Prognostic significance of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in predicting outcomes for peritoneal carcinomatosis patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Abstract

Background: Laboratory markers of systemic inflammation have demonstrated utility and cost-effectiveness in the prediction of clinical outcome in various malignancies. The aim of the present study is to evaluate the prognostic value of the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in peritoneal carcinomatosis (PC) patients who have undergone cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in a single institution.Methods: Data were prospectively collected from 164 consecutive patients who underwent CRS-HIPEC procedures between 2001 and 2014, where preoperative NLR and PLR were obtained. The primary endpoints in our study were overall survival (OS) and disease-free survival (DFS). DFS and OS were analyzed using the Kaplan–Meier method. The log-rank test was used to determine if there was a difference in survival between different groups of patients. Univariate and multivariate analyses were performed using the Cox proportional hazards model.Results: A total of 144 patients underwent 152 CRS-HIPEC procedures, of which 113 females (74.3%) and 31 males (25.6%) with a median age of 51.5 (range 14–74) were included. Neither NLR nor PLR was associated with DFS on univariate analysis. On the exclusion of Peritoneal carcinomatosis index, PLR was significantly associated with DFS, and NLR was not associated with OS on univariate or multivariate analysis. PLR was associated with OS as a continuous or categorical variable with a cutoff of 160 on univariate analysis, but this association disappeared on multivariate analysis.Conclusion: This study shows that PLR may be more closely associated with recurrence risk and survival of PC patients undergoing CRS-HIPEC than NLR.