Raised blood markers of chronic inflammation confer poor prognosis in gallbladder cancer.

BACKGROUND

Various pre-operative blood inflammatory markers and ratios have been used to prognosticate different cancers. We investigated a few and correlated it with Disease-Free Survival (DFS) and Overall Survival (OS) in Gallbladder Cancer (GBC) patients.

METHODS

Neutrophil to Lymphocyte ratio (NLR), Platelet to Lymphocyte ratio (PLR), Lymphocyte to Monocyte ratio (LMR), C-Reactive Protein (CRP), Lymphocyte to CRP ratio (LCR), modified Glasgow Prognostic Score (mGPS), CRP to Albumin ratio (CAR), and D dimer values were measured in 139 GBC patients (50 surgically resected and 89 not-operated).

RESULTS

Significantly higher risk of mortality was observed in patients with the high NLR, PLR, CRP, CAR, mGPS, and D dimer with hazard ratio of 6.935 (4.048 to 11.881), 17.101 (7.652 to 38.218), 5.916 (3.167 to 11.049), 5.532 (3.157 to 9.695), 6.912 (4.249 to 11.245), and 1.810 (1.203 to 2.725), respectively, on Univariate analysis. High LMR and LCR had significantly lower risk of mortality with hazard ratio of 0.066 (0.026 to 0.166) and 0.183 (0.11 to 0.303), respectively. Upon multivariate analysis, only high NLR, PLR, and mGPS remained statistically significant with adjusted hazard ratio of 8.278 (2.046 to 33.492), 3.907 (1.236 to 12.356), and 3.350 (1.796 to 6.249), respectively.

CONCLUSIONS

High NLR, PLR, and mGPS were significantly and independently associated with higher risk of mortality.