The impact of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio among patients with intrahepatic cholangiocarcinoma

Buettner, Stefan; Spolverato, Gaya; Kimbrough, Charles W.; Alexandrescu, Sorin; Marques, Hugo; Lamelas, Jorge; Aldrighetti, Luca; Gamblin, T. Clark; Maithel, Shishir K.; Pulitano, Carlo; Weiss, Matthew J.; Bauer, Todd W.; Shen, Feng; Poultsides, George A.; Marsh, J. Wallis; IJzermans, Jan N.M.; Koerkamp, Bas Groot; Pawlik, Timothy M.

doi:10.1016/j.surg.2018.05.002

Cited by 47 publications

(44 citation statements)

References 35 publications

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“…59 Macrophages, through their crosstalk with CCA cells participate in tumour growth by releasing a variety of inflammatory, growth and proliferative factors. [60][61][62] Elevated preoperative peripheral blood neutrophil-to-lymphocyte (NLR) ratio is also a poor prognostic factor for intrahepatic and extrahepatic CCA, [63][64][65][66] as well as in patients with advanced CCA undergoing chemotherapy. 67 73,74 Furthermore, immunotherapy with infusion of activated allogeneic NK cells has also been performed in HCC patients with promising outcomes.…”

Section: The Role Of the Innate Immune Sys Tem In CC Amentioning

confidence: 99%

The tumour microenvironment and immune milieu of cholangiocarcinoma

Fabris

Perugorria

Mertens

et al. 2019

Liver International

139

124

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Tumour microenvironment is a complex, multicellular functional compartment that, particularly when assembled as an abundant desmoplastic reaction, may profoundly affect the proliferative and invasive abilities of epithelial cancer cells. Tumour microenvironment comprises not only stromal cells, mainly cancer‐associated fibroblasts, but also immune cells of both the innate and adaptive system (tumour‐associated macrophages, neutrophils, natural killer cells, and T and B lymphocytes), and endothelial cells. This results in an intricate web of mutual communications regulated by an extensively remodelled extracellular matrix, where the tumour cells are centrally engaged. In this regard, cholangiocarcinoma, in particular the intrahepatic variant, has become the focus of mounting interest in the last years, largely because of the lack of effective therapies despite its rising incidence and high mortality rates worldwide. On the other hand, recent studies in pancreatic cancer, which similarly to cholangiocarcinoma, is highly desmoplastic, have argued against a tumour‐promoting function of the tumour microenvironment. In this review, we will discuss recent developments concerning the role of each cellular population and their multifaceted interplay with the malignant biliary epithelial counterpart. We ultimately hope to provide the working knowledge on how their manipulation may lead to a therapeutic gain in cholangiocarcinoma.

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Section: The Role Of the Innate Immune Sys Tem In CC Amentioning

confidence: 99%

The tumour microenvironment and immune milieu of cholangiocarcinoma

Fabris

Perugorria

Mertens

et al. 2019

Liver International

139

124

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“…Of note, the inflammatory variant was characterized by activation of inflammatory signaling pathways and overexpression of cytokines, and a worse prognosis . Interestingly, SIR markers such as NLR have been independently associated with worse survival among patients with ICC undergoing resection . In fact, individuals in the current cohort who had an elevated NLR were more likely to have discordant preoperative vs postoperative OS risk estimates, possibly suggesting more aggressive biology that was not detected until after surgery.…”

Section: Discussionmentioning

confidence: 77%

“…33 Interestingly, SIR markers such as NLR have been independently associated with worse survival among patients with ICC undergoing resection. 14,34 In fact, individuals in the current Abbreviations: BMI, body mass index; CA, carbohydrate antigen; CEA, carcinoembryonic antigen; CI, confidence interval; ln, natural logarithm; NLR, neutrophil to lymphocyte ratio.…”

Section: Discussionmentioning

confidence: 99%

“…albumin, bilirubin), preoperative systemic inflammatory response (SIR) marker (i.e. neutrophil to lymphocyte ratio [NLR]), tumor markers (i.e. preoperative serum level of carbohydrate antigen [CA] 19‐9, carcinoembryonic antigen [CEA]), tumor morphology (i.e.…”

