The Prognostic Significance Of Inflammation Associated Blood Cell Markers In Metastatic Colorectal Cancer
Abstract
Objectives: The aim is to perform prognostic evaluation with overall survival (OS) and progression-free survival (PFS) in hematological parameter-based groups in patients with metastatic colorectal cancer (mCRC).
Methods: In a single institution, 51 patients were retrospectively analyzed mCRC diagnosed between 2019 and 2022. Pretreatment hematological parameters of patients with mCRC receiving first-line chemotherapy in a single center were examined. The receiver operating characteristic curve was used to predict the tests. Median OS was calculated by the Kaplan-Meier method and compared with the log-rank test. Multivariate analyses were performed using a Cox regression model.
Results: The median OS of the patients included in the study was 27 months (3-88 months) by statistical calculation; the median PFS was 19 months (2-84 months). The median could not be reached. Among the risk factors affecting OS, it was found effective to have a bone metastasis site and a pancreatic metastasis site (p values 0.003 and 0.027, respectively). In the analysis of the risk factors affecting PFS, bone and pancreatic metastases were found to be significant (p values 0.001 and 0.004, respectively). Patients receiving chemotherapy and anti-VEGF therapy have a significantly reduced risk of death of 0.06 times compared to those who do not receive chemotherapy, which indicates that OS is significantly longer in people receiving chemotherapy in question (p=0.020). It was observed that blood cell marker levels were not statistically significant in PFS and OS. Of the 51 patients included in the study, 30 of them were still being followed up, while 21 of them died.
Conclusions: Chemotherapy plus anti-VEGF therapy is a treatment whose effectiveness has been determined in metastatic colorectal cancer. In the future, there is a need for more prospective and large patient group studies on this topic to measure the prognostic value of hematological parameters in metastatic colorectal cancer.
Keywords
Colorectal cancer, Progression free survival, Overall survival
Ethical Statement
2021-21/6
References
- Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010;140(6):883-899. doi:10.1016/j.cell.2010.01.025
- Templeton AJ, McNamara MG, Šeruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014;106(6):dju124. Published 2014 May 29. doi:10.1093/jnci/dju124
- Takeuchi H, Kawanaka H, Fukuyama S, Kubo N, Hiroshige S, Yano T. Comparison of the prognostic values of preoperative inflammation-based parameters in patients with breast cancer. PLoS One. 2017;12(5):e0177137. Published 2017 May 10. doi:10.1371/journal.pone.0177137
- Karsa LV, Lignini TA, Patnick J, Lambert R, Sauvaget C. The dimensions of the CRC problem. Best Pract Res Clin Gastroenterol. 2010;24(4):381-396. doi:10.1016/j.bpg.2010.06.004
- Pedrazzani C, Mantovani G, Fernandes E, et al. Assessment of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and platelet count as predictors of long-term outcome after R0 resection for colorectal cancer. Sci Rep. 2017;7(1):1494. Published 2017 May 4. doi:10.1038/s41598-017-01652-0
- Il'yasova D, Colbert LH, Harris TB, et al. Circulating levels of inflammatory markers and cancer risk in the health aging and body composition cohort. Cancer Epidemiol Biomarkers Prev. 2005;14(10):2413-2418. doi:10.1158/1055-9965.EPI-05-0316
- Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144(5):646-674. doi:10.1016/j.cell.2011.02.013
- Li MX, Liu XM, Zhang XF, et al. Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: a systematic review and meta-analysis. Int J Cancer. 2014;134(10):2403-2413. doi:10.1002/ijc.28536
- Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015;52(2):86-105. doi:10.3109/10408363.2014.992064
- Hu Z, Sun Y, Wang Q, et al. Red blood cell distribution width is a potential prognostic index for liver disease. Clin Chem Lab Med. 2013;51(7):1403-1408. doi:10.1515/cclm-2012-0704
