The decreased platelet-to-lymphocyte ratio could predict a good prognosis in patients with oligometastatic colorectal cancer: a single-center cohort retrospective study

Abstract

Background Inflammation markers have an important effect on tumor proliferation, invasion, and metastasis. Oligometastatic disease (OMD) is an intermediate state between widespread metastases and locally confined disease, where curative strategies may be effective for some patients. We aimed to explore the predictive value of inflammatory markers in patients with oligometastatic colorectal cancer (OMCC) and build a nomogram to predict the prognosis of these patients. Methods Two hundred nine patients with OMCC were retrospectively collected in this study. The Kaplan-Meier survival curves and Cox regression analysis were used to estimate overall survival (OS) and progression-free survival (PFS). A multivariate Cox analysis model was utilized to establish the nomogram. The concordance index (C-index), calibration curve, and receiver operating characteristics (ROC) were established to verify the validity and accuracy of the prediction model. Results According to the multivariate analysis, decreased platelet-to-lymphocyte ratio (PLR) might independently improve OS in patients with OMCC (HR = 2.396, 95% CI 1.391–4.126, P = 0.002). Metastases of extra-regional lymph nodes indicated poor OS (HR = 2.472, 95% CI 1.247–4.903, P = 0.010). While the patients with early N stage had better OS (HR = 4.602, 95% CI 2.055–10.305, P = 0.001) and PFS (HR = 2.100, 95% CI 1.364–3.231, P = 0.007). Primary tumor resection (HR = 0.367, 95% CI 0.148–0.908, P = 0.030) and lower fibrinogen (HR = 2.254, 95% CI 1.246–4.078, P = 0.007) could significantly prolong the OS in patients with OMCC. PLR, metastases of extra-regional lymph nodes, N stage, primary tumor resection, and fibrinogen were used to make up the nomogram. The C-index and area under the curve (AUC) of the ROC in nomogram were 0.721 and 0.772 respectively for OS, showed good consistency between predictive probability of OS and actual survival. Conclusions Decreased PLR could predict a good prognosis in patients with OMCC. The nomogram including inflammatory factors and clinicopathological markers was credible and accurate to predict survivals in patients with OMCC.

Emerging Role of Tumor-Educated Platelets as a New Liquid Biopsy Tool for Colorectal Cancer

“…Studies have shown that preoperative MPV/TPC in the peripheral blood of CRC cases is low, 53 , 57 High levels of pretreatment TPC to lymphocyte count ratio (PLR) is associated with poor overall survival in CRC patients, 58 and decreased TPC/PLR shows good prognosis in patients with oligometastatic colorectal cancer. 59 MPV/TPC was associated with tumor infiltration and regional lymph node metastasis in CRC. 53 TPC/PLR was associated with depth of infiltration, 60 and this infiltration was associated with poor prognosis in postsurgical CRC patients.…”

Prognostic factors in colorectal liver metastases patients with various tumor numbers treated by liver resection: a single-center, retrospective study

“…Multiple factors have been reported to be associated with survival outcomes, with tumor number being one of these [20,[27][28][29][30][31][32]. Large tumor numbers indicated poor tumor behavior.…”

Blood cholesterol-to-lymphocyte ratio as a novel prognostic marker to predict postoperative overall survival in patients with colorectal cancer

“…In addition, the systemic inflammatory response also plays a vital role in cancer occurrence and progression, since cancer-associated inflammatory mediators aid in lymphovascular invasion, suppression for immune effector cells, and immune escape [ 17 – 19 ]. Several immune and systemic inflammation-associated biomarkers have been reported to be associated with long-term prognosis and postoperative complications such as anastomotic leakage in CRC [ 20 – 24 ]. Among these biomarkers, the lymphocyte counts, Glasgow prognostic score (GPS), modified GPS (mGPS), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte-ratio (LMR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein to albumin ratio were commonly used to predict CRC outcomes or therapeutic response [ 19 , 25 – 32 ].…”