NLR>5 had a worse 5-year survival rate than patients with NLR <or= 5 (19% vs. 43%; P=0.009), and NLR>5 was the only independent preoperative predictor of worse survival (P=0.016; hazard ratio [HR]=2.22; 95% confidence interval [95% CI], 1.16-4.25). In the nonresection group, patients with prechemotherapy NLR>5 had a worse 3-year survival rate than patients with NLR <or= 5 (0% vs. 23%; P=0.0002), and NLR>5 was the only independent predictor of worse survival (P=0.001; HR = 2.91; 95% CI, 1.54-5.50). In the resection group, chemotherapy normalized high NLR in 17 of 25 patients, and these 17 patients had better survival than the 8 patients with high NLR both before chemotherapy and before surgery (P=0.021).

CONCLUSION:

NLR independently predicts survival in patients with CLM treated with chemotherapy followed by resection or chemotherapy only. When chemotherapy normalizes high NLR, improved survival is expected.

PMID:
19130139
DOI:
10.1245/s10434-008-0267-6
[Indexed for MEDLINE]

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