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Elevated preoperative neutrophil to lymphocyte ratio predicts survival following hepatic resection for colorectal liver metastases
- Source :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 34(1)
- Publication Year :
- 2007
-
Abstract
- The neutrophil-lymphocyte ratio (NLR) provides an indicator of inflammatory status. An elevated NLR has been shown to be a prognostic indicator in primary colorectal malignancy. The aim of this study was to establish whether NLR predicts outcome in patients undergoing resection for colorectal liver metastasis.Retrospective analysis of the white cell and differential counts for 440 patients undergoing liver resections for colorectal liver metastasis between January 1996 and January 2006. An NLRor = 5 was considered to be elevated.Two hundred and eighty-nine males and 151 females were included. Seventy-eight patients (18%) had an elevated NLR, 55 of whom died, giving elevated NLR a positive predictive value (PPV) for death of 71%. Sixty of the 78 patients had recurrent disease giving raised NLR an PPV for recurrence of 78%. The 5-year survival for patients undergoing resection with high NLR was significantly worse than that for patients with normal NLR (22% vs. 43%, p0.0001). Univariate analysis of factors affecting survival revealed raised NLR, number of metastases8, tumour size5 cm and age70 significantly affected outcome. All factors except tumour size remained significant predictors of term survival on multivariate analysis (NLR:HR=2.261, CI=1.654-3.129, p0.0001, metastases8:HR=1.611, CI=1.006-2.579, p=0.047, age70:HR=1.418, CI=1.049-1.930, p=0.027). Elevated NLR was found to be the sole positive predictor of recurrence on univariate analysis (HR=4.521, CI=2.475-8.257, p0.0001).Elevated NLR increases both risk of death and the risk of recurrence in patients who undergo surgery for CRLM. Preoperative NLR measurement may therefore provide a simple method of identifying patients with a poorer prognosis.
- Subjects :
- Adult
Male
medicine.medical_specialty
Multivariate analysis
Hepatic resection
Neutrophils
medicine.medical_treatment
Cell Count
Kaplan-Meier Estimate
Preoperative care
Gastroenterology
Disease-Free Survival
Metastasis
Predictive Value of Tests
Internal medicine
Preoperative Care
Medicine
Hepatectomy
Humans
Lymphocytes
Neutrophil to lymphocyte ratio
Aged
Aged, 80 and over
Univariate analysis
business.industry
fungi
Liver Neoplasms
General Medicine
Middle Aged
medicine.disease
Surgery
Oncology
Predictive value of tests
Multivariate Analysis
Female
Neoplasm Recurrence, Local
business
Colorectal Neoplasms
Subjects
Details
- ISSN :
- 15322157
- Volume :
- 34
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
- Accession number :
- edsair.doi.dedup.....ac98b3bd857cadb28c9da41411c96388