title: Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios predict chemotherapy outcomes and prognosis in patients with colorectal cancer and synchronous liver metastasis.
abstract: BACKGROUND
  Recent evidence indicates that inflammatory parameters could be useful to predict metastasis from colorectal cancer. However, their roles in predicting chemotherapy response and prognosis in patients with synchronous colorectal liver metastasis (CLM) are unknown.
  
  
  METHODS
  The clinical data and baseline laboratory parameters of 55 patients with synchronous CLM were retrospectively reviewed. All patients underwent palliative resection of the primary tumor and oxaliplatin-based chemotherapy. Two indices of systemic inflammation were reviewed-neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR)-preoperatively and before the second cycle of chemotherapy. Associations between prognostic variables and tumor response, progression, and survival were investigated.
  
  
  RESULTS
  NLR < 4 and PLR < 150 were correlated with better disease control (p = 0.024 and 0.026, respectively). In univariate analysis, elevated NLR and PLR were significant prognostic factors for poor overall survival (OS) and progression-free survival (PFS). In multivariate analysis, PLR (p = 0.027), age (p = 0.018), resection of liver metastases (p = 0.017), and lactate dehydrogenase level (p = 0.011) were independent predictors of PFS, while resection of liver metastases was the only independent predictor of OS (p = 0.002). In addition, when patients were divided into groups according to changes in NLR and/or PLR, reduced NLR and PLR were associated with improved disease control (p = 0.038 and 0.025, respectively). Normalization of NLR also was associated with improved PFS.
  
  
  CONCLUSIONS
  NLR and PLR are potentially useful clinical biomarkers to predict chemotherapy response in patients with synchronous CLM. PLR also may be useful to predict PFS in these patients.
authors.affiliation: Department of Oncology, Shanghai Medical College, Shanghai, 200032, China.|Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
authors.forename: Yuchen
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Oncology, Shanghai Medical College, Shanghai, 200032, China.|Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
authors.forename: Cong
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Oncology, Shanghai Medical College, Shanghai, 200032, China.|Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Oncology, Shanghai Medical College, Shanghai, 200032, China.|Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Oncology, Shanghai Medical College, Shanghai, 200032, China.|Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
authors.forename: Fangqi
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Oncology, Shanghai Medical College, Shanghai, 200032, China.|Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
authors.forename: Hongtu
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Department of Genetics, Shanghai-MOST Key Laboratory of Health and Disease Genomics, Chinese National Human Genome Center and Shanghai Industrial Technology Institute (SITI), Shanghai, 201203, China. wangzhm@chgc.sh.cn.
authors.forename: Zhimin
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Oncology, Shanghai Medical College, Shanghai, 200032, China. xu_shirley021@163.com.|Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. xu_shirley021@163.com.
authors.forename: Ye
authors.initials: Y
authors.lastname: Xu
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001792:Blood Platelets; D000069287:Capecitabine; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D010071:Oxaloacetates; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D010071:Oxaloacetates; D003841:Deoxycytidine; D000069287:Capecitabine; D002955:Leucovorin; D005472:Fluorouracil
keywords: Chemotherapy response; NLR; PLR; Prognosis; Synchronous colorectal liver metastasis