Novel composite score of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and aspartate-aminotransferase-lymphocyte ratio predicts overall survival in metastatic colorectal patients undergoing radioembolization.
Purpose: Various measures of systemic inflammation have been shown to predict outcomes in patients with metastatic colorectal cancer (mCRC). However, more work is needed in regards to the utility of systemic inflammatory markers predictive value in mCRC patients undergoing radioembolization. The purpose of this study was to evaluate the usefulness of a novel composite pre-treatment inflammation score for the prediction of radiologic response and overall survival (OS) following radioembolization for metastatic colorectal (mCRC).
Materials and Methods: Forty-two patients who underwent radioembolization for mCRC were reviewed. Laboratory values as well as radiologic response according to the European Association for the Study of the Liver (EASL) criteria were recorded. Overall radiologic response (ORR) was defined as those with a partial or complete response. Survival was measured from radioembolization to time of death. Patients were given 1 point each if their neutrophil-lymphocyte ratio (NLR) was ≥5.1, platelet-lymphocyte ratio (PLR) was ≥220 and aspartate-aminotransferase-lymphocyte ratio (ALRI) ratio ≥65 for a maximum score of 3.
Results: The cohort consisted of 21 (50%) women and 21 men (50%) with an average age of 58.5 ± 13.4 years. The average pretreatment values were NLR (5.1 ± 3.9), PLR (220.2 ± 142.2), and ALRI (65.2 ± 68.9). OS differed by score (CS 0 (0.99 ± 1.18 years), CS 1 (1.57 ± 1.25 years), CS 2 (0.65 ± 0.05 years) and CS 3 (0.62 ± 0.53 years)). The OS in those with a CS of 0 or 1 (1.33 ± 1.26 years) was significantly longer than those with a CS >1 (0.63 ± 0.44 years) (p=0.04). When looking at ORR there was no statistically significant difference between those with a composite score of 0 or 1 (9/14, 64.3%) and those with a composite score >1 (3/9, 33.3%) (p=0.14).
Conclusion: This novel composite score which utilizes NLR, PLR, and ALRI values may predict OS in patients undergoing radioembolization for mCRC.