Association of inflammatory biomarkers with long-term outcomes after curative surgery for mass-forming intrahepatic cholangiocarcinoma

Surg Today. 2020 Apr;50(4):379-388. doi: 10.1007/s00595-019-01905-7. Epub 2019 Oct 30.

Abstract

Purpose: Inflammatory biomarkers such as the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) are reportedly predictive of the long-term outcomes of several cancers. We evaluated their correlations with the post-surgical long-term outcomes of patients with mass-forming (MF) intrahepatic cholangiocarcinoma (ICC).

Methods: The subjects of this study were 52 patients who underwent hepatic resection for MF-ICC at our hospital. We measured the cutoff values of NLR, LMR and PLR, using receiver operating characteristic curves, and compared the survival rates of patients with high vs. those with low values. We also evaluated a prognostic scoring system based on significant inflammatory biomarkers.

Results: The cutoff values for NLR, LMR, and PLR were 1.93, 4.78, and 98, respectively. The high-NLR and low-LMR groups had significantly worse prognoses than the low-NLR and high-LMR groups. We designed a scoring system using the inflammation score (IS) based on NLR and LMR values, stratifying patients into three groups with scores of 0, 1, or 2. The IS was significantly correlated with overall survival (OS), with 5-year survival rates by the IS score of 100% for 0, 61% for 1, and 32% for 2 (P = 0.011). The IS was found to be an independent predictor of OS in multivariate analysis.

Conclusions: Our IS scoring system may predict long-term outcomes after surgery for MF-ICC.

Keywords: Inflammatory biomarker; Intrahepatic cholangiocarcinoma; Long-term outcome.

MeSH terms

  • Biomarkers, Tumor / blood*
  • Cholangiocarcinoma / diagnosis
  • Cholangiocarcinoma / surgery*
  • Inflammation
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / surgery*
  • Lymphocyte Count*
  • Monocytes*
  • Platelet Count*
  • Postoperative Period
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers, Tumor