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1Department of Colorectal Surgery, Singapore General Hospital, Singapore, Singapore
2Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
3Center for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore, Singapore
Copyright © 2021 The Korean Society of Coloproctology
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported.
Characteristic | NLR ≥ 4 (n = 23) | NLR < 4 (n = 34) | P-value |
---|---|---|---|
Age (yr) | 74.0 (57–81) | 71.5 (61.50–78.75) | 0.743 |
Male sex | 13 (56.5) | 22 (64.7) | 0.533 |
ASA PS classification III | 4 (17.4) | 3 (8.8) | 0.423 |
Diabetes mellitus | 6 (26.1) | 6 (17.6) | 0.443 |
Albumin (g/L) | 36.0 (31.0–40.0) | 37.0 (33.5–40.3) | 0.749 |
CEA (μg/L) | 7.75 (4.95–22.20) | 4.50 (2.55–12.55) | 0.412 |
Tumor characteristics | |||
Location | 0.435 | ||
Rectosigmoid | 5 (21.7) | 3 (8.8) | |
Sigmoid | 9 (39.1) | 15 (44.1) | |
Descending | 4 (17.4) | 12 (35.3) | |
Splenic flexure | 5 (21.7) | 4 (11.8) | |
Tumor staging | 0.149 | ||
T2 | 1 (4.3) | 0 (0) | |
T3 | 15 (65.2) | 29 (85.3) | |
T4 | 7 (30.4) | 5 (14.7) | |
Nodal involvement | 14 (60.9) | 18 (52.9) | 0.554 |
Number of positive nodes | 1 (0–3) | 1 (0–2.25) | 0.924 |
Apical lymph node involved | 5 (21.7) | 1 (2.9) | 0.034 |
Presence of tumor deposit(s) | 3 (13.0) | 6 (17.6) | 0.726 |
Tumor differentiation | 0.340 | ||
Well-differentiated | 1 (4.3) | 0 (0) | |
Moderately-differentiated | 22 (95.7) | 33 (97.1) | |
Poorly-differentiated | 0 (0) | 1 (2.9) | |
Mucinous component | 1 (4.3) | 1 (2.9) | 1.000 |
Perineural invasion | 10 (43.5) | 9 (26.5) | 0.181 |
Lymphovascular invasion | 12 (52.2) | 6 (17.6) | 0.006 |
Pericolic microabscess | 2 (8.7) | 5 (14.7) | 0.689 |
Operative and postoperative details | |||
Laparoscopic approach | 10 (43.5) | 19 (55.9) | 0.358 |
Stoma creation | 4 (17.4) | 0 (0) | 0.022 |
Postoperative morbidity | 5 (21.7) | 5 (14.7) | 0.493 |
Adjuvant chemotherapy | 10 (43.5) | 18 (52.9) | 0.483 |
Distant metastases | 13 (56.5) | 11 (32.4) | 0.070 |
Variable | Univariate |
Multivariate |
||
---|---|---|---|---|
HR (95% CI) | P-value | HR (95% CI) | P-value | |
Age | 1.04 (1.00–1.08) | 0.088 | 1.04 (1.00–1.09) | 0.068 |
ASA PS classification III and above | 2.41 (0.88–6.61) | 0.087 | ||
T4 staging | 1.87 (0.75–4.61) | 0.177 | ||
Apical LN+ | 2.17 (0.62–7.62) | 0.227 | ||
Poor differentiation | 1.56 (0.20–11.92) | 0.667 | ||
Tumor deposit(s) | 1.82 (0.66–5.02) | 0.250 | ||
Perineural infiltration | 3.05 (1.21–7.69) | 0.018 | ||
Lymphovascular invasion | 3.52 (1.51–8.21) | 0.004 | ||
Pericolic microabscess | 1.34 (0.40–4.52) | 0.637 | ||
Major postoperative complication(s) | 13.55 (3.62–50.81) | < 0.001 | 11.34 (2.49–51.56) | 0.002 |
Chemotherapy | 0.41 (0.17–0.95) | 0.039 | ||
NLR ≥ 4 | 4.97 (2.02–12.21) | < 0.001 | 3.69 (1.46–9.35) | 0.006 |
Variable | Univariate analysis |
Multivariate |
||
---|---|---|---|---|
HR (95% CI) | P-value | HR (95% CI) | P-value | |
Age | 1.00 (0.96–1.03) | 0.863 | ||
ASA PS classification III and above | 1.63 (0.48–5.49) | 0.432 | ||
T4 staging | 2.97 (1.29–6.60) | 0.011 | ||
Apical LN+ | 2.55 (0.75–8.73) | 0.136 | ||
Poor differentiation | 1.46 (0.19–11.03) | 0.712 | ||
Tumor deposit(s) | 1.66 (0.61–4.47) | 0.319 | ||
Perineural invasion | 4.59 (1.93–10.92) | < 0.001 | 3.37 (1.33–8.55) | 0.011 |
Lymphovascular invasion | 2.97 (1.32–6.67) | 0.009 | 1.85 (0.74–4.62) | 0.186 |
Pericolic microabscess | 0.94 (0.22–4.03) | 0.939 | ||
Major postoperative complication(s) | 7.98 (0.96–66.28) | 0.055 | ||
Chemotherapy | 1.04 (0.46–2.34) | 0.921 | ||
NLR ≥ 4 | 2.91 (1.29–6.60) | 0.010 | 1.63 (0.63–4.22) | 0.312 |
Values are presented as median (interquartile range) or number (%). ASA, American Society of Anesthesiologists; PS, physical status; CEA, carcinoembryonic antigen.
HR, hazard ratio; CI, confidence interval; ASA, American Society of Anesthesiologists; PS, physical status; LN+, lymph node positive; NLR, neutrophil-to-lymphocyte ratio.
HR, hazard ratio; CI, confidence interval; ASA, American Society of Anesthesiologists; PS, physical status; LN+, lymph node positive; NLR, neutrophil-to-lymphocyte ratio.