The prognostic value of C-reactive protein and albumin in patients undergoing resection of colorectal liver metastases. A retrospective cohort study

Frühling, Petter; Hellberg, Katarina; Ejder, Patric; Strömberg, C.; Urdzik, Jozef; Isaksson, Bengt

doi:10.1016/j.hpb.2020.10.019

Cited by 5 publications

(5 citation statements)

References 49 publications

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“…To summarize, our study builds upon the foundation laid by previous research, particularly Dupre et al,Malik et al,and Frühling et al [13,20,40,54]. By ranking variables and proposing the C-reactive protein as a potential substitute, we aimed to extend the utility of prognostic scoring systems and to address the challenges posed by unobtainable retrospective values, such as the neutrophil-lymphocyte ratio.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, along with its role in inflammation and cancer prognosis, elevated serum C-reactive protein values have been associated with the risk of malnutrition and neoplastic cachexia [34]. This protein can also be elevated in infectious and auto-immune diseases [20,42].…”

Section: Discussionmentioning

confidence: 99%

“…The routine blood work did not include determining the white blood cell count, but included the assessment of proteinaceous inflammatory markers: C-reactive protein, albumins, and fibrinogen [12]. They were measured by automatized analyzers from the peripheral vein blood of patients one day before the scheduled liver procedure [20]. Fibrinogen was obtained in a standard coagulation panel.…”

Section: Materials 211 Patientsmentioning

confidence: 99%

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Ranking as a Procedure for Selecting a Replacement Variable in the Score Predicting the Survival of Patients Treated with Curative Intent for Colorectal Liver Metastases

Plahuta,

Mencinger,

Peruš

et al. 2023

Medicina

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Background and Objectives: The issue of a missing variable precludes the external validation of many prognostic models. For example, the Liverpool score predicts the survival of patients undergoing surgical therapy for colorectal liver metastases, but it includes the neutrophil–lymphocyte ratio, which cannot be measured retrospectively. Materials and Methods: We aimed to find the most appropriate replacement for the neutrophil–lymphocyte ratio. Survival analysis was performed on data representing 632 liver resections for colorectal liver metastases from 2000 to 2020. Variables associated with the Liverpool score, C-reactive protein, albumins, and fibrinogen were ranked. The rankings were performed in four ways: The first two were based on the Kaplan-Meier method (log-rank statistics and the definite integral IS between two survival curves). The next method of ranking was based on univariate and multivariate Cox regression analyses. Results: The ranks were as follows: the radicality of liver resection (rank 1), lymph node infiltration of primary colorectal cancer (rank 2), elevated C-reactive protein (rank 3), the American Society of Anesthesiologists Classification grade (rank 4), the right-sidedness of primary colorectal cancer (rank 5), the multiplicity of colorectal liver metastases (rank 6), the size of colorectal liver metastases (rank 7), albumins (rank 8), and fibrinogen (rank 9). Conclusions: The ranking methodologies resulted in almost the same ranking order of the variables. Elevated C-reactive protein was ranked highly and can be considered a relevant replacement for the neutrophil–lymphocyte ratio in the Liverpool score. These methods are suitable for ranking variables in similar models for medical research.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Materials 211 Patientsmentioning

confidence: 99%

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Ranking as a Procedure for Selecting a Replacement Variable in the Score Predicting the Survival of Patients Treated with Curative Intent for Colorectal Liver Metastases

Plahuta,

Mencinger,

Peruš

et al. 2023

Medicina

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“…Several prognostic scoring systems, including CAR (C-reactive protein/albumin ratio) (19), GPS (Glasgow Prognostic Score) (20,21), mGPS (modi ed Glasgow Prognostic Score) (22), and CALLY (C-reactive protein, albumin, lymphocyte, and liver metastases count) (23), have also identi ed low albumin as a signi cant factor impacting patient outcomes in this context. In our study, albumin emerged as a robust and independent factor in multivariate analysis, exhibiting a substantial impact on both overall survival (OS) with a hazard ratio (HR) of 16.79 and disease-free survival (DFS) with an HR of 4.21.…”

Section: Discussionmentioning

confidence: 99%

The Surgical Outcome and Prognostic Factors for Solitary Colorectal Liver Metastasis

