Impact of preoperative inflammatory and nutritional markers on the prognosis of patients with peritoneal metastasis of colorectal cancer

doi:10.4251/wjgo.v16.i9.3865

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World Journal of Gastrointestinal Oncology

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World J Gastrointest Oncol. Sep 15, 2024; 16(9): 3865-3874
Published online Sep 15, 2024. doi: 10.4251/wjgo.v16.i9.3865

Table 1 Characteristics of patients with peritoneal metastases of colorectal cancer

Variables	Number of patients
Age (years), n (%)
≥ 60	64 (48.2)
< 60	69 (51.8)
Sex, n (%)
Male	89 (66.9)
Female	66 (33.1)
T category, n (%)
T0-3	56 (42.2)
T4	77 (57.8)
N category, n (%)
N0-1	72 (55.6)
N2	59 (44.4)
Location of tumor, n (%)
Right side of the colon	56 (42.2)
Left side of the colon	77 (57.8)
BMI (kg/m²), n (%)
≥ 18.5	24 (18.1)
< 18.5	109 (81.9)
PCI, n (%)
≥ 20	51 (38.3)
< 20	82 (61.6)
Histology, n (%)
Adenocarcinoma	105 (78.9)
Mucinous adenocarcinoma and signet-ring cell carcinoma	28 (21.1)
CRS, n (%)
CC 0/1	57 (42.8)
CC 2	76 (57.2)
HIPEC, n (%)
Yes	35 (26.4)
No	98 (73.6)
NLR, n (%)
≥ 3.1	54 (40.6)
< 3.1	79 (59.4)
Hb, n (%)
Normal	94 (70.6)
Low	39 (29.4)
Albumin (g/L), n (%)
≥ 35	99 (74.5)
< 35	34 (25.5)

BMI: Body mass index; CRS: Cytoreductive surgery; HIPEC: Hyperthermic intraperitoneal chemotherapy; PCI: Peritoneal cancer index; NLR: Neutrophil-to-lymphocyte ratio; Hb: Hemoglobin.

Table 2 Summary of demographics for patients treated with cytoreductive surgery according to the neutrophil-to-lymphocyte ratio/hemoglobin status

variables	NLR ≥ 3.1, n = 54	NLR < 3.1, n = 79	P value	Hb (normal), n = 94	Hb (low), n = 39	P value
Age (years), n (%)			0.531			0.017
≥ 60	31 (57.4)	41 (51.8)		39 (41.5)	25 (64.1)
< 60	23 (42.6)	38 (48.2)		55 (58.5)	14 (35.9)
Sex, n (%)			0.423			0.097
Male	34 (62.9)	55 (69.6)		67 (71.2)	22 (56.4)
Female	20 (37.1)	24 (30.4)		27 (28.7)	17 (43.6)
T category, n (%)			0.177			0.187
T0-3	24 (44.4)	26 (32.9)		43 (45.7)	13 (33.3)
T4	30 (55.6)	53 (67.1)		51 (54.2)	26 (66.7)
N category, n (%)			0.710			0.029
N0-1	29 (53.7)	45 (56.9)		58 (61.7)	16 (41.1)
N2	25 (46.3)	34 (43.1)		36 (38.2)	23 (58.9)
CRS, n (%)			0.014			0.001
CC 0/1	30 (55.6)	27 (34.1)		49 (52.1)	8 (20.5)
CC 2	24 (44.4)	52 (65.9)		45 (47.9)	31 (79.5)
HIPEC, n (%)			0.473			0.065
Yes	16 (29.6)	19 (24.1)		29 (30.8)	6 (15.3)
No	38 (70.4)	60 (75.9)		65 (69.2)	33 (84.7)
Albumin (g/L), n (%)			0.019			< 0.001
≥ 35	46 (85.1)	53 (67.1)		78 (82.9)	21 (53.9)
< 35	8 (14.8)	26 (32.9)		16 (17.1)	18 (46.1)
BMI (kg/m²), n (%)			0.907			0.985
≥ 18.5	44 (81.5)	65 (82.3)		77 (82.0)	32 (82.1)
< 18.5	10 (18.5)	14 (17.7)		17 (18.0)	7 (17.9)
Location of tumor, n (%)			0.320			0.319
Right side of the colon	16 (29.6)	30 (37.9)		35 (37.2)	11 (28.2)
Left side of the colon	38 (70.4)	49 (62.1)		59 (62.8)	28 (71.8)
PCI, n (%)			0.535			0.708
≥ 20	19 (35.1)	32 (40.5)		37 (39.3)	14 (35.8)
< 20	35 (64.8)	47 (59.5)		57 (60.7)	25 (64.2)
Histology, n (%)			0.305			0.572
Adenocarcinoma	45 (83.3)	60 (75.9)		73 (77.6)	32 (82.1)
Mucinous adenocarcinoma and signet-ring cell carcinoma	9 (16.6)	19 (24.1)		21 (22.4)	7 (17.9)

BMI: Body mass index; CRS: Cytoreductive surgery; HIPEC: Hyperthermic intraperitoneal chemotherapy; PCI: Peritoneal cancer index; NLR: Neutrophil-to-lymphocyte ratio; Hb: Hemoglobin.

Table 3 Cox univariate and multivariate analyses of the 133 patients with peritoneal metastases of colorectal cancer

Variables	Univariate analysis		Multivariate analysis
Variables	HR (95%CI)	P value	HR (95%CI)	P value
Sex (female)	0.89 (0.56-1.41)	0.621
Age (≤ 60)	0.55 (0.35-0.84)	0.006	0.63 (0.39-1.01)	0.050
CEA (≥ 5.0 ng/mL)	0.88 (0.73-1.75)	0.570
CA199 (≥ 37.0 U/mL)	1.71 (1.11-2.61)	0.014	1. 19 (0.74-1.91)	0.450
CA125 (≥ 35.0 U/mL)	1.07 (0.69-1.65)	0.769
BMI (< 18.5 kg/m²)	1.22 (0.88-1.62)	0.356
Location (right side)	0.94 (0.64-1.38)	0.756
NLR (≥ 3.1)	2.02 (1.28-3.19)	0.002	1.81 (1.13-2.89)	0.010
Hb (normal)	0.47 (0.31-0.72)	< 0.001	0.65 (0.39-1.07)	0.080
Albumin (< 35 g/L)	2.11 (1.37-3.51)	< 0.001	1.25 (0.72-2.17)	0.420
Category (T4)	1.04 (0.68-1.59)	0.854
Category (N2)	1.02 (0.79-1.21)	0.857
Histology (mucinous adenocarcinoma and signet-ring cell carcinoma)	1.46 (0.94-2.27)	0.090
PCI (≥ 20)	1.91 (1.24-2.93)	0.003	1.92 (1.21-3.07)	0.006

HR: Hazard ratio; CI: Confidence interval; CEA: Carcinoembryonic antigen; CA199: Carbohydrate antigen 199; CA125: Carbohydrate antigen 125; BMI: Body mass index; NLR: Neutrophil-to-lymphocyte ratio; Hb: Hemoglobin; PCI: Peritoneal cancer index.

Citation: Wu ZJ, Lan B, Luo J, Ameti A, Wang H, Hu QY. Impact of preoperative inflammatory and nutritional markers on the prognosis of patients with peritoneal metastasis of colorectal cancer. World J Gastrointest Oncol 2024; 16(9): 3865-3874
URL: https://www.wjgnet.com/1948-5204/full/v16/i9/3865.htm
DOI: https://dx.doi.org/10.4251/wjgo.v16.i9.3865