Pre-diagnostic prognostic value of leukocytes count and neutrophil-to-lymphocyte ratio in patients who develop colorectal cancer.

Results Pre-Leu, Pre-Neut and Pre-NLR showed an increasing trend approaching the date of diagnosis, while Pre-Lymph tended to decrease.

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The main findings of our study are: i) changes in the immune profile happen years before CRC diagnosis, with a rising trend for Pre-Leu, Pre-Neut and Pre-NLR, and a decreasing trend for Pre-Lymph; ii) Pre-CBC values are independent prognostic factors at multivariable analysis for OS and CRS; iii) the HR for OS and CRS increases proportionally with increasing values of Pre-Leu, Pre-Neut, and Pre-NLR, while the association with Pre-Lymph shows a dual trend; iv) Patients with the highest values of Pre-Leu, Pre-Neut and Pre-NLR or with the lowest values of Pre-Lymph present worse CRS after surgery, and the differences between sub-groups are more pronounced approaching the date of diagnosis.

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