ArticleUpdates in surgery2025
Prognostic impact of persistent postoperative neutrophil-to-lymphocyte ratio elevation 1 year after colorectal cancer surgery.
Article in Updates in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Article
- Systemic Inflammatory Biomarkers as Prognostic Indicators in Metastatic Colorectal Cancer: A Retrospective Study.Medicina (Kaunas, Lithuania) · 2026Observational
- Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Locally Advanced Rectal Cancer Treated with Neoadjuvant Concurrent Chemoradiotherapy and Robotic-Assisted Resection.Oncology research · 2026Article
- The role of peripheral blood cell analysis-derived inflammatory parameters in predicting malignant duodenal stenosis.BMC gastroenterology · 2025Article
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8 authors.
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Abstract
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.
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