Hsu,

Chern,

et al. 2023

Preprint

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Background: The study focused on patients who had surgery for solitary liver metastasis of colorectal cancer (CRLM) and experienced relapse. Its main objective was to analyze the factors that independently contribute to recurrence and long-term overall survival. Methods: We retrospectively analyzed 230 solitary CRLM patients who received liver resection between 2010 and 2019. Factors prognostic of disease recurrence and overall survival were investigated and nomograms were developed to predict patient outcome after liver resection. Results: For these patients, the 3-year-overall survival (OS) rate was 72.3% and 59.8% for 5-years. For the recurrence-free survival (RFS) rate, it was 40.0% for 3-years and 27.1% for 5-years. The multivariate analysis showed that age ≥ 70, resection margin width < 10 mm, initial N2 stage, hypoalbuminemia before liver resection, and neutrophil-lymphocyte ratio (NLR) ≥ 3 after liver resection were independent prognostic factors for OS. For RFS, the multivariate analysis showed that initial N2 stage, hypoalbuminemia before liver resection, NLR ≥ 3 after liver resection, abnormal Carcinoembryonic antigen (CEA) after liver resection, and CEA ratio (after/before liver resection) < 0.3 were independent prognostic factors. Conclusions: The study found that several factors significantly impact both the recurrence and overall survival rates of patients who had surgery for solitary liver metastasis of colorectal cancer. The most important risk factors identified were the initial N2 stage, a neutrophil-lymphocyte ratio of 3 or higher after liver resection, and hypoalbuminemia (albumin levels below 3.5 g/dL) before liver resection.

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“…Chen et al (11) showed that preoperative D-dimer and GGT levels were reliable biomarkers in predicting major postoperative complications or survival of CRLM patients after hepatic resection. Further, Frühling et al (12) found that a high preoperative Glasgow Prognostic Score, measured by preoperative C-reactive protein and albumin, was correlated with poor survival in CRLM patients.…”

Section: Introductionmentioning

confidence: 99%

Changes in serum lactate dehydrogenase levels as markers of pathological response and prognosis in colorectal liver metastases patients receiving neoadjuvant chemotherapy followed by resection

Chen¹,

Chen²,

Yao³

et al. 2021

Ann Palliat Med

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Background: This study sought to evaluate the effects of pre-neoadjuvant chemotherapy lactate dehydrogenase (pre-NAC LDH) levels, preoperative LDH levels, and changes in LDH levels on the pathological response and outcomes of colorectal liver metastases (CRLM) patients treated with liver resection after NAC.Methods: This study included 152 colorectal CRLM patients, who underwent NAC followed by liver resection. Patients were excluded if they were diagnosed with other malignancies or lacked follow-up and clinical data. Demographic and clinicopathological data were collected from hospital records. Pathological response and postoperative complications were measured according to the tumor regression grade (TRG) and Clavien-Dindo classification system, respectively. The optimal cutoff values were determined by the receiver operating characteristic curve and the X-tile analysis. Changes in LDH levels were graded as 0, 1, and 2. A logistic regression analysis was conducted to identify the independent predictors of pathological response and postoperative major complications. Univariate and multivariate Cox regression analyses were used to identify the independent risk factors of progression-free survival (PFS) and overall survival (OS). Results: The multivariate analysis indicated that a grade 2 LDH level change was a risk factor of an unfavorable histological response [odds ratio (OR) 0.249, 95% confidence interval (CI): 0.066-0.942; P=0.041] and major postoperative complications (OR 2.523, 95% CI: 1.179-10.530; P=0.024), which were independent of other clinical covariates. A pre-NAC LDH level ≥145 IU/L [hazards ratio (HR) 0.584, 95% CI: 0.359-0.950; P=0.030], a grade 1 LDH level change (HR 0.584, 95% CI: 0.359-0.950; P=0.030) and a grade 2 LDH level change (HR 0.447, 95% CI: 0.231-0.864; P=0.017) were independent prognostic predictors of PFS. A preoperative a LDH level ≥231 IU/L (HR 0.405, 95% CI: 0.192-0.852; P=0.017) and a grade 2 LDH level change (HR 0.362, 95% CI: 0.157-0.834; P=0.017) were independent prognostic factors of OS, which were independent of other clinical covariates.Conclusions: LDH levels and changes in LDH levels are potentially useful biomarkers for predicting the pathological response and prognosis of CRLM patients receiving NAC followed by liver resection.

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The prognostic value of C-reactive protein and albumin in patients undergoing resection of colorectal liver metastases. A retrospective cohort study

Cited by 5 publications

References 49 publications

Ranking as a Procedure for Selecting a Replacement Variable in the Score Predicting the Survival of Patients Treated with Curative Intent for Colorectal Liver Metastases

Ranking as a Procedure for Selecting a Replacement Variable in the Score Predicting the Survival of Patients Treated with Curative Intent for Colorectal Liver Metastases

The Surgical Outcome and Prognostic Factors for Solitary Colorectal Liver Metastasis

Changes in serum lactate dehydrogenase levels as markers of pathological response and prognosis in colorectal liver metastases patients receiving neoadjuvant chemotherapy followed by resection

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