title: Elevated neutrophil to lymphocyte ratio might predict poor prognosis for colorectal liver metastasis after percutaneous radiofrequency ablation.
abstract: OBJECTIVE
  Elevated neutrophil to lymphocyte ratio (NLR) has been shown to be a predictor of poor survival in certain malignancies. We hypothesised NLR might predict prognosis for patients with colorectal liver metastasis (CRLM) undergoing percutaneous radiofrequency ablation (RFA).
  
  
  METHODS
  A cohort of 92 consecutive patients with metachronous CRLM treated with RFA was retrospectively reviewed. Baseline clinico-pathological characteristics, recurrence, overall and disease-free survival were compared according to preoperative NLR level. Prognostic factors were assessed by multivariate analysis.
  
  
  RESULTS
  Elevated NLR (>5) was recorded in 21 patients (22.8%). No correlations between NLR and clinico-pathological characteristics were identified. Complete ablation was achieved in 90 patients (97.8%). After RFA, extrahepatic metastases (p = 0.015) were significantly higher in the elevated NLR group whilst local (p = 0.526) and intrahepatic (p = 0.715) recurrence. The 1, 3 and 5 years overall survival rates of 92 patients were 86.5%, 74.1%, 36.3%, and disease-free survival was 64.3%, 32.8%, 22.4% respectively. Multivariate analysis showed that NLR was an independent prognostic factor for both overall (p = 0.039, HR = 3.59, 95%CI 1.54-9.67) and disease-free survival (p = 0.022, HR = 3.19, 95%CI 1.87-8.24). The 1, 3, 5 years overall survival rates were 86.9%, 61.1%, 41.7% for the normal NLR group, and 85.2%, 53.2%, 18.4% for the elevated NLR group respectively (p = 0.036); the corresponding disease-free survival was 64.9%, 38.7%, 26.7% and 47.6%, 14.3%, 9.5% respectively (p = 0.047).
  
  
  CONCLUSIONS
  Elevated NLR (>5) might predict more extrahepatic metastasis and poorer survival for patients with CRLM after RFA.
authors.affiliation: Department of Hepatobiliary Surgery, Cancer Centre of Sun Yat-Sen University, Guangzhou, China and State Key Laboratory of Oncology in Southern China, Guangzhou, China.
authors.forename: Yaojun
authors.initials: Y
authors.lastname: Zhang
authors.forename: Zhenwei
authors.initials: Z
authors.lastname: Peng
authors.forename: Meixian
authors.initials: M
authors.lastname: Chen
authors.forename: Furong
authors.initials: F
authors.lastname: Liu
authors.forename: Junting
authors.initials: J
authors.lastname: Huang
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.forename: Yaqi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Minshan
authors.initials: M
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008113:Liver Neoplasms / Q000556:secondary*; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies