SSAT - PERITUMORAL CD3+ INFLAMMATION AND NEUTROPHIL TO LYMPHOCYTE RATIO PREDICT OVERALL SURVIVAL IN PATIENTS AFFECTED BY COLORECTAL LIVER METASTASES TREATED WITH SURGERY

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PERITUMORAL CD3+ INFLAMMATION AND NEUTROPHIL TO LYMPHOCYTE RATIO PREDICT OVERALL SURVIVAL IN PATIENTS AFFECTED BY COLORECTAL LIVER METASTASES TREATED WITH SURGERY
Matteo Maria Cimino^*¹, Matteo Donadon¹, Domenico Mavilio², Kelly Hudspeth², Luca Di Tommaso³, Guido Torzilli¹
¹Department of General and Hepatobiliary Surgery, Humanitas Research Hospital & Humanitas University, Rozzano, MI, Italy; ²Department of Immunology, Humanitas Research Hospital & Humanitas University, Rozzano, Italy; ³Department of Pathology, Humanitas Research Hospital & Humanitas University, Rozzano, Italy

Background: systemic and local inflammation plays an important role in many cancers and colorectal liver metastases (CLM). While the role of local immune response mediated by CD3+ tumour infiltrating lymphocyte is well established new evidence on systemic inflammation and cancer such as neutrophil-lymphocyte ratio (NLR) are emerging. The aim of the study is to associate these two markers of inflammation to stratify patients affected by CLM in different overall survival (OS) and recurrence free survival (RFS) risk groups.
Methods: from January 2006 to January 2013 128 consecutive patients affected by CLM treated with chemotherapy and surgery were included in the study. Different cut-off were calculated with ROC curves for each biomarkers and their relative outcome (OS or RFS).
Associating the two biomarkers three risk groups were determined: low risk group (two protective biomarkers) intermediate risk group (one protective biomarkers) high risk group (no protective biomarker).
Results: after a median of follow-up of 45 months, median OS and RFS were 44 and 9 months respectively. For OS 29 (22.66 %) 59 (46.09%) and 40 (31.25%) patients were in the low, intermediate and high risk group respectively. Adjusted Cox regression analysis
showed a worse OS survival comparing the groups (intermediate group HR 2.67 p=0.007 95%CI 1.31-5.42, high risk group 2.86 p=0.005 95%CI 1.37-5.99). For RFS 30 (23.44%), 52 (40.63%), 46 (35.94%) patients were in the low, intermediate and high risk group
respectively. Adjusted Cox regression analysis showed a worse RFS survival comparing the groups (intermediate group HR 2.01 p=0.029 95%CI 1.31-3.78, high risk group HR 1.95 p=0.049 95%CI 1.00-3.77).
Conclusion: systemic and local immune response index allow to stratify patients in different OS and RFS risk groups.

Overall survival analysis

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