Evaluation of Inflammatory Scores in Metastatic Colorectal Cancer Patients Undergoing Transarterial Radioembolization

Shamar Young; Ranjan Ragulojan; Soorya Todatry; Donna D’Souza; Jafar Golzarian; Siobhan Flanagan; Tina S Sanghvi

doi:10.1007/s00270-022-03313-w

Evaluation of Inflammatory Scores in Metastatic Colorectal Cancer Patients Undergoing Transarterial Radioembolization

Shamar Young
, Ranjan Ragulojan
, Soorya Todatry
, Donna D’Souza
, Jafar Golzarian
, Siobhan Flanagan
, Tina S Sanghvi

Radiology

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Purpose: To evaluate the correlation of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), aspartate aminotransferase-to-lymphocyte ratio (ALRI), systemic inflammation index (SII), and lymphocyte count to oncologic outcomes in metastatic colorectal cancer (mCRC) patients undergoing transarterial radioembolization (TARE). Materials and Methods: All patients undergoing TARE for mCRC were retrospectively reviewed at a single academic institution. A receiver operating characteristics (ROC) curve analysis was performed using a landmark survival point of 12 months, with an area under the curve (AUC) calculated. A cutoff point was determined by Youden’s index and used to separate patients for OS and PFS analysis. Cox proportional-hazards models which included pertinent clinical factors were also created to evaluate PFS and OS. Results: In total, 41 patients who underwent 66 TARE treatments were included. A correlation was seen between post-treatment ALRI < 45 (HR: 0.38 (95%CI: 0.17–0.86), p = 0.02) and PFS. Patients with a pretreatment ALRI score < 20 had a significantly longer OS (HR: 0.49 (95%CI: 0.19–0.88), p = 0.02) as did those with a post-treatment lymphocyte count > 1.1 10⁹/L (HR: 0.27 (95%CI: 0.11–0.68), p = 0.005). In multivariate analysis of PFS, post-treatment lymphocyte count (HR: 8.46 (95%CI: 1.14–62.89), p = 0.044) was the only significantly associated inflammatory marker and presence of extrahepatic disease (HR:8.46 (95%CI: 1.14–62.89, p = 0.044) also correlated. Multivariate analysis of OS showed that pretreatment PLR (HR:1.01 (95%CI:1.−1.03), p = 0.02) and post-treatment NLR (HR:0.33 (95%CI:0.14–0.76), p = 0.009), PLR (HR:0.98 (95%CI:0.97–1), p = 0.046), SII (HR:1.04 (95%CI:1.01–1.08), p = 0.014), and lymphocyte count (HR:0.07 (95%CI:0.01–0.16), p = 0.003) were significantly associated. Conclusion: Inflammatory markers may be associated with OS and PFS in mCRC patients undergoing TARE.

Original language	English (US)
Pages (from-to)	209-219
Number of pages	11
Journal	Cardiovascular and Interventional Radiology
Volume	46
Issue number	2
DOIs	https://doi.org/10.1007/s00270-022-03313-w
State	Published - Feb 2023

Bibliographical note

Funding Information:
This study was not supported by any funding.

Publisher Copyright:
© 2022, Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Colorectal cancer
Inflammatory markers
Transarterial radioembolization

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10.1007/s00270-022-03313-w

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@article{c868cb28cdc6436195c533175c017cbc,

title = "Evaluation of Inflammatory Scores in Metastatic Colorectal Cancer Patients Undergoing Transarterial Radioembolization",

