Postoperative Inflammatory Marker Surveillance in Colorectal Peritoneal Carcinomatosis

BACKGROUND: The prognostic significance of inflammatory markers in solid cancers is well-established, albeit with considerable heterogeneity. This study sought to investigate the postoperative inflammatory marker trend in peritoneal carcinomatosis (PC), with a focus on colorectal PC (CPC), and to pr...

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Detalles Bibliográficos
Autores principales: Thiagarajan, Sasinthiran, Tan, Joey Wee-Shan, Zhou, Siqin, Tan, Qiu Xuan, Hendrikson, Josephine, Ng, Wai Har, Ng, Gillian, Liu, Ying, Tan, Grace Hwei Ching, Soo, Khee Chee, Teo, Melissa Ching Ching, Chia, Claramae Shulyn, Ong, Chin-Ann Johnny
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Gastrointestinal Oncology
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8460570/
https://www.ncbi.nlm.nih.gov/pubmed/33655363
http://dx.doi.org/10.1245/s10434-020-09544-w
Descripción
Sumario:BACKGROUND: The prognostic significance of inflammatory markers in solid cancers is well-established, albeit with considerable heterogeneity. This study sought to investigate the postoperative inflammatory marker trend in peritoneal carcinomatosis (PC), with a focus on colorectal PC (CPC), and to propose optimal surveillance periods and cutoffs. METHODS: Data were collected from a prospectively maintained database of PC patients treated at the authors’ institution from April 2001 to March 2019. The platelet–lymphocyte ratio (PLR), the neutrophil–lymphocyte ratio (NLR), and the lymphocyte–monocyte ratio (LMR) were collected preoperatively and on postoperative days 0, 1 to 3, 4 to 7, 8 to 21, 22 to 56, and 57 to 90 as averages. Optimal surveillance periods and cutoffs for each marker were determined by maximally selected rank statistics. The Kaplan–Meier method and Cox proportional hazard regression models were used to investigate the association of inflammatory markers with 1-year overall survival (OS) and recurrence-free survival (RFS) using clinicopathologic parameters. RESULTS: The postoperative inflammatory marker trend and levels did not differ between the patients with and those without hyperthermic intraperitoneal chemotherapy (HIPEC). Low postoperative LMR (days 4–7), high postoperative NLR (days 8–21), and high postoperative PLR (days 22–56) were optimal for prognosticating poor 1-year OS, whereas high postoperative PLR and NLR (days 57–90) and low postoperative LMR (days 8–21) were associated with poor 1-year RFS. A composite score of these three markers was prognostic for OS in CPC. CONCLUSIONS: The reported cutoffs should be validated in a larger population of CPC patients. Future studies should account for the inflammatory response profile when selecting appropriate surveillance periods. SUPPLEMENTARY INFORMATION: The online version of this article (10.1245/s10434-020-09544-w) contains supplementary material, which is available to authorized users.

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