West German Cancer Center, Department of Medical Oncology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
Medical Faculty, University Duisburg-Essen, Essen, Germany.
J Cancer Res Clin Oncol. 2023 Jul;149(8):5085-5094. doi: 10.1007/s00432-022-04424-0. Epub 2022 Nov 5.
Systemic-inflammatory response parameters (SIR) are known prognostic markers in different tumour entities, but have not been evaluated in patients with iCCA treated with systemic chemotherapy. Therefore, we evaluated the impact of different SIR markers on the clinical course of patients with advanced iCCA treated at our center.
SIR markers were retrospectively evaluated in 219 patients with iCCA at the West-German-Cancer-Center Essen from 2014 to 2019. Markers included neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), CRP, and the modified Glasgow-Prognostic-Score (mGPS), which were correlated with clinico-pathological findings, response to chemotherapy (ORR), progression-free (PFS) and overall survival (OS) using Kaplan-Meier analyses, and Cox proportional models.
Median overall survival (OS) of the entire cohort was 14.8 months (95% CI 11.2-24.4). Median disease-free survival (DFS) in 81 patients undergoing resection was 12.3 months (95% CI 9.7-23.1). The median OS from start of palliative CTX (OS) was 10.9 months (95% 9.4-14.6). A combined Systemic Inflammatory Score (SIS) comprising all evaluated SIR markers correlated significantly with ORR, PFS, and OS. Patients with a high SIS (≥ 2) vs. SIS 0 had a significantly inferior OS (HR 8.7 95% CI 3.71-20.38, p < 0.001). Multivariate analysis including known prognostic markers (ECOG, CA19-9, LDH, and N- and M-status) identified the SIS as an independent prognostic factor.
Inflammatory markers associate with inferior survival outcomes in patients with iCCA. A simple SIS may guide treatment decisions in patients treated with systemic chemotherapy.
全身性炎症反应参数（SIR）是不同肿瘤实体的已知预后标志物，但尚未在接受全身化疗治疗的 iCCA 患者中进行评估。因此，我们评估了不同 SIR 标志物对在我们中心接受治疗的晚期 iCCA 患者临床病程的影响。
我们回顾性评估了 2014 年至 2019 年在德国埃森西德意志癌症中心（West-German-Cancer-Center Essen）接受治疗的 219 例 iCCA 患者的 SIR 标志物。标志物包括中性粒细胞/淋巴细胞比值（NLR）、淋巴细胞/单核细胞比值（LMR）、C 反应蛋白（CRP）和改良格拉斯哥预后评分（mGPS），这些标志物与临床病理发现、化疗反应（ORR）、无进展生存期（PFS）和总生存期（OS）相关，采用 Kaplan-Meier 分析和 Cox 比例模型进行分析。
整个队列的中位总生存期（OS）为 14.8 个月（95%CI 11.2-24.4）。81 例接受手术切除患者的中位无病生存期（DFS）为 12.3 个月（95%CI 9.7-23.1）。姑息性 CTX 起始时的中位 OS（OS）为 10.9 个月（95%CI 9.4-14.6）。包含所有评估的 SIR 标志物的综合全身性炎症评分（SIS）与 ORR、PFS 和 OS 显著相关。SIS 较高（≥2）的患者与 SIS 0 的患者 OS 显著降低（HR 8.7，95%CI 3.71-20.38，p<0.001）。包括已知预后标志物（ECOG、CA19-9、LDH、N 和 M 状态）的多变量分析将 SIS 确定为独立的预后因素。
炎症标志物与 iCCA 患者的生存结局较差相关。简单的 SIS 可能有助于指导接受全身化疗治疗的患者的治疗决策。
