International journal of colorectal disease · 2025
The impact of neoadjuvant therapy on the prognostic value of preoperative neutrophil-to-lymphocyte ratio for colorectal liver metastases: a multi-center cohort study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Wang Xiang-Yu, Zuo Jie-Liang, Fu Hong, Zhang Chong, Fan Qing-Qi, Zhang Bo, Tao Bao-Rui, Chen Zhen-Mei, Han Jia-Hao, Li Yi-Tong, Ma Yue, Ma Xiao-Chen, Zhang Rui, Zhu Ying, Zhu Wen-Wei, Lu Lu, Yu Ming-Xu, Chen Jin-Hong
Аннотация
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.
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.