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Background <p>Neutrophil-to-lymphocyte ratio (NLR) is a promising prognostic marker for patients undergoing hepatectomy for colorectal liver metastases (CRLM). However, its prognostic value in patients receiving neoadjuvant therapy (NAT) has not been sufficiently addressed.</p> Methods <p>From 2013 to 2023, a cohort of 692 patients with CRLM receiving hepatectomy were enrolled in five centers. Clinicopathological characteristics were obtained from a prospectively maintained multi-center database. The effect of NLR (&gt; 2 versus ≤ 2) on overall survival (OS) and recurrence-free survival was estimated by Kaplan–Meier analysis. Univariable and multivariable Cox regression analysis was applied to investigate the influence of individual clinicopathological parameters on OS.</p> Results <p>In the entire cohort, the median NLR level was 2.11 (0.30–16.33). There were 307 (44.4%) patients receiving NAT followed by hepatectomy, while 385 (55.6%) patients undergoing upfront surgery. Notably, patients in the NAT group showed significantly lower NLR level than those in the upfront surgery group (1.83 versus 2.32, <i>P</i> &lt; 0.001). In the upfront surgery group, high NLR was significantly associated with worse OS, independent of other factors (HR = 1.49, 95% CI 1.08–2.05, <i>P</i> = 0.02). In the NAT group, there was no significant difference in OS between the high NLR and low NLR group.</p> Conclusion <p>The prognostic value of NLR in surgically resected CRLM is potentially influenced by NAT in the modern era.</p>

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The impact of neoadjuvant therapy on the prognostic value of preoperative neutrophil-to-lymphocyte ratio for colorectal liver metastases: a multi-center cohort study

  • 期刊论文

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  • 发表日期：

    2025年1月9日

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  • Xiang-Yu Wang,
  • Jie-Liang Zuo,
  • Hong Fu,
  • Chong Zhang,
  • Qing-Qi Fan,
  • Bo Zhang,
  • Bao-Rui Tao,
  • Zhen-Mei Chen,
  • Jia-Hao Han,
  • Yi-Tong Li,
  • Yue Ma,
  • Xiao-Chen Ma,
  • Rui Zhang,
  • Ying Zhu,
  • Wen-Wei Zhu,
  • Lu Lu,
  • Ming-Xu Yu,
  • Jin-Hong Chen

摘要

Background

Neutrophil-to-lymphocyte ratio (NLR) is a promising prognostic marker for patients undergoing hepatectomy for colorectal liver metastases (CRLM). However, its prognostic value in patients receiving neoadjuvant therapy (NAT) has not been sufficiently addressed.

Methods

From 2013 to 2023, a cohort of 692 patients with CRLM receiving hepatectomy were enrolled in five centers. Clinicopathological characteristics were obtained from a prospectively maintained multi-center database. The effect of NLR (> 2 versus ≤ 2) on overall survival (OS) and recurrence-free survival was estimated by Kaplan–Meier analysis. Univariable and multivariable Cox regression analysis was applied to investigate the influence of individual clinicopathological parameters on OS.

Results

In the entire cohort, the median NLR level was 2.11 (0.30–16.33). There were 307 (44.4%) patients receiving NAT followed by hepatectomy, while 385 (55.6%) patients undergoing upfront surgery. Notably, patients in the NAT group showed significantly lower NLR level than those in the upfront surgery group (1.83 versus 2.32, P < 0.001). In the upfront surgery group, high NLR was significantly associated with worse OS, independent of other factors (HR = 1.49, 95% CI 1.08–2.05, P = 0.02). In the NAT group, there was no significant difference in OS between the high NLR and low NLR group.

Conclusion

The prognostic value of NLR in surgically resected CRLM is potentially influenced by NAT in the modern era.