Comparison of selected inflammation-based prognostic markers in relapsed or refractory metastatic colorectal cancer patients

Table 1 Baseline characteristics of patients

Variable		n	%
Clinicopathological factors
Age (yr)	< 65/≥ 65	123/54	69.5%/30.5%
Sex	Male/female	83/94	46.9%/53.1%
ECOG-PS	0-1/2-4	105/72	59.3%/40.7%
Tumor site	Colon/rectum	125/52	70.6%/29.4%
Liver metastasis	No/yes	69/108	39.0%/61.0%
Prior surgery	No/yes	33/144	18.6%/81.4%
Prior chemotherapy	None/1st line/2nd line/≥ 3rd line	21/28/54/74	11.9%/15.8%/30.5%/41.8%
Prior radiotherapy	No/yes	126/51	71.2%/28.8%
BMI (kg/m2)	< 18.5/18.5-22.9/≥ 23	22/88/64	12.6%/50.6%/36.8%
KM treatment duration (mo)	< 2.9/≥ 2.9	89/88	50.3%/49.7%
Laboratory factors
CEA (ng/mL)	≤ 5/> 5	31/140	18.1%/81.9%
CA19-9 (U/mL)	≤ 27/> 27	59/78	43.1%/56.9%
Hb (g/dL)	> 12.1/ ≤ 12.1	95/82	53.7%/46.3%
AST (IU/L)	< 40/≥ 40	147/30	83.1%/16.9%
ALT (IU/L)	< 40/≥ 40	157/20	88.7%/11.3%
eGFR (mL/min)	≥ 60/< 60	139/36	79.4%/20.6%
albumin (g/dL)	< 3.5/≥ 3.5	13/164	7.3%/92.7%
CRP (mg/L)	< 10.0/≥ 10.0	114/63	64.4%/35.6%
PLT (× 103/μL)	< 400/≥ 400	161/16	62.7%/37.3%
WBC (× 103/μL)	< 10.0/≥ 10.0	161/16	91.0%/9.0%
Neutrophil (%)	≤ 68.2/> 68.2	92/85	52.0%/48.0%
Lymphocyte (%)	≤ 24.3/> 24.3	111/66	62.7%/37.3%
Monocyte (%)	≤ 6.6/> 6.6	59/118	33.3%/66.7%
ANC (cells/μL)	≤ 4505.7/> 4505.7	104/73	58.8%/41.2%
ALC (cells/μL)	≤ 1651.3/> 1651.3	123/54	69.5%/30.5%
AMC (cells/μL)	≤ 460.8/> 460.8	83/94	46.9%/53.1%
mGPS	0/1/2	114/52/11	64.4%/29.4%/6.2%
NLR	< 5/≥ 5	144/33	81.4%/18.6%
PLR	< 150/150-300/> 300	73/78/26	41.2%/44.1%/14.7%
LMR	≤ 3.4/> 3.4	113/64	63.8%/36.1%
PNI	≤ 45.3/> 45.3	52/125	29.4%/70.6%

ECOG-PS: Eastern cooperative oncology group performance status; BMI: Body mass index; KM: Korean Medicine; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; Hb: Hemoglobin; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; eGFR: Estimated glomerular filtration rate; CRP: C-reactive protein; PLT: Platelet; WBC: White blood cell; ANC: Absolute neutrophil count; ALC: Absolute lymphocyte count; AMC: Absolute monocyte count; mGPS: Modified Glasgow prognostic score; NLR: Neutrophil to lymphocyte ratio; PLR: Platelet to lymphocyte ratio; LMR: Lymphocyte to monocyte ratio, PNI: Prognostic nutritional index.

