Prognostic value of serum inflammatory markers in colorectal cancer



To date, there have been many studies on postoperative complications and oncologic outcomes, but the findings remain controversial. The purpose of the study was to determine the prognostic value of serum inflammatory markers as pretreatment in curatively resected colorectal cancer. The effects of serum inflammatory marker levels on postoperative morbidity were also examined.


Prospectively collected data from 1590 patients with primary sporadic colorectal adenocarcinoma who underwent curative resection between September 2012 and December 2013 at our institution were retrospectively analyzed. White blood cell count (× 103/mcl), neutrophil/lymphocyte ratio, C-reactive protein, erythrocyte sedimentation rate (ESR), and Glasgow prognostic score (GPS) were evaluated. GPS was determined as follows: GPS of 2, elevated CRP level (> 1.0 mg/dl) and hypoalbuminemia (< 3.5 g/dl); GPS of 1, elevated CRP or hypoalbuminemia; and GPS of 0, neither elevated CRP nor hypoalbuminemia.


The median follow-up period for the 1590 patients was 59 months. The overall postoperative morbidity rate was 24.8%. In multivariate analysis, female sex (P = 0.006), rectal cancer other than colon cancer (P < 0.001), CEA level > 5 ng/ml (P < 0.001), ESR > 27 mm/h (P = 0.014), and a GPS of 1 or 2 (P < 0.001) were independent risk predictors for morbidity. A GPS of 1 or 2 (P < 0.001) and postoperative morbidity (P < 0.001) significantly affected both overall survival and disease-free survival in multivariate analyses.


A GPS of 1 or 2 is a significant risk factor for postoperative morbidity and a prognostic factor for long-term survival.

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Study proposal, design, analysis, data collection, and writing of manuscript are attributed to Sung Chul Lee and Jung Wook Huh. All authors drafted the work, and Woo Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Yoon Ah Park, and Jung Kyong Shin revised it critically for content. All authors approve the manuscript.

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Correspondence to Jung Wook Huh.

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This study was reviewed and approved by the Institutional Review Board of Samsung Medical Center (No. 2019-04-126).

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The authors declare that they have no conflict of interest.

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Lee, S.C., Huh, J.W., Lee, W.Y. et al. Prognostic value of serum inflammatory markers in colorectal cancer. Int J Colorectal Dis 35, 1211–1219 (2020).

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  • Colorectal cancer
  • Inflammatory marker
  • Long-term outcome
  • Glasgow prognostic score
  • Morbidity