Impact of Inflammation Markers on Survival in Patients with Metastatic Colorectal Cancer
Tarik Demir1, Mehmet Besiroglu21Departments of Medical Oncology, University of Health Sciences, Hamidiye Faculty of Medicine, Haydarpaşa Numune Health Application and Research Center, Istanbul, Turkey, 2Departments of Medical Oncology, Bezmialem Vakif University, Faculty of Medicine Hospital, Istanbul, Turkey
Objectives: This retrospective study evaluated the prognostic significance of inflammation markers (IMs) in patients with metastatic colorectal cancer (mCRC). Methods: A total of 101 patients—44 (43.6%) were female, and 57 (56.4%) were male—were included in the study. All medical records were reviewed retrospectively. The cut-off values for the IMs (c-reactive protein (CRP), CRP/albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and systemic immune-inflammatory index (neutrophils × platelets)/lymphocytes) (SIII)) were defined by receiver operating characteristic (ROC) analysis. Overall survival (OS) was plotted using the Kaplan–Meier method and compared using the log-rank test. Cox regression analysis was performed for univariate and multivariate analyses, and hazard ratios (HRs) with 95% confidence intervals (CIs) were used to quantify the indices estimating the survival. Results: ROC analysis was performed to determine the optimal prognostic value of each parameter. Accordingly, CRP: 11 mg/dL, NLR: 2.4, PLR: 137, SIII: 798, and CAR: 2.7 were determined as cut-off values for predicting OS based on the areas under the curve (AUC) in the ROC analysis (CRP: 0.742, p<0.001 (sensitivity: 66%, specificity: 82%); NLR: 0.720, p<0.001 (sensitivity: 78%, specificity: 62%); PLR: 0.631, p=0.040 (sensitivity: 72%, specificity: 48%); SIII: 0.695, p=0.002 (sensitivity: 68%, specificity: 72%); CAR: 0.742, p<0.001 (sensitivity: 72%, specificity: 48%)). Multivariate analysis demonstrated that PLR is an independent prognostic factor for OS (p<0.001) in patients with mCRC. Conclusion: The findings of the present study suggest that pretreatment PLR might be an independent prognostic marker for patients with mCRC and might have value compared with other established inflammation-based prognostic scores. Keywords: C-Reactive protein to albumin ratio, metastatic colorectal cancer, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, prognostic score
Cite This Article
Demir T, Besiroglu M. Impact of Inflammation Markers on Survival in Patients with Metastatic Colorectal Cancer. EJMI. 2020; 4(2): 235-242
Corresponding Author: Tarik Demir