Neutrophil count is the most important prognostic component of the differential white cell count in patients undergoing elective surgery for colorectal cancer

Am J Surg. 2015 Jul;210(1):24-30. doi: 10.1016/j.amjsurg.2014.12.031. Epub 2015 Mar 12.

Abstract

Background: Systemic inflammatory scoring systems such as the NLR have been reported to have prognostic value in many solid organ cancers. The aim of this study was to examine the relationships between the components of the white cell count (WCC) and survival in patients undergoing elective surgery for colorectal cancer.

Methods: Patients undergoing elective resection at a single center (1997 to 2008) were identified from a prospective database (n = 508). Patient demographics and preoperative laboratory measurements including the differential WCC and their association with cancer-specific survival (CSS) and overall survival were examined.

Results: There were 172 cancer deaths and 120 noncancer deaths. On Kaplan-Meier analysis of the whole cohort, age, Tumor, Nodal, and Metastasis stage, venous invasion, margin involvement, peritoneal involvement and tumor perforation, and white cell and neutrophil count (all P < .05) were associated with CSS. In those with node-negative colon cancer (n = 226), on multivariate analysis, age, venous invasion, modified Glasgow Prognostic Score, and neutrophil count (all P < .05) were independently associated with CSS.

Conclusion: Of the components of a differential WCC, only the neutrophil count was independently associated with survival, particularly in node-negative colon cancer.

Keywords: Colorectal cancer; Neutrophil; White cell count.

MeSH terms

  • Aged
  • Colorectal Neoplasms / blood
  • Colorectal Neoplasms / mortality*
  • Colorectal Neoplasms / surgery*
  • Cross-Sectional Studies
  • Elective Surgical Procedures
  • Female
  • Humans
  • Leukocyte Count
  • Male
  • Middle Aged
  • Neutrophils*
  • Prognosis
  • Retrospective Studies
  • Survival Rate