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Erschienen in: Updates in Surgery 1/2018

01.03.2018 | Original Article

Preoperative platelet–lymphocyte ratio is an independent factor of poor prognosis after curative surgery for colon cancer

verfasst von: Martin Bailon-Cuadrado, Ekta Choolani-Bhojwani, Francisco J. Tejero-Pintor, Javier Sanchez-Gonzalez, Mario Rodriguez-Lopez, Baltasar Perez-Saborido, Jose L. Marcos-Rodriguez

Erschienen in: Updates in Surgery | Ausgabe 1/2018

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Abstract

Interaction between tumour and host triggers a systemic inflammatory response. This situation has been associated to cancer progression. Several peripheral blood inflammatory scores have been recently developed, as PLR. Data about the relationship between these scores and cancer prognosis are contradictory. Therefore, the aim of our work is to evaluate the capability of PLR to predict long-term outcomes (OS and RFS) in patients who underwent curative surgery for colon cancer. A retrospective study was designed with patients who underwent curative surgery for colon cancer between September 2008 and January 2012 at Rio Hortega University Hospital, Valladolid (Spain). We analysed the influence of PLR and other clinical variables on OS and RFS. Finally, 201 patients were analysed. Optimal cut-off value for PLR, established with ROC curves, was 153. 1-, 3- and 5-year OS were: 99.0, 90.4 and 82.3% for low PLR, and 93.8, 74.9 and 61.9% for high PLR, p < 0.001. 1-, 3- and 5-year RFS were: 92.4, 84.7 and 77.6% for low PLR, and 83.3, 64.5 and 52.6% for high PLR, p < 0.001. In MVA, high PLR was an independent negative prognostic factor for OS (HR = 2.11; 95% CI 1.22–3.66; p = 0.008) and RFS (HR = 1.99; 95% CI 1.19–3.34; p = 0.009). PLR represents an independent negative prognostic factor for OS and RFS in our sample of patients who underwent curative surgery for colon cancer. However, further studies with a larger sample size from different populations are necessary to confirm this conclusion.
Literatur
1.
Zurück zum Zitat Aran V, Victorino AP, Thuler LC, Ferreira CG, Levine JS, Ahnen DJ et al (2016) Colorectal cancer: epidemiology, disease mechanisms and interventions to reduce onset and mortality. Clin Colorectal Cancer 15(3):195–203CrossRefPubMed Aran V, Victorino AP, Thuler LC, Ferreira CG, Levine JS, Ahnen DJ et al (2016) Colorectal cancer: epidemiology, disease mechanisms and interventions to reduce onset and mortality. Clin Colorectal Cancer 15(3):195–203CrossRefPubMed
3.
Zurück zum Zitat Hanahan D, Weinberg RA (2011) Hallmarks of cancer: the next generation. Cell 144(5):646–674CrossRefPubMed Hanahan D, Weinberg RA (2011) Hallmarks of cancer: the next generation. Cell 144(5):646–674CrossRefPubMed
4.
Zurück zum Zitat Ishizuka M, Nagata H, Takagi K, Iwasaki Y, Kubota K (2012) Inflammation-based prognostic system predicts postoperative survival of colorectal cancer patients with a normal preoperative serum level of carcinoembryonic antigen. Ann Surg Oncol 19(11):3422–3431CrossRefPubMed Ishizuka M, Nagata H, Takagi K, Iwasaki Y, Kubota K (2012) Inflammation-based prognostic system predicts postoperative survival of colorectal cancer patients with a normal preoperative serum level of carcinoembryonic antigen. Ann Surg Oncol 19(11):3422–3431CrossRefPubMed
5.
Zurück zum Zitat Pine JK, Morris E, Hutchins GG, West NP, Jayne DG, Quirke P et al (2015) Systemic neutrophil-to-lymphocyte ratio in colorectal cancer: the relationship to patient survival, tumour biology and local lymphocytic response to tumour. Br J Cancer 113(2):204–211CrossRefPubMedPubMedCentral Pine JK, Morris E, Hutchins GG, West NP, Jayne DG, Quirke P et al (2015) Systemic neutrophil-to-lymphocyte ratio in colorectal cancer: the relationship to patient survival, tumour biology and local lymphocytic response to tumour. Br J Cancer 113(2):204–211CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Park BK, Park JW, Han EC, Ryoo SB, Han SW, Kim TY et al (2016) Systemic inflammatory markers as prognostic factors in stage IIA colorectal cancer. J Surg Oncol 114(2):216–221CrossRefPubMed Park BK, Park JW, Han EC, Ryoo SB, Han SW, Kim TY et al (2016) Systemic inflammatory markers as prognostic factors in stage IIA colorectal cancer. J Surg Oncol 114(2):216–221CrossRefPubMed
