title: Inflammation-Based Prognostic Scores: Utility in Prognostication and Patient Selection for Cytoreduction and Perioperative Intraperitoneal Chemotherapy in Patients with Peritoneal Metastasis of Colonic Origin.
abstract: BACKGROUND
  Tumor-associated systemic inflammatory response has been correlated with prognosis. Our aim was to analyze the utility of inflammation-based prognostic scores for prognostication and patient selection for cytoreduction and perioperative intraperitoneal chemotherapy (POIC) in patients diagnosed with peritoneal metastasis of colonic origin.
  
  
  METHODS
  A retrospective analysis of a prospectively maintained database for all patients treated for peritoneal metastasis of colonic origin from February 2001 to April 2015. Inflammation-based prognostic scores including neutrophil-lymphocyte ratio, platelet-lymphocyte ratio (PLR) and Onodera's prognostic nutritional index (ONI) were calculated.
  
  
  RESULTS
  Of 123 patients, 70 (56.9%) were men and 53 (43.1%) were women. Mean age at diagnosis was 49.9 years. Significant prognosticators in univariate analysis included intraoperative peritoneal cancer index (p < 0.000), tumor marker CA19-9 (p < 0.000), PLR (p = 0.020), POIC regimen (p < 0.003), and completeness of cytoreduction (p < 0.000). Multivariate Cox analysis identified CA19-9 (hazard ratio [HR] 1.0; 95% confidence interval [CI] 1.00-1.01, p = 0.031), ONI (HR 0.86; 95% CI 0.79-0.94, p < 0.000), PLR (HR 1.0; 95% CI 0.90-1.01, p = 0.041), incompleteness of cytoreduction CC2 and CC3, and mucinous adenocarcinoma histology as significant independent prognosticators.
  
  
  CONCLUSIONS
  The inflammation-based prognostic scores PLR and ONI and tumor marker CA19-9 are significant prognosticators of survival. They are useful in patient selection and prognostication for cytoreductive surgery and POIC in patients with peritoneal carcinomatosis of colonic origin.
authors.affiliation: Program in Peritoneal Surface Oncology, Washington Cancer Institute, Washington, DC, USA. chukwuemeka.u.ihemelandu@medstar.net.
authors.forename: Chukwuemeka
authors.initials: C
authors.lastname: Ihemelandu
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000556:secondary / Q000628:therapy*; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001792:Blood Platelets; D018395:CA-19-9 Antigen / Q000097:blood; D003110:Colonic Neoplasms / Q000473:pathology*; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D007263:Infusions, Parenteral; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D009504:Neutrophils; D009752:Nutritional Status; D018579:Patient Selection; D010534:Peritoneal Neoplasms / Q000556:secondary* / Q000628:therapy*; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D018395:CA-19-9 Antigen