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Previous studies showed the prognostic impact of inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP), in resected non-small cell lung cancer (NSCLC). However, there are no studies that examined both of these markers simultaneously.Three hundred and one consecutive cases of resected NSCLC with a follow-up period of more than 5 years were reviewed retrospectively.A significant association was only observed between NLR and patients' survival (p0.0001). High CRP also led to a higher 5-year survival rate than low CRP (38.71% vs. 70.71%, p0.0001). We evaluated the prognostic significance of the use of NLR and CRP combined. The 5-year survival of patients with both low NLR and low CRP was 74.18%. On the other hand, that of patients with both of these at a low level was significantly poor (20.00%, p0.0001). Univariate and multivariate analyses of the clinicopathological factors affecting survival revealed that the combined use of preoperative NLR and CRP was an independent prognostic determinant.The combined use of preoperative NLR and CRP might be useful to predict the prognosis of patients with NSCLC.

The prognostic impact of neutrophil to lymphocyte ratio (NLR) in non-small cell lung cancer (NSCLC) was examined using patients with a follow-up period more than 5 years.Two hundred and eighty four consecutive resected NSCLC patients were reviewed retrospectively. In this study, patients who were treated with a follow-up period less than 5 years were omitted,The mean value of NLR was 2.44±2.22 (range: 0.56-29.44). The 5-year survival of the patients with a high NLR (≥2.5) was significantly worse than that of the patients with a low NLR (47.06% vs. 67.84%, p0.0001). Univariate analysis of the clinicopathological factors affecting survival revealed that age, gender, histology, pT status, pN status, high serum CEA level, positive findings of pleural lavage cytology and high NLR were significant risk factors for reduced survival. On multivariate analysis, a high NLR was an independent risk factor for reduced survival.A high preoperative NLR may be a convenient biomarker to identify patients with a poor prognosis after resection for NSCLC.

Prognostic impact of tumour marker index (TMI) based on preoperative serum carcinoembryonic antigen (CEA) and CYFRA 21-1 in non-small cell lung cancer (NSCLC) was examined using patients with a follow-up period more than 5 years.Two hundred and ninety-three consecutive NSCLC patients were reviewed retrospectively, and any patients with follow-up periods less than 5 years were omitted.The 5-year survival of the patients with normal and high serum CEA levels was 71.52% and 48.41%, respectively (p0.0001). The 5-year survival of the patients with a high serum CYFRA 21-1 level was 39.66%, which was significantly poorer compared with that of the patients with a normal serum CYFRA 21-1 level (66.95%, p0.0001). There was a 5-year-survival rate of 72.28% in patients with a TMI less than or equal to 1.0 compared to only 37.08% in patients with a TMI greater than 1.0 (p0.0001). Both univariate and multivariate analyses indicated the independent prognostic impact of TMI.TMI may be useful for predicting the prognosis of NSCLC patients.

Previous studies have reported any prognostic impact of preoperative leukocytosis, anemia and thrombocytosis in non-small cell lung cancer (NSCLC). The significance of the combined use of these 3 abnormal blood cell counts was investigated.Two hundred and eighty-nine consecutive NSCLC patients were reviewed retrospectively.The patients with leukocytosis, anemia and thrombocytosis had significantly worse prognosis. The 5-year survival of the patients with all three of these abnormal blood cell counts was 25.0%, which was significantly poorer compared with that of the patients without any of these abnormal cell counts (78.23%). The 5-year survival of the patients with 1 or 2 out of the three abnormal blood cell counts was an intermediate value. Both univariate and multivariate analyses indicated the independent prognostic impact of the use of these three abnormal blood cell counts combined.The use of leukocytosis, anemia and thrombocytosis combined might be useful for predicting the prognosis of NSCLC patients.

Only a few studies have reported any prognostic impact of the preoperative hemoglobin level itself in resectable non-small cell lung cancer (NSCLC). The survival impact of preoperative hemoglobin level and the relationship between hemoglobin and serum CEA level were investigated.Two hundred and forty consecutive NSCLC patients were reviewed retrospectively.The 5-year survival of patients with low and those with a normal hemoglobin level was 42.99% and 73.47%, respectively. Both univariate and multivariate analyses indicated the independent prognostic impact of the hemoglobin level. The result for stage I patients was identical. Patients with normal hemoglobin could be subdivided into 2 groups based on their serum CEA level; the 5-year survival of patients with normal and those with elevated CEA was 81.72% and 57.24%, respectively.The preoperative hemoglobin level was a prognostic factor for NSCLC patients. The combined use of hemoglobin and CEA levels might be useful to predict the prognosis of patients.

Controversy exists regarding the relationship between serum carcinoembryonic antigen (CEA) level and T status in non-small cell lung cancer.Two hundred and forty-seven lung cancer patients with pN0 disease were included in the study and the relationship between serum CEA level and T status, tumor size and degree of local extension was investigated.Patients with tumors 0 to 1.5 cm in diameter had significantly low serum CEA level. However, there were no significant differences in serum CEA level among other tumor size groups. Serum CEA level was not related to the degree of local extension. The 5-year survival of patients with both normal serum CEA levels and T1 disease was significantly better than that of patients with high serum CEA level and 72-4 disease.Serum CEA levels do not always relate to T status. The combined use of these factors might be useful in predicting the prognosis of pN0 non-small cell lung cancer patients.

The difficulty encountered in hepatectomy for the removal of a malignant tumor in the hepatic caudate lobe has recently been reported. However, few reports have described the clinical features of hepatic caudate lobe metastases from colorectal carcinoma.Retrospective clinicopathological data for 13 consecutive patients with colorectal metastases to the hepatic caudate lobe were analyzed for their various clinical aspects and long-term outcomes.The tumor-free margin of the resected specimen was significantly smaller in the hepatic caudate lobe metastases group than in the other 178 patients with colorectal metastases in other sites of the liver (p0.01), while the invasiveness of hepatectomy, as judged by the volume of liver resected and the duration of the procedure, was higher in the hepatic caudate lobe metastases group. Hepatic disease-free survival rates in the caudate lobe metastases group were lower than in the other group (p0.01). By multivariate analysis, metastases to the hepatic caudate lobe negatively impacted hepatic disease-free survival (adjusted relative risk, 2.085; p=0.048).In patients with hepatic caudate lobe metastases, hepatectomy with clear surgical margins is difficult, even when major hepatectomy is attempted. Hepatic metastasis in the caudate lobe is a risk factor for early liver recurrence after hepatectomy.

Although the prognostic significance of the serum carcinoembryonic antigen (CEA) level in non-small cell lung cancer has been reported in several studies, it is unknown whether the serum CEA level is a prognostic determinant for pN1 disease or not.Seventy patients with pN1 non-small cell lung cancer who received complete resection were reviewed. The preoperative serum CEA level was measured in all patients.The pN1 patients with pT2-4 disease, hilar node involvement, multiple N1 station and elevated serum CEA level (5 ng/mL) had a significantly unfavorable prognosis. Although a serum CEA level higher than 5 ng/mL was not an independent prognostic determinant, more than 10 ng/mL was an independent factor by multivariate analysis. In patients with pT1-2N1 disease, a serum CEA level more than 10 ng/mL was also a prognostic determinant.An elevated serum CEA level, especially higher than 10 ng/mL, is a significant prognostic determinant for pN1 lung cancer patients.