7.
Zurück zum Zitat Peng HX, Lin K, He BS, Pan YQ, Ying HQ, Hu XX et al (2016) Platelet-to-lymphocyte ratio could be a promising prognostic biomarker for survival of colorectal cancer: a systematic review and meta-analysis. FEBS Open Bio 6(7):742–750CrossRefPubMedPubMedCentral Peng HX, Lin K, He BS, Pan YQ, Ying HQ, Hu XX et al (2016) Platelet-to-lymphocyte ratio could be a promising prognostic biomarker for survival of colorectal cancer: a systematic review and meta-analysis. FEBS Open Bio 6(7):742–750CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Emir S, Aydin M, Can G, Bali I, Yildirim O, Öznur M et al (2015) Comparison of colorectal neoplastic polyps and adenocarcinoma with regard to NLR and PLR. Eur Rev Med Pharmacol Sci 19(19):3613–3618PubMed Emir S, Aydin M, Can G, Bali I, Yildirim O, Öznur M et al (2015) Comparison of colorectal neoplastic polyps and adenocarcinoma with regard to NLR and PLR. Eur Rev Med Pharmacol Sci 19(19):3613–3618PubMed
9.
10.
Zurück zum Zitat Pedrazzani C, Mantovani G, Fernandes E, Bagante F, Luca Salvagno G, Surci N et al (2017) Assessment of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and platelet count as predictors of long-term outcome after R0 resection for colorectal cancer. Sci Rep 7(1):1494CrossRefPubMedPubMedCentral Pedrazzani C, Mantovani G, Fernandes E, Bagante F, Luca Salvagno G, Surci N et al (2017) Assessment of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and platelet count as predictors of long-term outcome after R0 resection for colorectal cancer. Sci Rep 7(1):1494CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Akgül Ö, Çetinkaya E, Yalaza M, Özden S, Tez M (2017) Prognostic efficacy of inflammation-based markers in patients with curative colorectal cancer resection. World J Gastrointest Oncol 9(7):300–307CrossRefPubMedPubMedCentral Akgül Ö, Çetinkaya E, Yalaza M, Özden S, Tez M (2017) Prognostic efficacy of inflammation-based markers in patients with curative colorectal cancer resection. World J Gastrointest Oncol 9(7):300–307CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL et al (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12(5):489–495CrossRefPubMed Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL et al (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12(5):489–495CrossRefPubMed
13.
Zurück zum Zitat Blum D, Stene GB, Solheim TS, Fayers P, Hjermstad MJ, Baracos VE et al (2014) Validation of the consensus-definition for cancer cachexia and evaluation of a classification model—a study based on data from an international multicentre project (EPCRC-CSA). Ann Oncol 25(8):1635–1642CrossRefPubMed Blum D, Stene GB, Solheim TS, Fayers P, Hjermstad MJ, Baracos VE et al (2014) Validation of the consensus-definition for cancer cachexia and evaluation of a classification model—a study based on data from an international multicentre project (EPCRC-CSA). Ann Oncol 25(8):1635–1642CrossRefPubMed
14.
Zurück zum Zitat Nieswandt B, Hafner M, Echtenacher B, Männel DN (1999) Lysis of tumor cells by natural killer cells in mice is impeded by platelets. Cancer Res 59(6):1295–1300PubMed Nieswandt B, Hafner M, Echtenacher B, Männel DN (1999) Lysis of tumor cells by natural killer cells in mice is impeded by platelets. Cancer Res 59(6):1295–1300PubMed
15.
Zurück zum Zitat Mantovani A, Allavena P, Sica A, Balkwill F (2008) Cancer-related inflammation. Nature 454(7203):436–444CrossRefPubMed Mantovani A, Allavena P, Sica A, Balkwill F (2008) Cancer-related inflammation. Nature 454(7203):436–444CrossRefPubMed
16.
