Prognostic Value of Systemic Inflammatory Indices, NLR, PLR, and MPV, for Predicting 1-Year Survival of Patients Undergoing Cytoreductive Surgery with HIPEC
Abstract
:1. Introduction
2. Material and Methods
2.1. Patients
2.2. Data Collection
2.3. Statistical Analysis
3. Results
3.1. Demographics and Perioperative Variables
3.2. Systemic Inflammatory Indexes, Based on the NLR, PLR, and MPV
3.3. Prognostic Factors Affecting 1-Year Survival after CRS with HIPEC
3.4. Overall Survival
4. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variables | Non-Survival (N = 31) | Survival (N = 129) | p Value |
---|---|---|---|
Age, years | 55.7 (13.5) | 55.1 (11.8) | 0.815 |
Male sex | 19 (61%) | 60 (47%) | 0.140 |
Body mass index, kg/m2 | 19.9 (3.7) | 22.0 (3.7) | 0.007 * |
ASA physical status | 0.285 | ||
I | 5 (16%) | 37 (29%) | |
II | 20 (65%) | 76 (59%) | |
III | 6 (19%) | 16 (12%) | |
Comorbidities | |||
Hypertension | 7 (23%) | 37 (29%) | 0.495 |
Diabetes mellitus | 2 (6%) | 18 (14%) | 0.369 |
Prior chemotherapy | 24 (77%) | 81 (63%) | 0.124 |
Preoperative PCI score | 19.4 (11.7) | 12.6 (10.9) | 0.004 * |
Combined surgery | 20 (65%) | 78 (60%) | 0.678 |
Operation time, min | 649.5 (191.3) | 593.2 (195.3) | 0.150 |
Intraoperative input and output | |||
Total fluid, mL | 7183 (2694) | 6900 (3168) | 0.647 |
Colloid, mL | 952 (582) | 6032 (2960) | 0.425 |
20% Albumin, mL | 148 (190) | 111 (160) | 0.259 |
Blood loss, mL | 1373 (978) | 1076 (1028) | 0.148 |
Urine output, mL | 1040 (670) | 1104 (718) | 0.652 |
pRBC, n | 1.9 (2.4) | 0.9 (1.5) | 0.039 * |
Number of patients who received inotropic agents | |||
Phenylephrine, n | 13 (42%) | 66 (51%) | 0.356 |
Norepinephrine, n | 20 (65%) | 60 (47%) | 0.072 |
Temperature | |||
Prior to operation | 36.3 (0.5) | 36.2 (0.3) | 0.161 |
Highest | 38.6 (0.6) | 38.5 (0.8) | 0.430 |
At the end of operation | 36.3 (0.5) | 36.4 (0.6) | 0.621 |
ICU admission, n | 30 (97%) | 112 (87%) | 0.202 |
APACHE score | 16.4 (6.6) | 15.1 (6.8) | 0.346 |
Types of cancer | 0.425 | ||
Appendiceal cancer | 6 (19.4%) | 23 (17.8%) | |
Ascending colon cancer | 7 (22.6%) | 21 (16.3%) | |
Cecal cancer | 3 (9.7%) | 6 (4.7%) | |
Descending colon cancer | 2 (6.5%) | 3 (2.3%) | |
Peritoneal mesothelioma | 1 (3.2%) | 7 (5.4%) | |
Rectal cancer | 5 (16.1%) | 19 (14.7%) | |
Sigmoid cancer | 5 (16.1%) | 43 (33.3%) | |
Transverse colon cancer | 2 (6.5%) | 7 (5.4%) | |
Preoperative | |||
NLR | 4.6 (4.4) | 2.2 (1.5) | 0.005 * |
PLR | 243.3 (135.8) | 150.7 (84.8) | <0.001 * |
MPV | 9.8 (1.1) | 9.5 (0.9) | 0.094 |
Postoperative Day 2 | |||
NLR | 21.6 (13.7) | 14.7 (9.2) | 0.014 * |
PLR | 309.3 (208.6) | 207.0 (95.3) | 0.013 * |
