The Impact of Preoperative Inflammatory Markers on the Prognosis of Patients Undergoing Surgical Resection of Pulmonary Oligometastases

Francesco Londero, William Grossi, Orlando Parise, Jacqueline Cinel, Gianmarco Parise, Gianluca Masullo, Cecilia Tetta, Linda Renata Micali, Emanuela Mauro, Angelo Morelli, Jos G. Maessen, Sandro Gelsomino*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

The aim of this study was to assess the prognostic value of preoperative neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels in patients undergoing resection of pulmonary oligometastases. A retrospective analysis on 141 patients undergoing a first pulmonary metastasectomy in a single center was carried out. Two distinct analysis were performed subdividing patients according to their NLR ratio and CRP level. The main outcomes were survival and time to recurrence. At completion of follow-up 74 patients were still alive (52.5%). Subdividing patients according to their NLR yielded a significant difference in five-year progression-free survival (PFS, NLR <4:32% vs. NLR >= 4:18%, p = 0.01). When subdivided by their CRP levels, patients with preoperative CRP <5 mg/L demonstrated higher values of five-year overall survival (OS, 57% vs. 34%, p = 0.006) and five-year PFS (35% vs. 22%, p = 0.04). At multivariate analysis, level of neutrophils (p = 0.009) and lung comorbidities (p = 0.021) were independent predictors of death, whereas preoperative CRP (p = 0.002), multiple metastases (p = 0.003) and presence of lung comorbidities (p = 0.001) were independent predictors of recurrence. NLR and CRP are important predictors of prognostic outcome in patients undergoing pulmonary metastasectomy.

Original languageEnglish
Article number3378
Number of pages11
JournalJournal of Clinical Medicine
Volume9
Issue number10
DOIs
Publication statusPublished - Oct 2020

Keywords

  • pulmonary oligometastases
  • surgery
  • neutrophils
  • C-reactive protein
  • C-REACTIVE PROTEIN
  • LYMPHOCYTE RATIO
  • CURATIVE RESECTION
  • NEUTROPHIL
  • METASTASECTOMY
  • SURVIVAL
  • CANCER
  • TRAPS
  • TUMOR

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