Value of pre- and postoperative red cell distribution width-to-lymphocyte count ratio in judging the prognosis of patients with non-metastatic colorectal cancer / 肿瘤研究与临床

ABSTRACT

Objective:To explore the value of pre- and postoperative red cell distribution width-to-lymphocyte count ratio (RLR) in predicting the disease-free survival (DFS) for non-metastatic colorectal cancer patients.Methods:The data of 108 patients pathologically diagnosed with non-metastatic colorectal adenocarcinoma after surgery from December 2012 to January 2020 in Hainan Hospital of PLA General Hospital were retrospectively analyzed. RLR was calculated and its differences in patients with varied clinicopathological characteristics were analyzed. The receiver operating characteristics (ROC) curve was applied to analyze the value of pre- and postoperative RLR in predicting DFS of patients, and the cut-off value was determined by Youden index. DFS of patients with different stratification stratified by a cut-off value of RLR was analyzed by using Kaplan-Meier method followed by log-rank test. Cox proportional hazards model was used to make univariate and multivariate analysis.Results:Youden index of pre- and postoperative RLR in predicting DFS was 8.86%, 9.15%; based on the above index, the patients were divided into the preoperative RLR<8.86% group (73 cases) and preoperative RLR≥8.86% group (35 cases), postoperative RLR<9.15% group (48 cases) and postoperative RLR≥9.15% group (60 cases). According to ROC curve, the area under the curve (AUC) of preoperative RLR in predicating DFS was 0.66 (95% CI 0.55-0.77, P = 0.01), and AUC of postoperative RLR in predicating DFS was 0.62 (95% CI 0.51-0.74, P = 0.04). Pre- and postoperative RLR cut-off values were used to predict 3-year DFS rate of patients with the sensitivity of 51.60% and 71.00%, respectively, and the specificity of 76.60% and 50.60%, respectively. Kaplan-Meier analysis showed that patients in preoperative RLR<8.86% group had a better DFS compared with those in preoperative RLR≥8.86% group ( χ2 = 7.35, P < 0.01); there was no statistical difference in DFS between postoperative RLR<9.15% group and postoperative RLR≥9.15% group ( χ2 = 3.69, P = 0.06). Preoperative RLR was an independent affecting factor for DFS of patients ( HR = 1.13, 95% CI 1.04-1.22, P <0.01). Conclusions:Pre- and postoperative RLR could be useful in predicating 3-year DFS for patients with non-metastatic colorectal cancer. Preoperative RLR is an independent affecting factor for DFS, and the patients with low RLR have a better prognosis.