Cancer Management and Research (Apr 2019)
Dynamic impact of inflammation-based indices in colorectal cancer patients receiving FOLFOX-based chemotherapy
Abstract
Yong Tao,1 Danping Yuan,1 Hongshuang Pang,1 Hongbiao Wu,1 Dongfang Liu,1 Ningning Jin,1 Ningning Wu,1 Jianming Qiu,2 Yuepeng Cao11Department of Colorectal Surgery, Ningbo City First Hospital, Ningbo, Zhejiang, 86-315000, People’s Republic of China; 2Department of Colorectal Surgery, Hangzhou Third People’s Hospital, Hangzhou, 86-310009, People’s Republic of ChinaBackground: Inflammatory cellular response is implicated in the pathogenesis of colorectal cancer (CRC). Nevertheless, the dynamic effects of inflammatory index coNLR (neutrophil-to-lymphocyte ratio)-PLR (platelet-to-lymphocyte ratio) during chemotherapy remain elusive.Methods: The baseline clinical data and laboratory parameters of 480 CRC patients who received palliative resection of primary tumors and FOLFOX-based chemotherapy from January 2007 to January 2013 were retrospectively analyzed. Receiver operating characteristic curves were plotted to obtain the predictive NLR and PLR values, and to calculate the coNLR-PLR score. The Kaplan–Meier method was used to estimate the rates of recurrence-free survival (RFS) and overall survival (OS), and the Cox proportional hazards model was employed for analysis.Results: The dynamic cut-off values of NLR during four periods of chemotherapy were 3.029, 2.466, 2.102 and 1.795, respectively, and those of PLR were 216.438, 187.572, 169.027 and 174.368, respectively. A higher coNLR-PLR was significantly associated with lower rates of RFS and OS (P<0.05). Both univariate and multivariate analyses showed that coNLR-PLR was a significant independent prognostic factor for RFS and OS (P<0.05).Conclusions: CoNLR-PLR was a significant prognostic predictor for CRC patients who received FOLFOX-based chemotherapy. Evaluating this index can accurately predict the clinical treatment outcomes after chemotherapy.Keywords: colorectal cancer, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, FOLFOX-based chemotherapy, coNLR-PLR