abstract = "Purpose: To evaluate the correlation of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), aspartate aminotransferase-to-lymphocyte ratio (ALRI), systemic inflammation index (SII), and lymphocyte count to oncologic outcomes in metastatic colorectal cancer (mCRC) patients undergoing transarterial radioembolization (TARE). Materials and Methods: All patients undergoing TARE for mCRC were retrospectively reviewed at a single academic institution. A receiver operating characteristics (ROC) curve analysis was performed using a landmark survival point of 12 months, with an area under the curve (AUC) calculated. A cutoff point was determined by Youden{\textquoteright}s index and used to separate patients for OS and PFS analysis. Cox proportional-hazards models which included pertinent clinical factors were also created to evaluate PFS and OS. Results: In total, 41 patients who underwent 66 TARE treatments were included. A correlation was seen between post-treatment ALRI < 45 (HR: 0.38 (95\%CI: 0.17–0.86), p = 0.02) and PFS. Patients with a pretreatment ALRI score < 20 had a significantly longer OS (HR: 0.49 (95\%CI: 0.19–0.88), p = 0.02) as did those with a post-treatment lymphocyte count > 1.1 109/L (HR: 0.27 (95\%CI: 0.11–0.68), p = 0.005). In multivariate analysis of PFS, post-treatment lymphocyte count (HR: 8.46 (95\%CI: 1.14–62.89), p = 0.044) was the only significantly associated inflammatory marker and presence of extrahepatic disease (HR:8.46 (95\%CI: 1.14–62.89, p = 0.044) also correlated. Multivariate analysis of OS showed that pretreatment PLR (HR:1.01 (95\%CI:1.−1.03), p = 0.02) and post-treatment NLR (HR:0.33 (95\%CI:0.14–0.76), p = 0.009), PLR (HR:0.98 (95\%CI:0.97–1), p = 0.046), SII (HR:1.04 (95\%CI:1.01–1.08), p = 0.014), and lymphocyte count (HR:0.07 (95\%CI:0.01–0.16), p = 0.003) were significantly associated. Conclusion: Inflammatory markers may be associated with OS and PFS in mCRC patients undergoing TARE.",

keywords = "Colorectal cancer, Inflammatory markers, Transarterial radioembolization",

author = "Shamar Young and Ranjan Ragulojan and Soorya Todatry and Donna D{\textquoteright}Souza and Jafar Golzarian and Siobhan Flanagan and Sanghvi, \{Tina S\}",

note = "Funding Information: This study was not supported by any funding. Publisher Copyright: {\textcopyright} 2022, Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).",

year = "2023",

month = feb,

doi = "10.1007/s00270-022-03313-w",

language = "English (US)",

volume = "46",

pages = "209--219",

journal = "Cardiovascular and Interventional Radiology",

issn = "0174-1551",

publisher = "Springer",

number = "2",

}

TY - JOUR

T1 - Evaluation of Inflammatory Scores in Metastatic Colorectal Cancer Patients Undergoing Transarterial Radioembolization

AU - Young, Shamar

AU - Ragulojan, Ranjan

AU - Todatry, Soorya

AU - D’Souza, Donna

AU - Golzarian, Jafar

AU - Flanagan, Siobhan

AU - Sanghvi, Tina S

N1 - Funding Information: This study was not supported by any funding. Publisher Copyright: © 2022, Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).

PY - 2023/2

Y1 - 2023/2

N2 - Purpose: To evaluate the correlation of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), aspartate aminotransferase-to-lymphocyte ratio (ALRI), systemic inflammation index (SII), and lymphocyte count to oncologic outcomes in metastatic colorectal cancer (mCRC) patients undergoing transarterial radioembolization (TARE). Materials and Methods: All patients undergoing TARE for mCRC were retrospectively reviewed at a single academic institution. A receiver operating characteristics (ROC) curve analysis was performed using a landmark survival point of 12 months, with an area under the curve (AUC) calculated. A cutoff point was determined by Youden’s index and used to separate patients for OS and PFS analysis. Cox proportional-hazards models which included pertinent clinical factors were also created to evaluate PFS and OS. Results: In total, 41 patients who underwent 66 TARE treatments were included. A correlation was seen between post-treatment ALRI < 45 (HR: 0.38 (95%CI: 0.17–0.86), p = 0.02) and PFS. Patients with a pretreatment ALRI score < 20 had a significantly longer OS (HR: 0.49 (95%CI: 0.19–0.88), p = 0.02) as did those with a post-treatment lymphocyte count > 1.1 109/L (HR: 0.27 (95%CI: 0.11–0.68), p = 0.005). In multivariate analysis of PFS, post-treatment lymphocyte count (HR: 8.46 (95%CI: 1.14–62.89), p = 0.044) was the only significantly associated inflammatory marker and presence of extrahepatic disease (HR:8.46 (95%CI: 1.14–62.89, p = 0.044) also correlated. Multivariate analysis of OS showed that pretreatment PLR (HR:1.01 (95%CI:1.−1.03), p = 0.02) and post-treatment NLR (HR:0.33 (95%CI:0.14–0.76), p = 0.009), PLR (HR:0.98 (95%CI:0.97–1), p = 0.046), SII (HR:1.04 (95%CI:1.01–1.08), p = 0.014), and lymphocyte count (HR:0.07 (95%CI:0.01–0.16), p = 0.003) were significantly associated. Conclusion: Inflammatory markers may be associated with OS and PFS in mCRC patients undergoing TARE.