Zurück zum Zitat Gu X, Gao XS, Qin S, Li X, Qi X, Ma M et al (2016) Elevated platelet to lymphocyte ratio is associated with poor survival outcomes in patients with colorectal cancer. PLoS One 11(9):e0163523CrossRefPubMedPubMedCentral Gu X, Gao XS, Qin S, Li X, Qi X, Ma M et al (2016) Elevated platelet to lymphocyte ratio is associated with poor survival outcomes in patients with colorectal cancer. PLoS One 11(9):e0163523CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Min GT, Wang YH, Yao N, Zhao JM, Wang J, Wang HP et al (2017) The prognostic role of pretreatment platelet-to-lymphocyte ratio as predictors in patients with colorectal cancer: a meta-analysis. Biomark Med 11(1):87–97CrossRefPubMed Min GT, Wang YH, Yao N, Zhao JM, Wang J, Wang HP et al (2017) The prognostic role of pretreatment platelet-to-lymphocyte ratio as predictors in patients with colorectal cancer: a meta-analysis. Biomark Med 11(1):87–97CrossRefPubMed
18.
Zurück zum Zitat Huang XZ, Chen WJ, Zhang X, Wu CC, Zhang CY, Sun SS et al (2017) An elevated platelet-to-lymphocyte ratio predicts poor prognosis and clinicopathological characteristics in patients with colorectal cancer: a meta-analysis. Dis Markers 2017:1053125PubMedPubMedCentral Huang XZ, Chen WJ, Zhang X, Wu CC, Zhang CY, Sun SS et al (2017) An elevated platelet-to-lymphocyte ratio predicts poor prognosis and clinicopathological characteristics in patients with colorectal cancer: a meta-analysis. Dis Markers 2017:1053125PubMedPubMedCentral
19.
Zurück zum Zitat Guo YH, Sun HF, Zhang YB, Liao ZJ, Zhao L, Cui J et al (2017) The clinical use of the platelet/lymphocyte ratio and lymphocyte/monocyte ratio as prognostic predictors in colorectal cancer: a meta-analysis. Oncotarget 8(12):20011–20024CrossRefPubMedPubMedCentral Guo YH, Sun HF, Zhang YB, Liao ZJ, Zhao L, Cui J et al (2017) The clinical use of the platelet/lymphocyte ratio and lymphocyte/monocyte ratio as prognostic predictors in colorectal cancer: a meta-analysis. Oncotarget 8(12):20011–20024CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Son HJ, Park JW, Chang HJ, Kim DY, Kim BC, Kim SY et al (2013) Preoperative plasma hyperfibrinogenemia is predictive of poor prognosis in patients with nonmetastatic colon cancer. Ann Surg Oncol 20(9):2908–2913CrossRefPubMed Son HJ, Park JW, Chang HJ, Kim DY, Kim BC, Kim SY et al (2013) Preoperative plasma hyperfibrinogenemia is predictive of poor prognosis in patients with nonmetastatic colon cancer. Ann Surg Oncol 20(9):2908–2913CrossRefPubMed
21.
Zurück zum Zitat Baranyai Z, Krzystanek M, Jósa V, Dede K, Agoston E, Szász AM et al (2014) The comparison of thrombocytosis and platelet-lymphocyte ratio as potential prognostic markers in colorectal cancer. Thromb Haemost 111(3):483–490CrossRefPubMed Baranyai Z, Krzystanek M, Jósa V, Dede K, Agoston E, Szász AM et al (2014) The comparison of thrombocytosis and platelet-lymphocyte ratio as potential prognostic markers in colorectal cancer. Thromb Haemost 111(3):483–490CrossRefPubMed
22.
Zurück zum Zitat Mori K, Toiyama Y, Saigusa S, Fujikawa H, Hiro J, Kobayashi M et al (2015) Systemic analysis of predictive biomarkers for recurrence in colorectal cancer patients treated with curative surgery. Dig Dis Sci 60(8):2477–2487CrossRefPubMed Mori K, Toiyama Y, Saigusa S, Fujikawa H, Hiro J, Kobayashi M et al (2015) Systemic analysis of predictive biomarkers for recurrence in colorectal cancer patients treated with curative surgery. Dig Dis Sci 60(8):2477–2487CrossRefPubMed
23.
Zurück zum Zitat Szkandera J, Pichler M, Absenger G, Stotz M, Arminger F, Weissmueller M et al (2014) The elevated preoperative platelet to lymphocyte ratio predicts decreased time to recurrence in colon cancer patients. Am J Surg 208(2):210–214CrossRefPubMed Szkandera J, Pichler M, Absenger G, Stotz M, Arminger F, Weissmueller M et al (2014) The elevated preoperative platelet to lymphocyte ratio predicts decreased time to recurrence in colon cancer patients. Am J Surg 208(2):210–214CrossRefPubMed
24.
Zurück zum Zitat Ying HQ, Deng QW, He BS, Pan YQ, Wang F, Sun HL et al (2014) The prognostic value of preoperative NLR, d-NLR, PLR and LMR for predicting clinical outcome in surgical colorectal cancer patients. Med Oncol 31(12):305CrossRefPubMed Ying HQ, Deng QW, He BS, Pan YQ, Wang F, Sun HL et al (2014) The prognostic value of preoperative NLR, d-NLR, PLR and LMR for predicting clinical outcome in surgical colorectal cancer patients. Med Oncol 31(12):305CrossRefPubMed
