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Preoperative Neutrophil to Lymphocyte Ratio and Albumin Level as Predictors for Postoperative Complication in Patients with Colorectal Cancer
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Kyung Pil Kang, Young Hun Kim, Kyung Jong Kim PhD.
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Surg Metab Nutr 2020;11(2):66-72. Published online December 30, 2020
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DOI: https://doi.org/10.18858/smn.2020.11.2.66
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 Abstract
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- Purpose: Systematic inflammatory response biomarkers are recognized as potential prognostic factors for colorectal cancer (CRC). Recently, the neutrophil-to-lymphocyte ratio (NLR) has emerged as a possible marker for predicting the outcomes of patients with CRC. The purpose of the current study was to determine if NLR could function as a predictive marker of postoperative complications in patients with colorectal cancer who were treated surgically.
Materials and Methods: One hundred and seven patients who underwent radical surgery for colorectal cancer were enrolled in the study. The NLR values were determined from the complete blood counts within one month before surgery. Values of less than or greater than 3 were defined as low (NLR-low) or high (NLR-high), respectively. Statistical comparisons were made between the NLR and the clinical-pathological variables.
Results: Sixty-eight patients met the criteria of NLR-low, and 39 patients were categorized as NLR-high. The NLR status was significantly correlated with T-stage, perineural invasion, and an increased likelihood of complications. Univariate analysis indicated that both low albumin and meeting the criteria for the NLR-high group correlated with an increased occurrence of complications (P=0.004, P=0.004, respectively). Multivariate analysis identified NLR-high and low albumin levels as independent predictors for complications (P=0.007, odd ratio=6.405, P=0.016, odd ratio=9.641, respectively)
Conclusion: The current results suggest that the preoperative NLR levels could be useful tools for predicting the occurrence of postoperative complications.
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Relationship of the Psoas Muscle Index with the Other Nutritional Factors in Patients Who Underwent Emergency Operation with Colonic Perforation
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Young Hun Kim, Ki Wook Lee, Kyung Jong Kim
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Surg Metab Nutr 2018;9(2):36-40. Published online December 30, 2018
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DOI: https://doi.org/10.18858/smn.2018.9.2.36
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Purpose: This study examined the correlation between the preoperative nutritional index and Sarcopenia in emergency colonic perforation patients. Materials and Methods: Patients undergoing an emergency operation with colorectal perforation at Chosun University Hospital between January 2014 and December 2016 were included in the analysis, and the medical records were reviewed retrospectively. Sarcopenia was defined by the psoas muscle area measured by preoperative computed tomography (CT) cross sectional imaging at L3 vertebra. The clinical nutritional index of patients with PMI (psoas muscle index)-High group were compared with a PMI-Low group. Results: The median PMI of the males was 4.48 cm2/m2 and the median of females was 3.33 cm2/m2 (P=0.002) The PMI-High and PMI-Low groups were not correlated with age and gender (P=0.455 and P=0.806, respectively). The traditional indicators of the nutritional status, such as body mass index (BMI), albumin, and lymphocytes, were not associated with sarcopenia (P=0.094, P=0.676, and P=1.000, respectively). No significant difference was observed between the ASA classification and sarcopenia (P=0.145). Conclusion: Sarcopenia using PMI was not associated with previous nutritional indices in patients undergoing emergency surgery due to colonic perforation. In the future, large-scale studies will need to identify its role as a prognostic factor.
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