Sistemik inflamatuar index (SII) ve MELD skoru karaciğer metastatik kolorektal kanserde sağ kalımı öngörebilir mi ?

Amaç: Bu çalışmada kolorektal kanserlerde (CRC) karaciğer metastazı geliştiği andaki kan nötrofil lenfosit oranı (NLR), platelet lenfosit oranı (PLR) ve model for end-stage liver disease (MELD) skorunun genel sağ kalımı (OS) predikte edip etmediği ve prognositik rollerinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Onkoloji merkezimizde 2015-2020 yılları arasında takip edilen 1250 kolorektal kanser tanılı hasta retrospektif olarak tarandı ve 203 karaciğer metastatic kolorektal kanserli (LMCRC) hasta çalışmaya dahil edildi. Karaciğer metastazı geliştiği andaki kan NLR, PLR ve MELD skorları retrospektif olarak hesaplandı. Bulgular: NLR oranı 2.5 ve altında olan hastalarda liver specific OS (LSOS) 22 ay (95% C.I: 16.82-27.18) iken, 2.5 üzerinde olanlarda ise 10 ay idi (95% C.I:6.59-13.41) (p=0.004). PLR oranı 150 ve altında olan hastalarda LSOS 19 ay (95% C.I: 14.33-23.36), 150’nin üzerinde olanlarda ise 10 ay idi (95% C.I:5.52-14.47) (p=0.0042). MELD skoru ile LSOS arasında negatif bir korelasyon vardı (r.-0.152, p=0.031). Multivariate regresyon analizinde yüksek NLR oranı LSOS açısından bağımsız prognostic faktör olarak saptandı (HR:95% CI:1.08-1.98). Sonuç: Bu çalışmada yüksek NLR, PLR ve MELD skorunun LMCRC’de daha kötü bir sağ kalımla ilişkili olduğu gösterildi. NLR’nin LSOS için bağımsız prognostik bir faktör olduğu ortaya konuldu. Karaciğer metastazı geliştiği anda bakılan SII ve MELD skoru yüksek olan hastalarda daha yakın bir takip seçenek olabilir.

Anahtar Kelimeler:

NLR, PLR, MELD Skoru, Karaciğer Metastatik Kolorektal Kanser, Genel Sağ Kalım

Can systemic inflammatory index (SII) and MELD score predict survival in liver metastatic colorectal cancer?

Aim: In this study, it was aimed to investigate whether the blood neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and model for end-stage liver disease (MELD) score at the time of liver metastasis in colorectal cancers (CRC) predict overall survival (OS) and their prognostic roles. Materials and Methods: 1250 colorectal cancer patients followed up in our oncology center between 2015-2020 were retrospectively screened and 203 patients with liver metastatic colorectal cancer (LMCRC) were included in the study. Blood NLR, PLR and MELD scores at the time of liver metastasis were calculated retrospectively . Results: Liver specific OS (LSOS) was 22 months (95% CI: 16.82-27.18) in patients with an NLR ratio of 2.5 or less, while it was 10 months (95% CI: 6.59-13.41) in patients with an NLR rate above 2.5 (p=0.004). LSOS was 19 months (95% CI: 14.33-23.36) in patients with a PLR rate of 150 or less, and 10 months (95% CI: 5.52-14.47) in patients with a PLR rate above 150 (p=0.0042). There was a negative correlation between MELD score and LSOS (r.-0.152, p=0.031). In the multivariate regression analysis, high NLR rate was found to be an independent prognostic factor for LSOS (HR:95% CI:1.08-1.98). Conclusion: In this study, it was shown that higher NLR, PLR and MELD scores are associated with worse survival in LMCRC. NLR was revealed to be an independent prognostic factor for LSOS. Closer follow-up may be an option in patients with high SII and MELD scores when liver metastasis develops.

Keywords:

NLR, PLR, MELD Score, Liver Metastatic Colorectal Cancer, Overall Survival,

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