MPV | 10.6 (1.0) | 10.3 (0.8) | 0.153 |
Postoperative Day 3 | |||
NLR | 25.3 (19.4) | 14.8 (12.5) | 0.008 * |
PLR | 358.2 (228.5) | 226.7 (107.3) | 0.004 * |
MPV | 10.7 (0.9) | 10.2 (1.3) | 0.018 * |
Postoperative Day 4 | |||
NLR | 17.5 (12.0) | 10.9 (8.5) | 0.008 * |
PLR | 385.3 (229.1) | 291.7 (166.0) | 0.043 * |
MPV | 10.6 (0.9) | 10.2 (0.8) | 0.013 * |
Postoperative Day 5 | |||
NLR | 10.8 (5.5) | 7.6 (6.7) | 0.019 * |
PLR | 373.2 (246.2) | 290.0 (167.5) | 0.094 * |
MPV | 10.7 (0.9) | 10.1 (1.2) | 0.007 * |
Variables | 1-Year Survival | |
---|---|---|
HR (95% CI) | p Value | |
Age, years | 1.005 (0.976–1.035) | 0.750 |
Female sex | 1.691 (0.821–3.485) | 0.154 |
Body mass index, kg/m2 | 0.872 (0.787–0.966) | 0.009* |
ASA physical status | ||
I | 1 | |
II | 1.804 (0.677–4.806) | 0.238 |
III | 2.513 (0.767–8.236) | 0.128 |
Comorbidities | ||
Hypertension | 0.762 (0.328–1.769) | 0.527 |
Diabetes mellitus | 0.448 (0.107–1.876) | 0.272 |
Prior chemotherapy | 1.934 (0.833–4.488) | 0.125 |
Preoperative PCI score | 1.042 (1.012–1.074) | 0.006 * |
Combined surgery | 1.144 (0.548–2.388) | 0.720 |
Operation time, min | 1.001 (0.999–1.003) | 1.956 |
Intraoperative input and output | ||
Total fluid, mL | 1.000 (1.000–1.000) | 0.769 |
Colloid, mL | 1.000 (1.000–1.001) | 0.470 |
20% Albumin, mL | 1.112 (0.924–1.338) | 0.261 |
Blood loss, mL | 1.000 (1.000–1.000) | 0.179 |
Urine output, mL | 1.000 (0.999–1.000) | 0.589 |
pRBC, n | 1.226 (1.057–1.421) | 0.007 * |
Number of patients who received inotropic agents | ||
Phenylephrine, n | 0.717 (0.351–1.464) | 0.361 |
Norepinephrine, n | 1.972 (0.945–4115) | 0.071 |
Temperature | ||
Prior to operation | 2.316 (0.895–5.991) | 0.083 |
Highest | 1.217 (0.760–1.950) | 0.414 |
At the end of operation | 0.852 (0.451–1.610) | 0.622 |
ICU admission, n | 4.177 (0.570–30.629) | 0.160 |
APACHE score | 1.024 (0.975–1.076) | 0.340 |
Types of cancer | ||
Appendiceal cancer | 1 | |
Ascending colon cancer | 1.194 (0.401–3.552) | 0.750 |
Cecal cancer | 1.558 (0.389–6.229) | 0.531 |
Descending colon cancer | 2.381 (0.480–11.812) | 0.288 |
Peritoneal mesothelioma | 0.529 (0.064–4.398) | 0.529 |
Rectal cancer | 1.037 (0.316–3.397) | 0.952 |
Sigmoid cancer | 0.463 (0.141–1.518) | 0.204 |
Transverse colon cancer | 1.029 (0.208–5.097) | 0.972 |
Preoperative | ||
NLR | 1.289 (1.185–1.403) | <0.001 * |
PLR | 1.005 (1.003–1.007) | <0.001 * |
MPV | 1.371 (0.942–1.993) | 0.099 |
Postoperative day 2 | ||
NLR | 1.037 (1.014–1.061) | 0.001 * |
PLR | 1.004 (1.002–1.006) | <0.001 * |
MPV | 1.316 (0.895–1.935) | 0.163 |
Postoperative day 3 | ||
NLR | 1.026 (1.011–1.041) | <0.001 * |
