Lymphocyte-to-monocyte ratio predicts survival after radiofrequency ablation for colorectal liver metastases
Lymphocyte-to-monocyte ratio predicts survival after radiofrequency ablation for colorectal liver metastases
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DOI：
10.3748/wjg.v22.i16.4211
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发表时间：
2016-04-28
影响因子：
4.3
通讯作者：
Muscatiello, Nicola
中科院分区：
文献类型：
--
作者：
Facciorusso, Antonio;Del Prete, Valentina;Muscatiello, Nicola
目的：检测结直肠癌肝转移（CLMs）射频消融（RFA）后淋巴细胞与单核细胞比率（LMR）和生存率之间的相关性。方法：从2003年7月至2012年2月，在福贾大学，连续127例患者（193例组织学证实不可切除的CLMs）接受经皮RFA治疗。所有患者在RFA前均接受了原发性结直肠肿瘤切除术，并接受了全身化疗。通过将淋巴细胞计数除以基线时评估的单核细胞计数计算LMR。治疗相关毒性定义为术后4周内发生的任何不良事件。通过Kaplan-Meier曲线和中位数（95% CI），从RFA日期估计总生存期（OS）和至复发时间（TTR）。使用考克斯单变量和多变量回归模型对至事件发生时间数据进行推断分析，以估计风险比（HR）和95% CI。从单变量考克斯分析的统计学显着变量被认为是多变量models.Results：中位年龄为66岁（范围38-88）和患者的precedented男性（69.2%）。中位LMR为4.38%（0.79-88），而中位结节数量为2（1-3），中位最大直径为27 mm（10-45）。全组中位OS为38个月（34-53），1年、4年和5年生存率（SR）分别为89.4%、40.4%和33.3%。运行对数秩检验分析发现，3.96%是LMR最显著的预后截止点，根据该LMR值对研究人群进行分层，结果显示，LMR > 3.96%的患者中位OS为55个月（37-69），LMR 3.96%的患者中位OS为34个月（26-39），该组中位OS为25个月（18-30
AIM: To test the correlation between lymphocyte-to-monocyte ratio (LMR) and survival after radiofrequency ablation (RFA) for colorectal liver metastasis (CLMs).METHODS: From July 2003 to Feb 2012, 127 consecutive patients with 193 histologically-proven unresectable CLMs were treated with percutaneous RFA at the University of Foggia. All patients had undergone primary colorectal tumor resection before RFA and received systemic chemotherapy. LMR was calculated by dividing lymphocyte count by monocyte count assessed at baseline. Treatment-related toxicity was defined as any adverse events occurred within 4 wk after the procedure. Overall survival (OS) and time to recurrence (TTR) were estimated from the date of RFA by Kaplan-Meier with plots and median (95% CI). The inferential analysis for time to event data was conducted using the Cox univariate and multivariate regression model to estimate hazard ratios (HR) and 95% CI. Statistically significant variables from the univariate Cox analysis were considered for the multivariate models.RESULTS: Median age was 66 years (range 38-88) and patients were prevalently male (69.2%). Median LMR was 4.38% (0.79-88) whereas median number of nodules was 2 (1-3) with a median maximum diameter of 27 mm (10-45). Median OS was 38 mo (34-53) and survival rate (SR) was 89.4%, 40.4% and 33.3% at 1, 4 and 5 years respectively in the whole cohort. Running log-rank test analysis found 3.96% as the most significant prognostic cut-off point for LMR and stratifying the study population by this LMR value median OS resulted 55 mo (37-69) in patients with LMR > 3.96% and 34 (26-39) mo in patients with LMR 3.96% and 25 mo (18-30) in the group