Abstract
Background:
Biliary tract cancer is a poor prognosis disease. Due to the role of chronic inflammation in the development of BTC, inflammatory markers such as NLR, PLR, and SII might be useful as prognostic markers in this disease group.
Methods:
Data from sequential pts with BTC referred to The Christie (Jan 2012 - Aug 2017) were reviewed retrospectively. Median (med) value was used to dichotomise subgroups for baseline NLR, PLR and SII (Platelets x Neutrophils/Lymphocytes) for balanced division of patients. The Kaplan-Meier survival method was used and association of overall survival (OS) with different co-variables was analysed using Cox proportional hazard regression.
Results:
Data from 591 pts were included; median age was 69 years, 46% were males, Eastern Co-operative Oncology Group performance status (ECOG PS) 1 was the commonest PS (51.1%). Patients had extrahepatic cholangiocarcinoma (CCA): 32.3%, intrahepatic CCA: 28.7%, gallbladder carcinoma: 20.6%, or ampulla of Vater carcinoma: 15.9%. Stage: 54.2% stage IV, 32.5% stage III, and 13.2% stage I/II; 89% of pts had died at time of analysis. The cut-off for NLR was ≥3.64, PLR was ≥193.3 and SII was ≥1082.1. The median OS for the entire cohort was 13.4 months (mths) (95% Confidence Interval [CI] 12-14.8); the 5-year survival rate was 5.1% (95%CI 3.3-7.9). The multivariable analysis was adjusted for gender, age, stage, ECOG PS, treatment type, and NLR, PLR and SII at baseline as these were significant at univariate analysis. On multivariable analysis, NLR (HR 1.34, 95%CI 1.1-1.7, p=0.01) and SII (HR 1.57, 95%CI 1.2-2.0, p<0.001) were both independent prognostic factors, with better OS in patients with lower NLR (med OS 17.7 mths vs 9.2 mths, [95% CI 16.66-22.3], p<0.001) and lower SII (med OS 17.9 mths vs 8.6 mths [95% CI 16.26-22.16], p<0.001).
Conclusions:
Lower baseline NLR and SII were prognostic for better OS in pts with BTC. Prospective studies are needed to explore the clinical prognostic relevance of these markers.
Biliary tract cancer is a poor prognosis disease. Due to the role of chronic inflammation in the development of BTC, inflammatory markers such as NLR, PLR, and SII might be useful as prognostic markers in this disease group.
Methods:
Data from sequential pts with BTC referred to The Christie (Jan 2012 - Aug 2017) were reviewed retrospectively. Median (med) value was used to dichotomise subgroups for baseline NLR, PLR and SII (Platelets x Neutrophils/Lymphocytes) for balanced division of patients. The Kaplan-Meier survival method was used and association of overall survival (OS) with different co-variables was analysed using Cox proportional hazard regression.
Results:
Data from 591 pts were included; median age was 69 years, 46% were males, Eastern Co-operative Oncology Group performance status (ECOG PS) 1 was the commonest PS (51.1%). Patients had extrahepatic cholangiocarcinoma (CCA): 32.3%, intrahepatic CCA: 28.7%, gallbladder carcinoma: 20.6%, or ampulla of Vater carcinoma: 15.9%. Stage: 54.2% stage IV, 32.5% stage III, and 13.2% stage I/II; 89% of pts had died at time of analysis. The cut-off for NLR was ≥3.64, PLR was ≥193.3 and SII was ≥1082.1. The median OS for the entire cohort was 13.4 months (mths) (95% Confidence Interval [CI] 12-14.8); the 5-year survival rate was 5.1% (95%CI 3.3-7.9). The multivariable analysis was adjusted for gender, age, stage, ECOG PS, treatment type, and NLR, PLR and SII at baseline as these were significant at univariate analysis. On multivariable analysis, NLR (HR 1.34, 95%CI 1.1-1.7, p=0.01) and SII (HR 1.57, 95%CI 1.2-2.0, p<0.001) were both independent prognostic factors, with better OS in patients with lower NLR (med OS 17.7 mths vs 9.2 mths, [95% CI 16.66-22.3], p<0.001) and lower SII (med OS 17.9 mths vs 8.6 mths [95% CI 16.26-22.16], p<0.001).
Conclusions:
Lower baseline NLR and SII were prognostic for better OS in pts with BTC. Prospective studies are needed to explore the clinical prognostic relevance of these markers.
| Original language | English |
|---|---|
| Publication status | Published - 2020 |
| Event | ESMO 2020 - Virtual Duration: 18 Sept 2020 → … |
Conference
| Conference | ESMO 2020 |
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| Period | 18/09/20 → … |
Keywords
- Biliary tract cancer
- Neutrophil
- Lymphocyte
- NLR
Research Beacons, Institutes and Platforms
- Manchester Cancer Research Centre
