Inflammatory Markers and Outcomes After Liver Resection for Colorectal Liver Metastases
Rider May Cedro, Gilton Marques Fonseca, Fabíola Trocoli Novaes, José Donizeti Meira Júnior, Vagner Birk Jeismann, Fabio Ferrari Makdissi, Jaime Arthur Pirolla Kruger, Fabricio Ferreira Coelho, Paulo HermanABSTRACT
Background and Objectives
The liver is the main site of colorectal metastatic disease. This study evaluated the association of Neutrophil‐to‐Lymphocyte Ratio (NLR), Platelet‐to‐Lymphocyte Ratio (PLR), and Monocyte‐to‐Lymphocyte Ratio (MLR) among patients with colorectal liver metastases (CRLM) undergoing liver resection.
Methods
A cohort of patients undergoing curative‐intent liver resection for CRLM between 2009 and 2020 was evaluated. Association between inflammatory indices and overall survival (OS), disease‐free survival (DFS), and postoperative morbidity and mortality were studied. Subgroup analyses included patients undergoing major hepatectomies (≥ 3 segments) and those receiving preoperative chemotherapy. The indices variation before and after chemotherapy were assessed for OS, DFS, and complete pathological response rates.
Results
After exclusion criteria, 380 patients were selected for the study. No significant associations were found between inflammatory indices and OS or DFS. Lower preoperative PLR was associated with higher postoperative morbidity ( p = 0.021) after major hepatectomies. Among patients receiving chemotherapy, a greater reduction in PLR was associated with a higher complete pathological response rate ( p = 0.002).
Conclusions
Although inflammatory indices were not predictive of survival outcomes, PLR was associated with postoperative morbidity and pathological response in specific subgroups; although these findings require validation.