Perioperative change in peripheral blood monocyte count may predict prognosis in patients with colorectal liver metastasis after hepatic resection.
BACKGROUND
Prognostic value of perioperative change in peripheral blood leukocyte subset count of cancer patients have not been fully investigated. Therefore, we retrospectively investigated the relation between perioperative change in peripheral blood monocyte count and disease-free as well as overall survival after hepatic resection for colorectal liver metastasis (CRLM).


METHODS
The subjects were 64 patients who underwent hepatic resection for CRLM between January 2000 and December 2008. We retrospectively investigated the relation between perioperative change in peripheral blood monocyte count and disease-free as well as overall survival.


RESULTS
In multivariate analysis, more than four lymph node metastases (P = 0.0298) and extrahepatic disease (P = 0.0423) were significant predictors of disease-free survival, while significant predictor of overall survival were more than four lymph node metastases (P = 0.0011), bilobar disease (P = 0.0024), and increase in perioperative monocyte less than twice (P = 0.0029). Morover, increase in perioperative monocyte of less than twice positively correlated with intraoperative blood transfusion.


CONCLUSIONS
Perioperative change in peripheral blood monocyte count is an independent risk factor for overall survival after hepatic resection for CRLM, and may reflect immunosuppressive state.
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan. haruki@jikei.ac.jp
Koichiro
K
Haruki
Hiroaki
H
Shiba
Yuki
Y
Fujiwara
Kenei
K
Furukawa
Shigeki
S
Wakiyama
Masaichi
M
Ogawa
Yuichi
Y
Ishida
Takeyuki
T
Misawa
Katsuhiko
K
Yanaga
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000097:blood / Q000276:immunology / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D016867:Immunocompromised Host; D007564:Japan; D007694:Killer Cells, Natural / Q000276:immunology; D008113:Liver Neoplasms / Q000097:blood / Q000276:immunology / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009000:Monocytes; D015999:Multivariate Analysis; D059035:Perioperative Period; D011237:Predictive Value of Tests; D011379:Prognosis; D050378:T-Lymphocytes, Regulatory / Q000276:immunology