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Prognostic Predictors for Survival in Patients Treated for Colorectal Cancer

By: Celeste L. Dixon
Posted: Thursday, March 22, 2018

The results of a retrospective review confirm that pretreatment inflammatory indexes are not just associated with progression-free and overall survival in patients with colorectal cancer receiving neoadjuvant chemoradiotherapy, but they may have particular predictive value. Ma and colleagues of the Collaborative Innovation Center for Biotherapy, Chengdu, China, published their findings in Scientific Reports. The indexes studied were neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII).

The analysis included 98 patients, all of whom received neoadjuvant chemoradiotherapy. At the start, 40 had distant metastasis, 81 had an Eastern Cooperative Oncology Group (ECOG) performance status of 0, and 17 had an ECOG performance status of 1 to 2.  Univariate analysis and the Kaplan-Meier curve indicated that higher ECOG performance status and distant metastasis had statistically significant associations with poorer progression-free and overall survival—not too surprisingly. However, higher NLR, PLR, and SII, as well as lower LMR, were also all significantly associated with poorer progression-free and overall survival rates.

The multivariate analysis results indicated that of the inflammatory indexes, elevated NLR was a significant independent predictor of poorer progression-free survival (hazard ratio [HR], 2.243; P = .034) and poorer overall survival (HR, 2.336; P = .017), as were higher ECOG performance status and distant metastasis.

With these results, the authors concluded: “Pretreatment inflammatory indexes, especially NLR, could be good parameters for predicting survival of colorectal cancer patients receiving neoadjuvant chemoradiotherapy. However, further investigations are required to validate these results.”

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