Prognostic Value of Systemic Inflammatory Biomarkers in Patients Undergoing Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy.

BackgroundLaboratory biomarkers have been used as prognostic markers in several solid tumors. This study aims to evaluate 3 preoperatively measured laboratory values: blood neutrophil to lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), as potential prognostic biomarkers in patients with peritoneal carcinomatosis undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).MethodsWe performed a retrospective review of 156 patients who underwent CRS-HIPEC between 2013 and 2020. Biomarker ratios were calculated based on the preoperative laboratory values closest to the date of CRS-HIPEC. Multivariable Cox regression models were used to evaluate the biomarkers' associations with survival (OS), recurrence-free survival (RFS), and postoperative outcomes.ResultsIncreased MLR was independently associated with worse OS (P < 0.001) and RFS (P = 0.03) in this patient cohort. Additionally, increased MLR was independently associated with increased rate of hospital re-admission within 30 days after discharge (P = 0.04). None of the analyzed biomarkers were associated with increased rate of Clavien-Dindo class III/IV complication or hospital length of stay.ConclusionsIn this retrospective review, increased preoperative MLR was independently associated with worse overall and recurrence-free survival as well as increased rate of hospital re-admission. Preoperative PLR was associated with increased hospital length of stay. Thus, the utilization of preoperative systemic inflammatory biomarkers may aid in preoperative counseling and risk stratification prior to CRS-HIPEC.