GLR in Colorectal Cancers: An Easily Accessible Prognostic Marker

Abstract

İsa Caner Aydin,1 Ismail Ege Subasi,2 Ahmet Orhan Sunar,1 Serkan Ademoglu,1 Selcuk Gulmez,1 Mursit Dincer,1 Mustafa Duman,1 Erdal Polat1 1University of Health Sciences, Kartal Kosuyolu Training and Research Hospital, Gastroenterologic Surgery Department, Istanbul, Turkey; 2University of Health Sciences, Van City Hospital Gastroenterologic Surgery Department, Van, TurkeyCorrespondence: İsa Caner Aydin, University of Health Sciences, Kartal Kosuyolu Training and Research Hospital, Gastroenterologic Surgery Department, Email [email protected] and Objectives: Colorectal cancer remains a significant health concern, necessitating reliable prognostic indicators for effective management. This study explores the preoperative prognostic significance of the Glucose/Lymphocyte Ratio (GLR) in colorectal cancers.Methods: The study retrospectively analyzed records of patients who underwent surgery for elective colorectal cancers between January 1, 2013, and December 31, 2021, at the Koşuyolu Training and Research Hospital Gastroenterologic Surgery Department. Demographic, clinicopathological, and follow-up data were comprehensively assessed. A cutoff was established from GLR ratios and patients were divided into two groups for prognosis analysis.Results: The study enrolled 222 eligible patients, examining variables such as age, sex, ASA score, neoadjuvant treatment, lymphovascular and perineural invasion, tumor grade, TNM stage, and GLR. The groups consisted of 128 patients with low GLR and 94 patients with high GLR. Statistical analyses revealed relations between GLR levels (p ≤ 0.001) and various prognostic factors such as age (p = 0.034), Perineural Invasion (PNI) (p = 0.002), tumor grade (p = 0.017), TNM stage (p = 0.003), and surgery time (p = 0.029), individuals with GLR ≥ 3.04 were observed to show higher mortality rates (p = 0.001). Above GLR cutoff point of 3.04 patients showed better overall survival rates. All survival related parameters were related with prognosis in univariant Cox regression tests. In multivariant cox regression tests GLR ≥ 3.04 significantly increased mortality by 2.9 times. (p = 0.003).Conclusion: This study demonstrates that GLR, calculated from preoperative glucose and lymphocyte values serves as an independent prognostic factor in colorectal cancers. The findings suggest potential applications for GLR in survival analyses, with significant associations identified in age, PNI, tumor grade, TNM stage, and surgery time. Further investigations are warranted in homogeneous patient populations.Keywords: colorectal cancer, prognostic factor, survival, Glucose-to-lymphocyte Ratio, cancer-specific survival

Keywords

• colorectal cancer
• prognostic factor
• survival
• glucose-to-lymphocyte ratio
• cancer-spesific survival