Prognostic significance of inflammation-based indexes in patients with stage III/IV colorectal cancer after adjuvant chemoradiotherapy

Inflammation-based indexes such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation indexes (SII) have been reported to be associated with prognosis in cancer patients.The aim of this study was to estimate the prognostic significance of inflammation-based indexes such as NLR, PLR, LMR, and SII in stage III/IV colorectal cancer (CRC) patients undertaking adjuvant chemoradiotherapy (CRT).Two hundred twenty stage III/IV CRC patients were enrolled in this study. Inflammatory indexes were defined as follows: NLR=absolute neutrophil counts/absolute lymphocyte counts; PLR=absolute platelet counts/absolute lymphocyte counts; LMR=absolute lymphocyte counts/absolute monocyte counts; SII=absolute neutrophil counts x absolute platelet counts/absolute lymphocyte counts. The correlations between indexes and prognosis were evaluated using the Cox proportional hazard model.The results of univariate analysis demonstrated that NLR, PLR, and SII were significantly associated with progression-free survival (PFS) and overall survival (OS). Multivariate analysis showed that SII (P=.030) was an independent predictor of PFS, and NLR (P=.047) was an independent prognostic factor of OS.Those inflammation-based indexes could provide a convenient and secure method to predict the outcomes of stage III/IV CRC patients receiving adjuvant CRT.