Comprehensive Comparative Analysis of Prognostic Value of Systemic Inflammatory Biomarkers for Patients with Stage II/III Colon Cancer

  • Shinsuke Suzuki
  • Takashi AkiyoshiEmail author
  • Koji Oba
  • Fuhito Otsuka
  • Tetsuro Tominaga
  • Toshiya Nagasaki
  • Yosuke Fukunaga
  • Masashi Ueno
Colorectal Cancer



Among numerous systemic inflammatory biomarkers, it remains unclear which is the most prognostic for patients with stage II/III colon cancer. We aimed to compare the prognostic significance of systemic inflammatory biomarkers among patients with stage II/III colon cancer.


We included 1303 patients with stage II/III colon cancer who underwent potentially curative resection from July 2004 to December 2013. Sixteen systemic inflammatory biomarkers—derived from combinations of neutrophils, lymphocytes, monocytes, platelets, C-reactive protein (CRP), and albumin—were compared to identify the biomarker most associated with overall survival (OS) and disease-free survival (DFS) using receiver operating characteristic (ROC) curve analysis.


Nine inflammatory biomarkers were predictive for OS, among which lymphocyte-to-CRP ratio (LCR), CRP-to-albumin ratio (CAR), neutrophil × CRP, monocyte × CRP, and platelet × CRP were also predictive for DFS. Among these five inflammatory biomarkers, the area under the curve (AUC) value was highest (0.630) for LCR, being significantly higher than that for neutrophil × CRP (P = 0.010), monocyte × CRP (P = 0.007), or platelet × CRP (P = 0.010) for OS. When the prognostic impact of LCR and CAR were analyzed by multivariate analysis, only LCR was an independent predictor of both OS [hazard ratio (HR), 1.77; 95% confidence interval (CI), 1.23–2.60; P = 0.002] and DFS (HR, 1.29; 95% CI, 1.00–1.66; P = 0.048).


LCR may be the most useful predictive factor for OS and DFS in patients with stage II or III colon cancer.



This work was supported by a grant-in-aid of the Public Trust Fund for Clinical Cancer Research, and JSPS KAKENHI under Grant Nos. 18K08664 and 18K08635.

Author Contributions

SS and TA designed the study and wrote the manuscript. SS, TA, TT, TN, YF, and MU contributed to data collection. SS, TA, KO, and FO contributed to the analysis and interpretation of data. All authors contributed to analysis and interpretation of data. All authors critically reviewed the manuscript and approved the final version of the manuscript.


The authors declare no conflicts of interest for this article.

Approval of Research Protocol

This retrospective research protocol was approved by the Institutional Review Board of Cancer Institute Hospital (Reference No. 2016-1090), and it conforms to the provisions of the Declaration of Helsinki.


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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  1. 1.Department of Gastroenterological SurgeryCancer Institute Hospital, Japanese Foundation for Cancer ResearchTokyoJapan
  2. 2.Department of Biostatistics, Graduate School of MedicineThe University of TokyoTokyoJapan
  3. 3.Statistics Analysis Department, Data Science Division, Development Business HeadquartersEPS CorporationTokyoJapan

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