Prognostic value of neutrophil-to-lymphocyte ratio and CA 19-9 in overall survival of patients with peritoneal carcinomatosis of colorectal cancer undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

BACKGROUND

The neutrophil-to-lymphocyte ratio and other inflammatory factors have been used as prognostic indicators in several cancers. This study aims to evaluate the prognostic value of inflammatory factors and tumor markers in patients with peritoneal metastasis of colorectal cancer (CRC) after undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

METHODS

We collected data from 116 patients who underwent CRS and HIPEC for peritoneal carcinomatosis of colorectal origin between August 2015 and December 2018 at Hubei Cancer Hospital. Kaplan-Meier analysis was used to calculate overall survival (OS) and Progression-Free-Survival (PFS). Univariate and multivariate Cox regression analyses were conducted to evaluate the influence of inflammatory factors and tumor markers on OS and PFS.

RESULTS

The median OS was 52.63 months (95% CI 46.02-59.25), and the median PFS was 27.03 months(95% CI 23.35-30.72). Significant differences in OS and PFS were observed between patients with NLR < 2.33 and those with NLR ≥ 2.33(65.38 vs. 44.20, p = 0.005, 35.49 vs. 21.90, p < 0.001). Patients with CA 19-9 > 36.65 also showed significantly poorer OS and PFS compared to patients with CA 19-9 ≤ 36.65(34.86 vs. 65.68, p < 0.001, 17.80 vs. 34.00, p < 0.001). Multivariate analyses suggested that NLR < 2.33, PCI < 10, and CA 19-9 ≤ 36.65 were independent predictive factors for better OS and PFS.

CONCLUSIONS

Preoperative NLR and CA 19-9 may serve as prognostic markers in patients with peritoneal metastasis of CRC undergoing CRS and HIPEC. These markers may have potential value as selection tools for determining the suitability for CRS + HIPEC in these patients.