Platelet to lymphocyte ratio is associated with tumor localization and outcomes in metastatic colorectal cancer

Abstract

The aim of this study was to investigate the predictive and prognostic value of PLR, and the relationship between PLR and tumor localization.A total of 229 patients with de-novo metastatic CRC were retrospectively analyzed. The cutoff value for PLR was defined by the receiver operating characteristic (ROC) curve analysis and threshold value of 196.5 as best cut-off value was found.The higher rate of BRAF mutation was significantly detected for patients with PLRhigh (> 196.5) compared to those with PLRlow (≤196.5) (P = .001). PLR was significantly higher in tumors located on the right colon (P = .012). PLR, tumor localization, the presence of surgery for primary tumor, the presence of curative surgery, the presence of metastasectomy for progression-free survival (PFS) and PLR, gender, BRAF mutation, tumor localization, the presence of surgery for primary tumor, the presence of metastasectomy for overall survival (OS) were found to be prognostic factors by univariate analysis. Multivariate analysis showed that PLR, the presence of curative surgery and the presence of metastasectomy for both PFS and OS were found to be independent prognostic factors. Moreover, a logistic regression analysis indicated that PLR and tumor localization were found to be an independent factors for predicting response to systemic treatment (P < .001 and P = .023 respectively).Our results showed that pretreatment PLR was readily feasible and simple biomarker predicting response to treatment and survival, in addition it was significantly associated with tumor localization.

Emerging roles of platelets in cancer biology and their potential as therapeutic targets

“…As mentioned earlier, combining liquid biopsy sources for cancer detection and localization is effective. In patients with metastatic colorectal cancer and upper urinary tract cancer with a tumor diameter >3 cm, the platelet/lymphocyte ratio was found to be correlated with tumor location and prognosis (106,107). In patients with oral and lingual squamous cell carcinoma, the platelet-to-neutrophil ratio can predict lymph node metastasis (108).…”

Fashionable, but What is Their Real Clinical Usefulness? NLR, LMR, and PLR as a Promising Indicator in Colorectal Cancer Prognosis: A Systematic Review

“…OS and DFS were significantly better in patients with low PLR compared to patients with high PLR. 87 In a large-scale retrospective study of 1868 patients with CRC, Kim et al 39 demonstrated a PLR AUC of 0.556, with a mean PLR of 200.17 ± 168.96 and a cut-off of 160. Interestingly, the prognosis based on NLR and PLR differed depending on the stage of the cancer.…”

“…Increased PLT in patients with CRC is associated with poor prognosis and an increased risk of distant metastasis. 87 Thrombocytosis is related with systemic inflammation due to cancer, additionally, thrombosis can show systemic inflammatory and tumor activity. However, the assessment of the diagnostic power of PLR did not show that it is an indicator of high diagnostic utility in colorectal neoplasms.…”

“…Ackigoz et al 87 investigated the prognostic and predictive value of PLR and the relationship between PLR and tumor location in 229 patients suffering from CRC. Based on the size of the area under the ROC curve (AUC=0.690), the PLR cut-off was 196.5 (sensitivity and specificity respectively 85.0% and 65.0%).…”

“…OS and DFS were significantly better in patients with low PLR compared to patients with high PLR. 87 …”