Section: Methodsmentioning

confidence: 99%

“…albumin, bilirubin), preoperative systemic inflammatory response (SIR) marker (i.e. neutrophil to lymphocyte ratio [NLR]), 14 [IG], periductal infiltrating [PI]), regional lymph node status according to AJCC 8th edition, 7 and the receipt of adjuvant chemotherapy.…”

Section: Study Population and Data Collectionmentioning

confidence: 99%

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Discordance in prediction of prognosis among patients with intrahepatic cholangiocarcinoma: A preoperative vs postoperative perspective

Moro

Paredes

Farooq

et al. 2019

Journal of Surgical Oncology

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Background The objective of the current study was to characterize patients with intrahepatic cholangiocarcinoma (ICC) undergoing curative‐intent surgery with discordant preoperative and postoperative prediction scores and determine factors associated with prediction discrepancy. Methods Patients who underwent hepatectomy for ICC between 1990 and 2016 were identified in a multi‐institutional international database. Preoperative and postoperative prognostic models were designed and discordant prognostic scores were identified. A multivariable logistic regression analysis was completed to determined factors associated with score discordance. Results Among 1149 patients, those who had concordant prediction scores were older (median age, 60 vs 56), and more likely to have a smaller median tumor size (6.0 vs 7.5 cm) (all P < .05). On multivariable logistic analysis, patients with higher neutrophil‐lymphocyte ratio (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.09‐1.19), higher CEA levels (OR, 1.25; 95% CI, 1.04‐1.50), larger tumors (OR, 1.10; 95% CI, 1.04‐1.15) and suspicious lymph nodes (OR, 2.05; 95% CI, 1.25‐3.36) were more likely to have preoperative and postoperative score discordance. Older patients had decreased odds of having score discordance (OR, 0.98; 95% CI, 0.96‐0.99). Patients with score discordance had worse overall survival compared with patients with concordant scores (median:15.9 vs 21.7 months, P < .05). Conclusion Score discordance may reflect an aggressive variant of ICC that would benefit from early integration of multidisciplinary treatment strategies.

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The predictive value of lymphocyte to monocyte ratio for overall survival in cholangiocarcinoma patients with hepatic resection

Wang

Zhang

et al. 2023

Cancer Medicine

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Background There is considerable heterogeneity in clinical behavior and survival outcomes in patients with cholangiocarcinoma (CCA), and the prognosis of CCA patients is poor. We proposed lymphocyte to monocyte ratio (LMR) as a novel prognostic element for CCA patients with hepatic resection in present study. Methods By retrospectively analyzing the clinical data of 145 CCA patients with hepatic resection, we determined the optimal LMR cutoff value according to the receiver operating characteristic (ROC). We comparatively analyzed the clinical features of CAA patients between low LMR group and high LMR group, mainly including overall survival (OS) analysis by using the Kaplan‐Meier method, univariate and multivariate Cox regression. Results We found there was a longer OS in CCA patients of the high LMR group than the low LMR group. The total median OS of cholangiocarcinoma patients were 13.6 months, and the OS of low LMR group was markedly lower than the high LMR group. The 1‐year, 3‐year, and 5‐year OS of high LMR group were respectively 62.9%, 32.4%, and 16.4%, and were significantly higher the cholangiocarcinoma patients of low LMR group (40.2%, 16.4%, and 0%). Multivariate regression analyses showed that preoperative cholangitis, elevated CEA level and nerve invasion were risk factors for the OS of cholangiocarcinoma patients, while the high LMR level and postoperative treatment were protective factors for the OS of cholangiocarcinoma patients. Conclusions Preoperative LMR was a vital prognostic factor to predict the prognosis of CCA patients with hepatic resection and provided additional prognostic value beyond standard clinicopathological parameters.

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The impact of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio among patients with intrahepatic cholangiocarcinoma

Abstract: Elevated neutrophil-to-lymphocyte ratio was independently associated with worse overall survival and improved the prognostic estimation of long-term survival among patients with intrahepatic cholangiocarcinoma undergoing resection.

Cited by 47 publications

References 35 publications

The tumour microenvironment and immune milieu of cholangiocarcinoma

The tumour microenvironment and immune milieu of cholangiocarcinoma

Discordance in prediction of prognosis among patients with intrahepatic cholangiocarcinoma: A preoperative vs postoperative perspective

The predictive value of lymphocyte to monocyte ratio for overall survival in cholangiocarcinoma patients with hepatic resection

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