AB - Purpose: To evaluate the correlation of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), aspartate aminotransferase-to-lymphocyte ratio (ALRI), systemic inflammation index (SII), and lymphocyte count to oncologic outcomes in metastatic colorectal cancer (mCRC) patients undergoing transarterial radioembolization (TARE). Materials and Methods: All patients undergoing TARE for mCRC were retrospectively reviewed at a single academic institution. A receiver operating characteristics (ROC) curve analysis was performed using a landmark survival point of 12 months, with an area under the curve (AUC) calculated. A cutoff point was determined by Youden’s index and used to separate patients for OS and PFS analysis. Cox proportional-hazards models which included pertinent clinical factors were also created to evaluate PFS and OS. Results: In total, 41 patients who underwent 66 TARE treatments were included. A correlation was seen between post-treatment ALRI < 45 (HR: 0.38 (95%CI: 0.17–0.86), p = 0.02) and PFS. Patients with a pretreatment ALRI score < 20 had a significantly longer OS (HR: 0.49 (95%CI: 0.19–0.88), p = 0.02) as did those with a post-treatment lymphocyte count > 1.1 109/L (HR: 0.27 (95%CI: 0.11–0.68), p = 0.005). In multivariate analysis of PFS, post-treatment lymphocyte count (HR: 8.46 (95%CI: 1.14–62.89), p = 0.044) was the only significantly associated inflammatory marker and presence of extrahepatic disease (HR:8.46 (95%CI: 1.14–62.89, p = 0.044) also correlated. Multivariate analysis of OS showed that pretreatment PLR (HR:1.01 (95%CI:1.−1.03), p = 0.02) and post-treatment NLR (HR:0.33 (95%CI:0.14–0.76), p = 0.009), PLR (HR:0.98 (95%CI:0.97–1), p = 0.046), SII (HR:1.04 (95%CI:1.01–1.08), p = 0.014), and lymphocyte count (HR:0.07 (95%CI:0.01–0.16), p = 0.003) were significantly associated. Conclusion: Inflammatory markers may be associated with OS and PFS in mCRC patients undergoing TARE.

KW - Colorectal cancer

KW - Inflammatory markers

KW - Transarterial radioembolization

UR - https://www.scopus.com/pages/publications/85142445117

UR - https://www.scopus.com/pages/publications/85142445117#tab=citedBy

U2 - 10.1007/s00270-022-03313-w

DO - 10.1007/s00270-022-03313-w

M3 - Article

C2 - 36416916

AN - SCOPUS:85142445117

SN - 0174-1551

VL - 46

SP - 209

EP - 219

JO - Cardiovascular and Interventional Radiology

JF - Cardiovascular and Interventional Radiology

IS - 2

ER -

Evaluation of Inflammatory Scores in Metastatic Colorectal Cancer Patients Undergoing Transarterial Radioembolization

Abstract

Bibliographical note

UN SDGs

Keywords

Publisher link

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