Author(s)

Shinya Munakata^*, Kiichi Sugimoto, Kumpei Honjo, Masaya Kawai, Shingo Kawano, Hirohiko Kamiyama, Masakazu Ouchi, Makoto Takahashi, Yuichi Tomiki, Kazuhiro Sakamoto

Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.

Objectives: Our aim is investigating the predictive potential of these available and convenient laboratory dates in stage IV colorectal cancer (CRC) patients. Methods: We identified the cases of 114 consecutive patients who underwent the surgery at our Hospital between January 2006 and December 2012 by using the multivariate analysis, the Cox proportional-hazard regression model. Results: Multivariate analysis for the predictors of survival showed metastatic lesion resection [hazard ratio (HR) = 3.2, 95% confidence interval (CI) 1.6 - 6.6; p = 0.007] and only primary lesion resection (HR = 1.9, 95% CI 1.1 - 4.0; p = 0.045) remained independently significant prognostic factors. Therefore, we divided in 3 groups, 1) metastatic lesion resection group with primary lesion resection (n = 52 in the Met/Prim lesion group), 2) primary lesion resection without metastatic lesion resection (n = 38 in the Primary lesion group) and 3) palliative operation (n = 24 in the Palliative group). Age was the only independent risk factor in the Met/Prim lesion group. In the Primary lesion group, Neutrophil lymphocyte ratio (NLR) > 5, elevated Alanine aminotransferase and patients without chemotherapy were correlated with poor survival. In the Palliative group, NLR > 5 and patients who could not be treated with chemotherapy remained independent predictors of worse survival. Conclusions: NLR is not only simple and convenient for classification of patients, but also one of the important predictors of mortality for stage IV incurable CRC patients.

Colorectal Cancer, Neutrophil-Lymphocyte Ratio, Surgery, Prognosis, Metastasis

Munakata, S. , Sugimoto, K. , Honjo, K. , Kawai, M. , Kawano, S. , Kamiyama, H. , Ouchi, M. , Takahashi, M. , Tomiki, Y. and Sakamoto, K. (2018) Neutrophil-Lymphocyte Ratio as a Prognostic Factor in Incurable Stage IV Colorectal Cancer. Open Journal of Gastroenterology, 8, 45-56. doi: 10.4236/ojgas.2018.82005.