The predictive value of lymphocyte to monocyte ratio for overall survival in cholangiocarcinoma patients with hepatic resection

Abstract

Background There is considerable heterogeneity in clinical behavior and survival outcomes in patients with cholangiocarcinoma (CCA), and the prognosis of CCA patients is poor. We proposed lymphocyte to monocyte ratio (LMR) as a novel prognostic element for CCA patients with hepatic resection in present study. Methods By retrospectively analyzing the clinical data of 145 CCA patients with hepatic resection, we determined the optimal LMR cutoff value according to the receiver operating characteristic (ROC). We comparatively analyzed the clinical features of CAA patients between low LMR group and high LMR group, mainly including overall survival (OS) analysis by using the Kaplan‐Meier method, univariate and multivariate Cox regression. Results We found there was a longer OS in CCA patients of the high LMR group than the low LMR group. The total median OS of cholangiocarcinoma patients were 13.6 months, and the OS of low LMR group was markedly lower than the high LMR group. The 1‐year, 3‐year, and 5‐year OS of high LMR group were respectively 62.9%, 32.4%, and 16.4%, and were significantly higher the cholangiocarcinoma patients of low LMR group (40.2%, 16.4%, and 0%). Multivariate regression analyses showed that preoperative cholangitis, elevated CEA level and nerve invasion were risk factors for the OS of cholangiocarcinoma patients, while the high LMR level and postoperative treatment were protective factors for the OS of cholangiocarcinoma patients. Conclusions Preoperative LMR was a vital prognostic factor to predict the prognosis of CCA patients with hepatic resection and provided additional prognostic value beyond standard clinicopathological parameters.

Total lesion glycolysis by 18F‐fluorodeoxyglucose positron emission tomography predicts tumor aggressiveness in patients with extrahepatic bile duct carcinoma

“…In this study, we found that preoperative low LMR, high mGPS, and high tumor TLG were independent prognostic factors for poor RFS. The association between preoperative low LMR and poor prognosis has been described in several malignancies, including bile duct carcinoma 22 . In addition, mGPS, one of the nutritional indicators using preoperative CRP and albumin, is associated with poor prognosis in bile duct carcinoma 23 .…”

“…The association between preoperative low LMR and poor prognosis has been described in several malignancies, including bile duct carcinoma. 22 In addition, mGPS, one of the nutritional indicators using preoperative CRP and albumin, is associated with poor prognosis in bile duct carcinoma. 23 In the present study, multivariate analysis showed that the HR of high tumor TLG was higher than that with low LMR or high mGPS.…”

Clinical Implications of Naples Prognostic Score for Patients with Resected Cholangiocarcinoma: A Real-World Experience

“…The study found that higher level of preoperative LMR were associated with a better prognosis. 18 However, a single marker was insufficient for risk stratification. NPS was a novel prognostic marker that incorporated both inflammation and nutritional indicators.…”

The predictive value of LGR for distant metastasis-free survival in locally advanced rectal cancer patients

“…However, an increase in monocytes and lymphocytes strengthens the body's defense against tumor invasion. There has been increasing evidence that local and systemic inflammatory responses are associated with survival prognosis of solid tumors such as rectal cancer [ 7 ], cholangiocarcinoma [ 8 ], lung cancer [ 9 ], and esophageal cancer [ 10 ]. Recent studies showed that many inflammatory indicators can be used as prognostic markers of tumor patients, such as lymphocyte to monocyte ratio (LMR) [ 11 , 12 ], white blood cell to monocyte ratio (WMR) [ 13 ], white blood cell to C-reactive protein ratio (WCR) [ 14 ], platelets to lymphocyte ratio (PLR) [ 15 ], and neutrophil to lymphocyte ratio (NLR) [ 16 ].…”