Table 2 Univariate analyses of factors related to overall survival

Variable		Hazard ratio (95%CI)	P value
Clinicopathological factors
Age (yr)	< 65 vs≥ 65	1.295 (0.922-1.821)	0.136
Sex	Female vs male	0.897 (0.653-1.233)	0.504
ECOG-PS	0-1 vs 2-4	1.528 (1.107-2.109)	0.010
Tumor site	Colon vs rectum	0.823 (0.575-1.177)	0.286
Liver metastasis	No vs yes	1.469 (1.056-2.044)	0.023
Prior surgery	No vs yes	0.797 (0.525-1.211)	0.288
Prior chemotherapy	None vs 1st or 2nd line	0.670 (0.392-1.145)	0.143
	None vs≥ 3rd line	0.897 (0.526-1.529)	0.689
Prior radiotherapy	No vs yes	0.991 (0.698-1.409)	0.962
BMI (kg/m2)	< 18.5 vs 18.5-22.9	0.697 (0.425-1.144)	0.154
	< 18.5 vs≥ 23	0.700 (0.420-1.169)	0.173
KM treatment duration (mo)	≥ 2.9 vs < 2.9	1.966 (1.425-2.711)	< 0.001
Laboratory factors
CEA (ng/mL)	≤ 5 vs > 5	1.576 (1.016-2.444)	0.042
CA19-9 (U/mL)	≤ 27 vs > 27	1.654 (1.139-2.402)	0.008
Hb (g/dL)	> 12.1 vs ≤ 12.1	1.721 (1.246-2.378)	0.001
AST (IU/L)	< 40 vs≥ 40	2.547 (1.678-3.867)	< 0.001
ALT (IU/L)	< 40 vs≥ 40	1.845 (1.139-2.991)	0.013
eGFR (mL/min)	≥ 60 vs < 60	0.942 (0.634-1.399)	0.766
albumin (g/dL)	≥ 3.5 vs < 3.5	2.202 (1.214-3.993)	0.009
CRP (mg/L)	< 10.0 vs≥ 10.0	2.202 (1.577-3.076)	< 0.001
PLT (× 103/μL)	< 400 vs≥ 400	0.618 (0.367-1.042)	0.071
WBC (× 103/μL)	< 10.0 vs≥ 10.0	1.595 (0.945-2.691)	0.080
Neutrophil (%)	≤ 68.2 vs > 68.2	1.576 (1.146-2.168)	0.005
Lymphocyte (%)	> 24.3 vs ≤ 24.3	1.923 (1.369-2.700)	< 0.001
Monocyte (%)	≤ 6.6 vs > 6.6	1.316 (0.931-1.860)	0.120
ANC (cells/μL)	≤ 4505.7 vs > 4505.7	1.832 (1.328-2.527)	< 0.001
ALC (cells/μL)	≤ 1651.3 vs > 1651.3	0.779 (0.549-1.107)	0.164
AMC (cells/μL)	≤ 460.8 vs > 460.8	1.830 (1.325-2.527)	< 0.001
Systemic inflammation markers
mGPS	0 vs 1	1.998 (1.403-2.844)	< 0.001
	0 vs 2	4.741 (2.418-9.297)	< 0.001
NLR	< 5 vs≥ 5	2.388 (1.609-3.545)	< 0.001
PLR	< 150 vs 150-300	1.204 (0.849-1.708)	0.297
	< 150 vs > 300	1.989 (1.253-3.157)	0.004
LMR	> 3.4 vs ≤ 3.4	2.045 (1.450-2.884)	< 0.001
PNI	> 45.3 vs ≤ 45.3	1.785 (1.271-2.507)	0.001

ECOG-PS: Eastern cooperative oncology group performance status; BMI: Body mass index; KM: Korean Medicine; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; Hb: Hemoglobin; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; eGFR: Estimated glomerular filtration rate; CRP: C-reactive protein; PLT: Platelet; WBC: White blood cell; ANC: Absolute neutrophil count; ALC: Absolute lymphocyte count; AMC: Absolute monocyte count; mGPS: Modified Glasgow prognostic score; NLR: Neutrophil to lymphocyte ratio; PLR: Platelet to lymphocyte ratio; LMR: Lymphocyte to monocyte ratio; PNI: Prognostic nutritional index.

Table 3 Stepwise multivariate proportional hazards model for predictors of overall survival

Variable		Hazard ratio (95%CI)	P value
mGPS			0.017
	0 vs 1	1.135 (0.717-1.797)	0.588
	0 vs 2	3.212 (1.437-7.716)	0.004
LMR	> 3.4 vs ≤ 3.4	1.658 (1.092-2.518)	0.018
CA19-9 (U/mL)	≤ 27 vs > 27	1.482 (1.007-2.182)	0.046
AST (IU/L)	< 40 vs≥ 40	2.377 (1.359-4.155)	0.002
KM treatment duration (mo)	≥ 2.9 vs < 2.9	1.718 (1.160-2.543)	0.007

mGPS: Modified Glasgow prognostic score; LMR: Lymphocyte to monocyte ratio; CA19-9: Carbohydrate antigen 19-9; AST: Aspartate aminotransferase; KM: Korean Medicine.