Blood cell markers that can predict the long-term outcomes of patients with colorectal cancer

Objectives To identify blood cell markers that predict the long-term outcomes of patients with colorectal cancer. Methods Data from 892 stage II and III colorectal cancer patients who underwent R0 resection were included. We analyzed the correlations of the preoperative blood data, previously reported prognostic indices, and clinicopathologic factors with the long-term outcomes, such as relapse-free survival and overall survival, using univariate and multivariate analyses. Results Multivariate analysis showed that tumor location, stage, mean corpuscular volume, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio were significantly correlated with relapse-free survival. A mean corpuscular volume >= 80.5 fL, neutrophil-to-lymphocyte ratio >= 5.5, and lymphocyte-to-monocyte ratio <3.4 had hazard ratios for disease relapse between 1.39 and 1.93. The cumulative scores of these three factors were aggregated into a laboratory prognostic score, with a maximum score at 6. The relapse-free survival and overall survival were well stratified by a laboratory prognostic score between 0-3 and 4-6, respectively, independent of the stage. Conclusion The mean corpuscular volume, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio can serve as blood cell markers to predict the long-term outcomes of patients who underwent R0 resection for stage II/III colorectal cancer.