BACKGROUND AND OBJECTIVES: The detection of a simple and reliable prognostic biomarker for colorectal cancer (CRC) outcomes remains a significant challenge. The use of neutrophil-to-lymphocyte ratio (NLR), has been reported to predict surgical and survival outcomes. The aim of our review was to assess the predictive value of pre-operative NLR in predicting post-operative outcomes in CRC. METHODS: A systematic review of the available studies on NLR in CRC was performed. Primarily, we assessed its ability to predict survival outcomes, and highlight values that would help adjuvant therapy choices. RESULTS: 19 studies comprising 10 259 patients were included. Eleven and eight studies reported on patients with localized CRC and colorectal liver metastasis, respectively. Five-year survival for those with localized CRC was 77.2% in patients with a "low" pre-operative NLR versus 50.8% in those with a "high" pre-operative NLR value. Alternatively, for patients with colorectal liver metastasis, patients with a "high" pre-operative NLR value had a 5-year survival of 27%. CONCLUSION: Elevated pre-operative NLR>5 is associated with poorer long-term survival in both patients with localized CRC and those with liver metastasis. NLR is a useful biomarker in delineating those patients with poorer prognosis and whom may benefit from adjuvant therapies.
BACKGROUND AND OBJECTIVES: The detection of a simple and reliable prognostic biomarker for colorectal cancer (CRC) outcomes remains a significant challenge. The use of neutrophil-to-lymphocyte ratio (NLR), has been reported to predict surgical and survival outcomes. The aim of our review was to assess the predictive value of pre-operative NLR in predicting post-operative outcomes in CRC. METHODS: A systematic review of the available studies on NLR in CRC was performed. Primarily, we assessed its ability to predict survival outcomes, and highlight values that would help adjuvant therapy choices. RESULTS: 19 studies comprising 10 259 patients were included. Eleven and eight studies reported on patients with localized CRC and colorectal liver metastasis, respectively. Five-year survival for those with localized CRC was 77.2% in patients with a "low" pre-operative NLR versus 50.8% in those with a "high" pre-operative NLR value. Alternatively, for patients with colorectal liver metastasis, patients with a "high" pre-operative NLR value had a 5-year survival of 27%. CONCLUSION: Elevated pre-operative NLR>5 is associated with poorer long-term survival in both patients with localized CRC and those with liver metastasis. NLR is a useful biomarker in delineating those patients with poorer prognosis and whom may benefit from adjuvant therapies.
Authors: Daniel Triner; Samantha N Devenport; Sadeesh K Ramakrishnan; Xiaoya Ma; Ryan A Frieler; Joel K Greenson; Naohiro Inohara; Gabriel Nunez; Justin A Colacino; Richard M Mortensen; Yatrik M Shah Journal: Gastroenterology Date: 2018-12-11 Impact factor: 22.682
Authors: Daniel C McFarland; Devika R Jutagir; Andrew H Miller; William Breitbart; Christian Nelson; Barry Rosenfeld Journal: J Natl Compr Canc Netw Date: 2020-04 Impact factor: 11.908
Authors: Elizabeth M Cespedes Feliciano; Candyce H Kroenke; Jeffrey A Meyerhardt; Carla M Prado; Patrick T Bradshaw; Marilyn L Kwan; Jingjie Xiao; Stacey Alexeeff; Douglas Corley; Erin Weltzien; Adrienne L Castillo; Bette J Caan Journal: JAMA Oncol Date: 2017-12-01 Impact factor: 31.777