TPT 1.03 Pre-Operative Systemic Inflammation Predicts Inferior Oncological Adequacy and Increased Recurrence Following Colorectal Cancer Surgery

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ID: 323998
2026
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Abstract
Abstract Background Systemic inflammatory response is increasingly recognised as a marker of aggressive tumour biology in colorectal cancer. Its relationship with surgical oncological adequacy and long-term recurrence remains incompletely defined. This study evaluated whether routinely available pre-operative inflammatory markers predict oncological quality and disease recurrence following colorectal cancer surgery. Methods A retrospective cohort study was performed of patients undergoing colorectal cancer resection at Kettering General Hospital between 2020 and 2023. Pre-operative haemoglobin, neutrophil count, lymphocyte count, and neutrophil-to-lymphocyte ratio (NLR) were analysed. High systemic inflammation was defined as NLR ≥4. Oncological adequacy outcomes included lymph node yield (<12 vs ≥12) and resection margin status (R0 vs R1/R2). Recurrence within five years was the primary long-term outcome. Results A total of 415 patients were included, with complete inflammatory data available for 410 (99%). Median pre-operative NLR was 3.75 (IQR 2.47–5.55), with 44.7% of patients demonstrating high systemic inflammation (NLR ≥4). Patients with elevated NLR had a higher rate of involved resection margins compared with those with lower NLR (12.9% vs 6.1%). Five-year recurrence occurred in 22.1% of the overall cohort and was significantly more common in patients with elevated pre-operative NLR (30.2% vs 15.8%). Pre-operative anaemia and lymphopenia demonstrated similar associations with adverse oncological outcomes. Conclusion Pre-operative systemic inflammation is associated with inferior oncological adequacy and increased disease recurrence following colorectal cancer surgery. Simple blood-based inflammatory markers may assist surgeons in identifying patients at increased oncological risk and support enhanced pre-operative risk stratification and optimisation strategies.
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openalex_W7172498502 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Ahmed Kassem, Mohamed Ahmed, Khaled Hureibi
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.159
URL
https://doi.org/10.1093/bjs/znag087.159
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