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<p>Colorectal cancer (CRC) remains a major cause of cancer-related mortality despite advances in screening and treatment. Inflammation plays a key role in tumor progression, with the neutrophil-to-lymphocyte ratio (NLR) emerging as a potential prognostic marker. While preoperative NLR is a well-established predictor of survival, its prognostic value 1&#xa0;year postoperatively remains underexplored. This study aims to evaluate the prognostic significance of NLR 1&#xa0;year after curative CRC surgery, identify factors associated with its elevation, and assess its impact on survival and recurrence. A retrospective analysis was conducted on 788 patients who underwent curative-intent CRC surgery between 2015 and 2022. NLR was assessed preoperatively and 1&#xa0;year postoperatively, using a cutoff of 3.3. Patients were categorized into four subgroups:&#xa0;“Low-Low”:&#xa0;NLR ≤ 3.3 pre- and postoperatively;&#xa0;“Low–High”:&#xa0;NLR ≤ 3.3 preoperatively but &gt; 3.3 postoperatively;&#xa0;“High-Low”:&#xa0;NLR &gt; 3.3 preoperatively but ≤ 3.3 postoperatively, and&#xa0;“High-High”:&#xa0;NLR &gt; 3.3 at both time points. Survival analysis was performed using Cox regression. Postoperative NLR values were significantly lower than preoperative levels (median: 2.8 vs. 4.1, p &lt; 0.001). An elevated post-NLR (&gt; 3.3) correlated with poorer survival and higher recurrence rates. The “Low–High” group exhibited the worst prognosis, with a 5-year survival rate of 42.6% compared to 79.8% in the “Low-Low” group. Multivariate analysis confirmed post-NLR &gt; 3.3 as an independent predictor of worse survival (HR: 3.49; 95%CI 2.41–5.04). Persistently elevated NLR 1&#xa0;year after CRC surgery is associated with worse survival and higher recurrence. Routine postoperative NLR monitoring may help identify high-risk patients for closer follow-up and early intervention. </p>

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Prognostic impact of persistent postoperative neutrophil-to-lymphocyte ratio elevation 1 year after colorectal cancer surgery

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月25日

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  • David Ortíz-López,
  • Joaquín Marchena-Gómez,
  • Yurena Sosa-Quesada,
  • Manuel Artiles-Armas,
  • Beatriz Arencibia-Pérez,
  • Julia Gil-García,
  • Eva Nogués-Ramía,
  • Cristina Roque-Castellano

摘要

Colorectal cancer (CRC) remains a major cause of cancer-related mortality despite advances in screening and treatment. Inflammation plays a key role in tumor progression, with the neutrophil-to-lymphocyte ratio (NLR) emerging as a potential prognostic marker. While preoperative NLR is a well-established predictor of survival, its prognostic value 1 year postoperatively remains underexplored. This study aims to evaluate the prognostic significance of NLR 1 year after curative CRC surgery, identify factors associated with its elevation, and assess its impact on survival and recurrence. A retrospective analysis was conducted on 788 patients who underwent curative-intent CRC surgery between 2015 and 2022. NLR was assessed preoperatively and 1 year postoperatively, using a cutoff of 3.3. Patients were categorized into four subgroups: “Low-Low”: NLR ≤ 3.3 pre- and postoperatively; “Low–High”: NLR ≤ 3.3 preoperatively but > 3.3 postoperatively; “High-Low”: NLR > 3.3 preoperatively but ≤ 3.3 postoperatively, and “High-High”: NLR > 3.3 at both time points. Survival analysis was performed using Cox regression. Postoperative NLR values were significantly lower than preoperative levels (median: 2.8 vs. 4.1, p < 0.001). An elevated post-NLR (> 3.3) correlated with poorer survival and higher recurrence rates. The “Low–High” group exhibited the worst prognosis, with a 5-year survival rate of 42.6% compared to 79.8% in the “Low-Low” group. Multivariate analysis confirmed post-NLR > 3.3 as an independent predictor of worse survival (HR: 3.49; 95%CI 2.41–5.04). Persistently elevated NLR 1 year after CRC surgery is associated with worse survival and higher recurrence. Routine postoperative NLR monitoring may help identify high-risk patients for closer follow-up and early intervention.