The impact of neoadjuvant therapy on the prognostic value of preoperative neutrophil-to-lymphocyte ratio for colorectal liver metastases: a multi-center cohort study.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

International Journal of Colorectal Disease Pub Date : 2025-01-09 DOI:10.1007/s00384-024-04800-x

Xiang-Yu Wang, Jie-Liang Zuo, Hong Fu, Chong Zhang, Qing-Qi Fan, Bo Zhang, Bao-Rui Tao, Zhen-Mei Chen, Jia-Hao Han, Yi-Tong Li, Yue Ma, Xiao-Chen Ma, Rui Zhang, Ying Zhu, Wen-Wei Zhu, Lu Lu, Ming-Xu Yu, Jin-Hong Chen

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引用次数: 0

Abstract

Background: Neutrophil-to-lymphocyte ratio (NLR) is a promising prognostic marker for patients undergoing hepatectomy for colorectal liver metastases (CRLM). However, its prognostic value in patients receiving neoadjuvant therapy (NAT) has not been sufficiently addressed.

Methods: From 2013 to 2023, a cohort of 692 patients with CRLM receiving hepatectomy were enrolled in five centers. Clinicopathological characteristics were obtained from a prospectively maintained multi-center database. The effect of NLR (> 2 versus ≤ 2) on overall survival (OS) and recurrence-free survival was estimated by Kaplan-Meier analysis. Univariable and multivariable Cox regression analysis was applied to investigate the influence of individual clinicopathological parameters on OS.

Results: In the entire cohort, the median NLR level was 2.11 (0.30-16.33). There were 307 (44.4%) patients receiving NAT followed by hepatectomy, while 385 (55.6%) patients undergoing upfront surgery. Notably, patients in the NAT group showed significantly lower NLR level than those in the upfront surgery group (1.83 versus 2.32, P < 0.001). In the upfront surgery group, high NLR was significantly associated with worse OS, independent of other factors (HR = 1.49, 95% CI 1.08-2.05, P = 0.02). In the NAT group, there was no significant difference in OS between the high NLR and low NLR group.

Conclusion: The prognostic value of NLR in surgically resected CRLM is potentially influenced by NAT in the modern era.

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一项多中心队列研究：新辅助治疗对结肠肝转移术前中性粒细胞与淋巴细胞比值预后价值的影响。

背景：中性粒细胞与淋巴细胞比率（NLR）是结肠直肠癌肝转移（CRLM）患者行肝切除术的预后指标。然而，它在接受新辅助治疗（NAT）的患者中的预后价值尚未得到充分的解决。方法：从2013年到2023年，在5个中心纳入692例接受肝切除术的CRLM患者。临床病理特征从前瞻性维护的多中心数据库中获得。NLR （bb0 2 vs≤2）对总生存期（OS）和无复发生存期的影响通过Kaplan-Meier分析估计。采用单变量和多变量Cox回归分析探讨个体临床病理参数对OS的影响。结果：在整个队列中，NLR中位数为2.11（0.30-16.33）。307例（44.4%）患者接受NAT后肝切除术，385例（55.6%）患者接受术前手术。值得注意的是，NAT组患者NLR水平明显低于前期手术组（1.83比2.32，P）。结论：NLR在手术切除的CRLM中的预后价值在现代可能受到NAT的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Colorectal Disease 医学-外科

CiteScore

4.90

自引率

3.60%

发文量

206

审稿时长

3-8 weeks

期刊介绍： The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.