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.

IF 1.7 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-01-01 Epub Date: 2024-06-10 DOI:10.1007/s00595-024-02875-1

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

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引用次数: 0

Abstract

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.

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淋巴细胞与单核细胞比率对使用结肠支架的阻塞性结直肠癌患者预后的影响：日本一项回顾性多中心研究。

目的：淋巴细胞与单核细胞（LMR）比值对包括结直肠癌（CRC）在内的各种癌症的预后价值已有报道。对于有手术指征的梗阻性 CRC 患者，插入结肠支架被认为是有效的，但其 LMR 会因支架扩张引起的炎症和梗阻性结肠炎的改善等因素而变化。然而，LMR 在阻塞性 CRC 和结肠支架患者中的实用性及其最佳测量时机仍不明确。我们开展了这项研究，以探讨支架前 LMR 与作为手术桥梁（BTS）的阻塞性 CRC 和支架患者的中期预后之间的关系：这项回顾性多中心研究的对象是175名病理分期为2期或3期的CRC患者。患者被分为支架前 LMR 低组（87 人）和支架前 LMR 高组（83 人）：结果：只有3年无复发生存率在低支架前LMR组和高支架前LMR组之间存在显著差异（分别为39.9%和63.6%；P = 0.015）。在多变量分析中，支架前 LMR 是无复发生存率的预后因素（危险比 2.052，95% 置信区间 1.242-3.389；P = 0.005），但不是总生存率的预后因素：结论：对于使用结肠支架作为 BTS 的梗阻性 CRC 患者来说，支架前 LMR 低是术后复发的预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.