Journal article
Comparison of Hematologic and Other Prognostic Markers in Metastatic Colorectal Cancer
Journal of gastrointestinal cancer, Vol.50(3), pp.493-506
09/15/2019
DOI: 10.1007/s12029-018-0108-1
PMID: 29704170
Abstract
Background Associations of thrombocytosis, neutrophilia, and lymphopenia with prognosis have been confirmed in many cancers. This study aims at comparing various prognostic indices based on blood counts in metastatic colorectal adenocarcinomas.
Patients and Methods Records from 152 patients with metastatic colorectal cancer who were treated in our center were reviewed. Demographic and disease characteristics and hematologic parameters data were extracted and patients were stratified according to their scores of several hematologic ratios. Hematologic ratios and parameters considered included the platelet-neutrophil to lymphocyte ratio (PNLR), the platelet to lymphocyte ratio (PLR), the neutrophil to lymphocyte ratio (NLR), the Abnormal Hematological Markers Index (AHMI), and the neutrophil-platelet score (NPS). Optimal cutoffs were defined with the aid of an online tool. Baseline parameters of the two groups derived for each tool were evaluated and compared with the chi(2) test. Univariate and multivariate Cox proportional-hazards regression analyses were performed on variables of interest.
Results Progression-Free Survival (PFS) hazard ratios (HR) between the high-risk and low-risk groups derived from the multivariate analyses for each index were as follows: for PNLR 2.0 (95% CI 1.28-3.13), for PLR 1.74 (95% CI 1.13-2.67), for NLR 1.54 (95% CI 1.04-2.29), for AHMI 1.62 (95% CI 1.06-2.46), and for NPS 1.47 (95% CI 1.1-1.96). Overall Survival (OS) hazard ratios (HR) derived from the multivariate analyses for each index were as follows: for PNLR 2.23 (95% CI 1.36-3.66), for PLR 1.68 (95% CI 1.03-2.75), for NLR 1.62 (95% CI 1.06-2.49), for AHMI 1.7 (95% CI 1.07-2.69), and for NPS 1.53 (95% CI 1.11-2.11). Another prognostic index called PRONOPALL, which is based on ECOG PS (0-1 versus 2-3 versus 4), number of metastatic sites (<= 1 versus >= 2), LDH (<600U/L versus >= 600U/L), and albumin (>= 33g/L versus <33g/L), had HRs of 1.75 and 2.20 for PFS and OS, respectively, with a cutoff of <4 versus >= 4. This score has a range of 0 to 10 and points are attributed for the presence of each of the four prognostic factors.
Conclusion In this analysis of metastatic colorectal cancer patients, several ratios and other prognostic tools had prognostic value for both OS and PFS. While other variables held significance for poorer prognosis, PNLR had the highest HR and the highest significance in multivariate analysis for both PFS and OS. Thus, it represents a valid prognostic tool in metastatic colorectal cancer among the spectrum of hematologic parameter-constructed tools.
Details
- Title: Subtitle
- Comparison of Hematologic and Other Prognostic Markers in Metastatic Colorectal Cancer
- Creators
- Joey Mercier - Northern Ontario Sch Med, Div Clin Sci, Sudbury, ON, CanadaIoannis A. Voutsadakis - Northern Ontario Sch Med, Div Clin Sci, Sudbury, ON, Canada
- Resource Type
- Journal article
- Publication Details
- Journal of gastrointestinal cancer, Vol.50(3), pp.493-506
- DOI
- 10.1007/s12029-018-0108-1
- PMID
- 29704170
- NLM abbreviation
- J Gastrointest Cancer
- ISSN
- 1941-6628
- eISSN
- 1941-6636
- Publisher
- Springer Nature
- Number of pages
- 14
- Grant note
- Dean's summer student research award of the Northern Ontario School of Medicine, Canada
- Language
- English
- Date published
- 09/15/2019
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984806498602771
Metrics
3 Record Views