Effect of the lymphocyte-to-monocyte ratio on the prognosis of patients with obstructive colorectal cancer with a colonic stent: a retrospective multicenter study in Japan

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发表日期：

2024年6月10日

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Toshio Shiraishi,
Tetsuro Tominaga,
Takashi Nonaka,
Yuma Takamura,
Kaido Oishi,
Shintaro Hashimoto,
Keisuke Noda,
Rika Ono,
Makoto Hisanaga,
Hiroaki Takeshita,
Mitsutoshi Ishii,
Syosaburo Oyama,
Kazuhide Ishimaru,
Masaki Kunizaki,
Terumitsu Sawai,
Keitaro Matsumoto

摘要

Purpose

The prognostic value of the lymphocyte-to-monocyte (LMR) ratio has been reported for various cancers, including colorectal cancer (CRC). The insertion of colonic stents is considered effective for patients with surgically indicated obstructive CRC, but their LMR can vary depending on factors such as inflammation associated with stent dilation and improvement of obstructive colitis. However, the usefulness of the LMR in patients with obstructive CRC and colonic stents and the optimal timing for its measurement remain unclear. We conducted this study to investigate the relationship between the pre-stent LMR and the mid-term prognosis of patients with obstructive CRC and stents as a bridge to surgery (BTS).

Methods

The subjects of this retrospective multicenter study were 175 patients with pathological stage 2 or 3 CRC. Patients were divided into a low pre-stent LMR group (n = 87) and a high pre-stent LMR group (n = 83).

Results

Only 3-year relapse-free survival differed significantly between the low and high pre-stent LMR groups (39.9% vs. 63.6%, respectively; p = 0.015). The pre-stent LMR represented a prognostic factor for relapse-free survival in multivariate analyses (hazard ratio 2.052, 95% confidence interval 1.242–3.389; p = 0.005), but not for overall survival.

Conclusions

A low pre-stent LMR is a prognostic factor for postoperative recurrence in patients with obstructive CRC and a colonic stent as a BTS.