PLR | 1.005 (1.003–1.007) | <0.001 * |
MPV | 1.564 (1.062–2.303) | 0.023 * |
Postoperative day 4 | ||
NLR | 1.041 (1.016–1.067) | 0.001 * |
PLR | 1.002 (1.000–1.004) | 0.012 * |
MPV | 1.617 (1.099–2.381) | 0.015 * |
Postoperative day 5 | ||
NLR | 1.038 (1.005–1.073) | 0.025 * |
PLR | 1.002 (1.000–1.004) | 0.018 * |
MPV | 1.884 (1.312–2.707) | <0.001 * |
Preoperative | Postoperative Day 2 | Postoperative Day 3 | Postoperative Day 4 | Postoperative Day 5 | ||||||
---|---|---|---|---|---|---|---|---|---|---|
HR (95% CI) | p Value | HR (95% CI) | p Value | HR (95% CI) | p Value | HR (95% CI) | p Value | HR (95% CI) | p Value | |
BMI | 0.897 (0.789–1.021) | 0.099 | 0.968 (0.856–1.094) | 0.600 | 0.978 (0.866–1.105) | 0.719 | 0.961 (0.853–1.083) | 0.516 | 0.948 (0.840–1.069) | 0.384 |
Pre-PCI score | 1.016 (0.980–1.054) | 0.375 | 1.017 (0.981–1.055) | 0.359 | 1.015 (0.977–1.054) | 0.436 | 1.025 (0.987–1.064) | 0.204 | 1.029 (0.993–1.066) | 0.113 |
pRBC, n | 1.180 (0.952–1.463) | 0.130 | 1.216 (0.968–1.528) | 0.092 | 1.192 (0.970–1.466) | 0.095 | 1.112 (0.899–1.376) | 0.326 | 1.194 (0.958–1.489) | 0.115 |
NLR | 1.250 (1.118–1.398) | <0.001 * | 0.983 (0.944–1.024) | 0.420 | 0.977 (0.953–1.002) | 0.071 | 0.992 (0.954–1.032) | 0.705 | 0.958 (0.906–1.013) | 0.135 |
PLR | 1.001 (0.998–1.004) | 0.482 | 1.004 (1.002–1.007) | 0.001 * | 1.005 (1.003–1.008) | <0.001 * | 1.002 (1.000–1.003) | 0.115 | 1.003 (1.001–1.005) | 0.007 * |
MPV | 1.658 (1.071–2.566) | 0.023 * | 1.522 (1.017–2.276) | 0.041 * | 1.820 (1.158–2.859) | 0.009 * | 1.532 (0.978–2.398) | 0.062 | 1.970 (1.298–2.990) | 0.002 * |
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Kim, N.Y.; Chun, D.-H.; Kim, S.Y.; Kim, N.K.; Baik, S.H.; Hong, J.H.; Kim, K.S.; Shin, C.-s. Prognostic Value of Systemic Inflammatory Indices, NLR, PLR, and MPV, for Predicting 1-Year Survival of Patients Undergoing Cytoreductive Surgery with HIPEC. J. Clin. Med. 2019, 8, 589. https://doi.org/10.3390/jcm8050589
Kim NY, Chun D-H, Kim SY, Kim NK, Baik SH, Hong JH, Kim KS, Shin C-s. Prognostic Value of Systemic Inflammatory Indices, NLR, PLR, and MPV, for Predicting 1-Year Survival of Patients Undergoing Cytoreductive Surgery with HIPEC. Journal of Clinical Medicine. 2019; 8(5):589. https://doi.org/10.3390/jcm8050589
Chicago/Turabian StyleKim, Na Young, Duk-Hee Chun, So Yeon Kim, Nam Kyu Kim, Seung Hyuk Baik, Jung Hwa Hong, Kyung Sub Kim, and Cheung-soo Shin. 2019. "Prognostic Value of Systemic Inflammatory Indices, NLR, PLR, and MPV, for Predicting 1-Year Survival of Patients Undergoing Cytoreductive Surgery with HIPEC" Journal of Clinical Medicine 8, no. 5: 589. https://doi.org/10.3390/jcm8050589