Preprocedural Platelet-To-Lymphocyte and PlateletTo-Neutrophile Ratios As The Predictors of Local Recurrence Following Ultrasound-Guided Microwave Ablation For Colorectal Cancer Liver Metastases

The aim of the present study was to demonstrate the role of blood parameters as a potential prognostic factor for local recurrence (LR) after ultrasound (US)-guided percutaneous microwave ablation (MWA) of colorectal liver metastases (CRLM). Between February 2016 and February 2020, 76 patients with US-guided percutaneous MWA of the CRLM were analysed. The patients with LR were included in first or study group (15 patients) and the patients with no evidence of LR were included in second or control group (20 patients). The following blood parameters obtained from the blood sampling at the day before the MWA treatment were also recorded: Haemoglobin (gr/dl), neutrophile (uL), lymphocyte (uL) and platelet (10^3/uL) counts, platelet distribution width (PDW) (fL) and red cell distribution width (RDW) (%) values. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and platelet-to-neutrophile ratio (PNR) were calculated. The mean PLR was 129.9 (97.6-197.7) and 92.1 (83.7-117.7) in the study and the control group respectively and we found statistically significant association between the groups (p=0.036). The mean PNR was 61.4 (49.5 -68.5) and 44.35 (38-55.3) in study and control group respectively A statistically significant assoc iation were also seen between these two groups (p=0.003) In conclusion, this study suggests that CRLM patients with elevated preprocedural PLR and PNR values are more inclined to local recurrence after US-guided MWA. This simple and costless way can be easily used in order to predict the local response of the thermal ablative treatments in routine clinical practice.

PDF

___

1. Chow FCL, Chok KSH. Colorectal liver metastases: An update on multidisciplinary approach. World J Hepatol 2019; 11: 150-172.

2. Jessup JM, Mc Ginnis LS, Steele Jr GD, Menck HR, Winchester DP. National Cancer Data Base. Report on colon cancer. Cancer 1996; 78: 918-926.

3. Minagawa M, Makuuchi M, Torzilli G et al. Extension of the frontiers of surgical indications in the treatment of liver metastases from colorectal cancer: long-term results. Ann Surg 231: 487-499.

4. Line PD, Hagness M, Dueland S. The Potential Role of Liver Transplantation as a Treatment Option in Colorectal Liver Metastases. Can J Gastroenterol Hepatol 2018; 17: 8547940.

5. Evrard S, Poston G, Kissmeyer-Nielsen P et al. Combined ablation and resection (CARe) as an effective parenchymal sparing treatment for extensive colorectal liver metastases. PLoS One 2014; 9: e114404.

6. Noori SS, Gonsalves CF, Shaw CM. Metastatic liver disease: Indications for locoregional therapy and supporting data. Semin Intervent Radiol 2017; 34: 145-166.

7. Mulier S, Ni Y, Jamart J, Ruers T, Marchal G, Michel L. Local recurrence after hepatic radiofrequency coagulation: multivariate metaanalysis and review of contributing factors. Ann Surg 242: 158-171.

8. Kishi Y, Kopetz S, Chun YS, Palavecino M, Abdalla EK, Vauthey JN. Blood neutrophil-tolymphocyte ratio predicts survival in patients with colorectal liver metastases treated with systemic chemotherapy. Ann Surg Oncol 2009; 16: 614-622.

9. Proctor MJ, McMillan DC, Morrison DS, Fletcher CD, Horgan PG, Clarke SJ. A derived neutrophil to lymphocyte ratio predicts survival in patients with cancer. Br J Cancer 2012; 107: 695-699.

10. Cerutti PA, Trump BF. Inflammation and oxidative stress in carcinogenesis. Cancer Cells 1991; 3: 1-7.

11. Coussens LM, Werb Z. Inflammation and cancer. Nature 2002; 420: 860-867.

12. Palapattu GS, Sutcliffe S, Bastian PJ et.al. Prostate carcinogenesis and inflammation: emerging insights. Carcinogenesis 2005; 26: 1170-1181.

13. Shibutani M, Maeda K, Nagahara H et al. Significance of Markers of Systemic Inflammation for Predicting Survival and Chemotherapeutic Outcomes and Monitoring Tumor Progression in Patients with Unresectable Metastatic Colorectal Cancer. Anticancer Research 2015; 35: 5037-5046.

14. Giakoustidis A, Neofytou K, Khan AZ, Mudan S. Neutrophil to Lymphocyte Ratio Predicts Pattern of Recurrence in Patients Undergoing Liver Resection for Colorectal Liver Metastasis and Thus the Overall Survival. Journal of Surgical Oncology 2015; 111: 445-450.

15. Li X, Han Z, Cheng Z et al. Preoperative neutrophil-to-lymphocyte ratio is a predictor of recurrence following thermal ablation for recurrent hepatocellular carcinoma: a retrospective analysis. PLoS One 2014; 9: e110546.

16. Sakin A, ġahin S, Yasar N et al. The Relation Between Hemogram Parameters and Survival in Extensive-Stage Small Cell Lung Cancer. Oncol Res Treat 2019; 42: 506-515.

17. Asher V, Lee J, Innamaa A, Bali A. Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer. Clin Transl Oncol 2011; 13: 499-503.

18. Gay LJ, Felding-Habermann B. Contribution of platelets to tumour metastasis. Nat Rev Cancer 2011; 11: 123-134.

19. Li X, Han Z, Cheng Z, Yu J, Yu X, Liang P. Clinical significance of preoperative plateletto-lymphocyte ratio in recurrent hepatocellular carcinoma after thermal ablation: A retrospective analysis. International Journal of Hyperthermia 2015; 31: 758-763.

20. Neofytou K, Smyth EC, Giakoustidis A, Khan AZ, Cunningham D, Mudan S. 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 2014; 31: 239.

21. Jin PP, Li XM, Chen J et al. Platelet-toneutrophil ratio is a prognostic marker for 90- days outcome in acute ischemic stroke. Journal of Clinical Neuroscience 2019; 63: 110-115.

22. Semba RD, Patel KV, Ferrucci L et al. Serum antioxidants and inflammation predict red cell distribution width in older women: The Women's Health and Aging Study I. ClinNutr. 2010; 29: 600-604.

23. Sakin A, Sahin S, Sakin A, et al. Mean platelet volume and platelet distribution width correlates with prognosis of early colon cancer. J BUON 2020; 25: 227‐239