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         headline:Elevated preoperative neutrophil to lymphocyte ratio predicts risk of recurrence following curative resection for stage IIA colon cancer
         description:Adjuvant chemotherapy for stage II colon cancer remains controversial but may be considered for patients with high-risk features. Recent studies have shown that elevated neutrophil to lymphocyte ratio (NLR) is a worse prognostic factor and a predictor of response to chemotherapy in patients with advanced colorectal cancer. The purpose of this study was to evaluate whether NLR predicts risk of recurrence in patients with stage IIA colon cancer undergoing curative resection without adjuvant chemotherapy. We retrospectively reviewed 141 consecutive patients with stage IIA colon cancer treated with curative surgery alone from 2002 to 2006. NLR, as well as demographics, clinical, histopathologic, and laboratory data were analyzed. Univariate and multivariate analyses were conducted to identify prognostic factors associated with recurrent-free survival (RFS). Cox’s regression analysis demonstrated that elevated NLR (>4) (hazard ratio, 4.88; P < 0.01) and less lymph node sampling (<15 lymph nodes; hazard ratio, 3.80; P < 0.05) were adverse prognostic factors for RFS. The 5-year RFS was 91.4% (95% CI, 88.6–94.2%) for patients with normal NLR and 63.8% (51.1–76.3%) for patients with elevated NLR. The 5-year RFS for patients with 0, 1, and 2 of the identified risk factors was 95.1%, 87.4%, and 33.3%, respectively (P < 0.001). Elevated preoperative NLR is an independent predictor of worse RFS for patients with stage IIA colon cancer and a potential biomarker to identify candidates for adjuvant chemotherapy.
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            Colon cancer
            Stage IIA
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            Internal Medicine
            Gastroenterology
            Hepatology
            Proctology
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      headline:Elevated preoperative neutrophil to lymphocyte ratio predicts risk of recurrence following curative resection for stage IIA colon cancer
      description:Adjuvant chemotherapy for stage II colon cancer remains controversial but may be considered for patients with high-risk features. Recent studies have shown that elevated neutrophil to lymphocyte ratio (NLR) is a worse prognostic factor and a predictor of response to chemotherapy in patients with advanced colorectal cancer. The purpose of this study was to evaluate whether NLR predicts risk of recurrence in patients with stage IIA colon cancer undergoing curative resection without adjuvant chemotherapy. We retrospectively reviewed 141 consecutive patients with stage IIA colon cancer treated with curative surgery alone from 2002 to 2006. NLR, as well as demographics, clinical, histopathologic, and laboratory data were analyzed. Univariate and multivariate analyses were conducted to identify prognostic factors associated with recurrent-free survival (RFS). Cox’s regression analysis demonstrated that elevated NLR (>4) (hazard ratio, 4.88; P < 0.01) and less lymph node sampling (<15 lymph nodes; hazard ratio, 3.80; P < 0.05) were adverse prognostic factors for RFS. The 5-year RFS was 91.4% (95% CI, 88.6–94.2%) for patients with normal NLR and 63.8% (51.1–76.3%) for patients with elevated NLR. The 5-year RFS for patients with 0, 1, and 2 of the identified risk factors was 95.1%, 87.4%, and 33.3%, respectively (P < 0.001). Elevated preoperative NLR is an independent predictor of worse RFS for patients with stage IIA colon cancer and a potential biomarker to identify candidates for adjuvant chemotherapy.
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         Neutrophil to lymphocyte ratio
         Colon cancer
         Stage IIA
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         Gastroenterology
         Hepatology
         Proctology
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      name:Cancer Center, Sun Yat-sen University
      address:
         name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
         type:PostalAddress
      name:State Key Laboratory of Oncology in South China
      address:
         name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
         type:PostalAddress
      name:Cancer Center, Sun Yat-sen University
      address:
         name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
         type:PostalAddress
      name:State Key Laboratory of Oncology in South China
      address:
         name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
         type:PostalAddress
      name:Cancer Center, Sun Yat-sen University
      address:
         name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
         type:PostalAddress
      name:State Key Laboratory of Oncology in South China
      address:
         name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
         type:PostalAddress
      name:Cancer Center, Sun Yat-sen University
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         name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
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            address:
               name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
            name:Cancer Center, Sun Yat-sen University
            address:
               name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
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            name:State Key Laboratory of Oncology in South China
            address:
               name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
            name:Cancer Center, Sun Yat-sen University
            address:
               name:Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
      name:Rong-Xin Zhang
      affiliation:
            name:State Key Laboratory of Oncology in South China
            address:
               name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
               type:PostalAddress
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            name:Cancer Center, Sun Yat-sen University
            address:
               name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
      name:Yu-Jing Fang
      affiliation:
            name:State Key Laboratory of Oncology in South China
            address:
               name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
               type:PostalAddress
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            name:Cancer Center, Sun Yat-sen University
            address:
               name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
      name:Li-Ren Li
      affiliation:
            name:State Key Laboratory of Oncology in South China
            address:
               name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
            name:Cancer Center, Sun Yat-sen University
            address:
               name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
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      affiliation:
            name:State Key Laboratory of Oncology in South China
            address:
               name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
            name:Cancer Center, Sun Yat-sen University
            address:
               name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
      name:Xiao-Jun Wu
      affiliation:
            name:State Key Laboratory of Oncology in South China
            address:
               name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
            name:Cancer Center, Sun Yat-sen University
            address:
               name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
      name:Zhen-Hai Lu
      affiliation:
            name:State Key Laboratory of Oncology in South China
            address:
               name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
            name:Cancer Center, Sun Yat-sen University
            address:
               name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
      name:Jun-Zhong Lin
      affiliation:
            name:State Key Laboratory of Oncology in South China
            address:
               name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
            name:Cancer Center, Sun Yat-sen University
            address:
               name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
      name:Ling-Heng Kong
      affiliation:
            name:State Key Laboratory of Oncology in South China
            address:
               name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
            name:Cancer Center, Sun Yat-sen University
            address:
               name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
      name:De-Sen Wan
      affiliation:
            name:State Key Laboratory of Oncology in South China
            address:
               name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
            name:Cancer Center, Sun Yat-sen University
            address:
               name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
      name:Zhi-Zhong Pan
      affiliation:
            name:State Key Laboratory of Oncology in South China
            address:
               name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
            name:Cancer Center, Sun Yat-sen University
            address:
               name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
               type:PostalAddress
            type:Organization
      email:[email protected]
PostalAddress:
      name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
      name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
      name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
      name:Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
      name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
      name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
      name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
      name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
      name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
      name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
      name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
      name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
      name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
      name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
      name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
      name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
      name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
      name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
      name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
      name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
      name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
      name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
      name:State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
      name:Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
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