A prognostic index for colorectal cancer based on preoperative absolute lymphocyte, monocyte, and neutrophil counts

Associations between the preoperative absolute neutrophil count (NC), lymphocyte count (LC), and monocyte count (MC) in the peripheral blood and the prognosis of colorectal cancer (CRC) patients have not been widely studied.

We enrolled 361 patients who underwent surgery for CRC between January 2007 and December 2013 to analyze correlations among the LC, MC, and NC and prognosis.

Based on cut-off values determined by a receiver operating characteristic analysis, patients were subgrouped as Lymph^High or Lymph^Low (cut-off: LC = 1460 cells/µL); as Mono^High or Mono^Low (cut-off: MC = 421 cells/µL); and as Neut^High or Neut^Low (cut-off: NC = 3247 cells/µL). Patients were then given lymphocyte-monocyte-neutrophil (LMN) scores by adding the points of their different subgroups (1 point each for Lymph^Low, Mono^High and Neut^High; 0 points for Lymph^High, Mono^Low and Neut^Low). The 5-year overall survival rates significantly differed by the LMN score (0: 89.7%, 1: 80.6%, 2: 68.8%, and 3: 57.4%; P < 0.0001). In the multivariate analysis, the LMN score was found to be an independent prognostic indicator.

The combination of the preoperative absolute number of lymphocytes, monocytes, and neutrophils is a useful prognostic indicator in CRC patients.