Prognostic Value of Systemic Inflammatory Biomarkers in Patients Undergoing Cytoreductive Surgery With Hyperthermic...

BackgroundLaboratory biomarkers have been used as prognostic markers in several solid tumors. This study aims to evaluate 3 preoperatively measured laboratory values: blood neutrophil to lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), as potential prognostic biomarkers in patients with peritoneal carcinomatosis undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).MethodsWe performed a retrospective review of 156 patients who underwent CRS-HIPEC between 2013 and 2020. Biomarker ratios were calculated based on the preoperative laboratory values closest to the date of CRS-HIPEC. Multivariable Cox regression models were used to evaluate the biomarkers' associations with survival (OS), recurrence-free survival (RFS), and postoperative outcomes.ResultsIncreased MLR was independently associated with worse OS (P < 0.001) and RFS (P = 0.03) in this patient cohort. Additionally, increased MLR was independently associated with increased rate of hospital re-admission within 30 days after discharge (P = 0.04). None of the analyzed biomarkers were associated with increased rate of Clavien-Dindo class III/IV complication or hospital length of stay.ConclusionsIn this retrospective review, increased preoperative MLR was independently associated with worse overall and recurrence-free survival as well as increased rate of hospital re-admission. Preoperative PLR was associated with increased hospital length of stay. Thus, the utilization of preoperative systemic inflammatory biomarkers may aid in preoperative counseling and risk stratification prior to CRS-HIPEC.