Systemic Inflammatory Markers as Prognostic Factors in Stage IIA Colorectal Cancer

Background: The aim of this study was to evaluate systemic inflammatory markers as prognostic factors in patients with stage IIA colorectal cancer. Methods: Among the patients who underwent curative resection for colorectal cancer at Seoul National University Hospital between 2002 and 2010, 1,035 who were classified as postoperative pathologic stage IIA (T3N0M0) were included. Systemic inflammatory markers, such as the neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), and serum fibrinogen level, were retrospectively reviewed. The patients were divided into two groups according to the cut-off values of the systemic inflammatory markers after receiver operating characteristic (ROC) curve analysis. Survival analysis was performed to identify factors associated with disease-free survival (DFS) and overall survival (OS). Results: Age, American Society of Anesthesiologists (ASA) score, tumor location, number of harvested lymph nodes, venous invasion, perineural invasion, adjuvant treatment and PNI (HR = 1.534, 95% CI: 1.065-2.211, P = 0.022; HR = 1.915, 95% CI: 1.286-2.852, P = 0.001 for DFS and OS, respectively) were independent significant prognostic factors for both DFS and OS. Conclusions: PNI can be a prognostic marker in stage IIA colorectal cancer. (C) 2016 Wiley Periodicals, Inc.