25.
Zurück zum Zitat Neofytou K, Smyth EC, Giakoustidis A, Khan AZ, Cunningham D, Mudan S (2014) Elevated platelet to lymphocyte ratio predicts poor prognosis after hepatectomy for liver-only colorectal metastases, and it is superior to neutrophil to lymphocyte ratio as an adverse prognostic factor. Med Oncol 31(10):239CrossRefPubMed Neofytou K, Smyth EC, Giakoustidis A, Khan AZ, Cunningham D, Mudan S (2014) Elevated platelet to lymphocyte ratio predicts poor prognosis after hepatectomy for liver-only colorectal metastases, and it is superior to neutrophil to lymphocyte ratio as an adverse prognostic factor. Med Oncol 31(10):239CrossRefPubMed
26.
Zurück zum Zitat Zou ZY, Liu HL, Ning N, Li SY, Du XH, Li R (2016) Clinical significance of pre-operative neutrophil lymphocyte ratio and platelet lymphocyte ratio as prognostic factors for patients with colorectal cancer. Oncol Lett 11(3):2241–2248CrossRefPubMedPubMedCentral Zou ZY, Liu HL, Ning N, Li SY, Du XH, Li R (2016) Clinical significance of pre-operative neutrophil lymphocyte ratio and platelet lymphocyte ratio as prognostic factors for patients with colorectal cancer. Oncol Lett 11(3):2241–2248CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Josse JM, Cleghorn MC, Ramji KM, Jiang H, Elnahas A, Jackson TD et al (2016) The neutrophil-to-lymphocyte ratio predicts major perioperative complications in patients undergoing colorectal surgery. Colorectal Dis 18(7):O236–O242CrossRefPubMed Josse JM, Cleghorn MC, Ramji KM, Jiang H, Elnahas A, Jackson TD et al (2016) The neutrophil-to-lymphocyte ratio predicts major perioperative complications in patients undergoing colorectal surgery. Colorectal Dis 18(7):O236–O242CrossRefPubMed
28.
Zurück zum Zitat Cao X, Zhao G, Yu T, An Q, Yang H, Xiao G (2017) Preoperative prognostic nutritional index correlates with severe complications and poor survival in patients with colorectal cancer undergoing curative laparoscopic surgery: a retrospective study in a single Chinese institution. Nutr Cancer 69(3):454–463CrossRefPubMed Cao X, Zhao G, Yu T, An Q, Yang H, Xiao G (2017) Preoperative prognostic nutritional index correlates with severe complications and poor survival in patients with colorectal cancer undergoing curative laparoscopic surgery: a retrospective study in a single Chinese institution. Nutr Cancer 69(3):454–463CrossRefPubMed
29.
Zurück zum Zitat Kwon HC, Kim SH, Oh SY, Lee S, Lee JH, Choi HJ et al (2012) Clinical significance of preoperative neutrophil-lymphocyte versus platelet-lymphocyte ratio in patients with operable colorectal cancer. Biomarkers 17(3):216–222CrossRefPubMed Kwon HC, Kim SH, Oh SY, Lee S, Lee JH, Choi HJ et al (2012) Clinical significance of preoperative neutrophil-lymphocyte versus platelet-lymphocyte ratio in patients with operable colorectal cancer. Biomarkers 17(3):216–222CrossRefPubMed
30.
Zurück zum Zitat Ozawa T, Ishihara S, Nishikawa T, Tanaka T, Tanaka J, Kiyomatsu T et al (2015) The preoperative platelet to lymphocyte ratio is a prognostic marker in patients with stage II colorectal cancer. Int J Colorectal Dis 30(9):1165–1171CrossRefPubMed Ozawa T, Ishihara S, Nishikawa T, Tanaka T, Tanaka J, Kiyomatsu T et al (2015) The preoperative platelet to lymphocyte ratio is a prognostic marker in patients with stage II colorectal cancer. Int J Colorectal Dis 30(9):1165–1171CrossRefPubMed
Metadaten
Titel
Preoperative platelet–lymphocyte ratio is an independent factor of poor prognosis after curative surgery for colon cancer
verfasst von
Martin Bailon-Cuadrado
Ekta Choolani-Bhojwani
Francisco J. Tejero-Pintor
Javier Sanchez-Gonzalez
Mario Rodriguez-Lopez
Baltasar Perez-Saborido
Jose L. Marcos-Rodriguez
Publikationsdatum
01.03.2018
Verlag
Springer Milan
Erschienen in
Updates in Surgery / Ausgabe 1/2018
Print ISSN: 2038-131X
Elektronische ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-017-0503-3

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