Results
Title

The impact of neoadjuvant therapy on the prognostic value of preoperative neutrophil-to-lymphocyte ratio for colorectal liver metastases: a multi-center cohort study.

Authors

Wang, Xiang-Yu; Zuo, Jie-Liang; Fu, Hong; Zhang, Chong; Fan, Qing-Qi; Zhang, Bo; Tao, Bao-Rui; Chen, Zhen-Mei; Han, Jia-Hao; Li, Yi-Tong; Ma, Yue; Ma, Xiao-Chen; Zhang, Rui; Zhu, Ying; Zhu, Wen-Wei; Lu, Lu; Yu, Ming-Xu; Chen, Jin-Hong

Abstract

Background: Neutrophil-to-lymphocyte ratio (NLR) is a promising prognostic marker for patients undergoing hepatectomy for colorectal liver metastases (CRLM). However, its prognostic value in patients receiving neoadjuvant therapy (NAT) has not been sufficiently addressed. Methods: From 2013 to 2023, a cohort of 692 patients with CRLM receiving hepatectomy were enrolled in five centers. Clinicopathological characteristics were obtained from a prospectively maintained multi-center database. The effect of NLR (> 2 versus ≤ 2) on overall survival (OS) and recurrence-free survival was estimated by Kaplan–Meier analysis. Univariable and multivariable Cox regression analysis was applied to investigate the influence of individual clinicopathological parameters on OS. Results: In the entire cohort, the median NLR level was 2.11 (0.30–16.33). There were 307 (44.4%) patients receiving NAT followed by hepatectomy, while 385 (55.6%) patients undergoing upfront surgery. Notably, patients in the NAT group showed significantly lower NLR level than those in the upfront surgery group (1.83 versus 2.32, P < 0.001). In the upfront surgery group, high NLR was significantly associated with worse OS, independent of other factors (HR = 1.49, 95% CI 1.08–2.05, P = 0.02). In the NAT group, there was no significant difference in OS between the high NLR and low NLR group. Conclusion: The prognostic value of NLR in surgically resected CRLM is potentially influenced by NAT in the modern era.

Subjects

COLORECTAL liver metastasis; NEUTROPHIL lymphocyte ratio; PROGNOSIS; NEOADJUVANT chemotherapy; LIVER surgery

Publication

International Journal of Colorectal Disease, 2025, Vol 40, Issue 1, p1

ISSN

0179-1958

Publication type

Academic Journal

DOI

10.1007/s00384-024-04800-x