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Prognostic biomarkers in metastatic colorectal cancer: delta prognostic nutritional index, delta neutrophil to lymphocyte ratio, and delta platelet to lymphocyte ratio

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Abstract

Background

The aim of this study is to determine the prognostic value of the prognostic nutritional index (PNI), the neutrophil to lymphocyte ratio (NLR), and the platelet to lymphocyte ratio (PLR) and their dynamic changes on survival outcomes in metastatic colorectal cancers (mCRC).

Methods

The data of 199 patients with mCRC were retrospectively analyzed. To evaluate the temporal relation between the PNI, NLR, and PLR values and survival, pre-chemotherapy PNI, NLR, and PLR levels were assessed from peripheral blood cell counts on admission; post-chemotherapy PNI, NLR, and PLR levels were assessed with follow-up blood cell counts within two weeks after chemotherapy; and the difference between pre-chemotherapy PNI, NLR, and PLR levels and post-chemotherapy PNI, NLR, and PLR levels was evaluated as delta PNI, delta NLR, and delta PLR.

Results

The median PNI, PLR, and NLR were 39.01, 150.2 and 2.53 before chemotherapy and 38.2, 146.6, and 3.31 after chemotherapy, respectively. The median OS was 23.7 months (95%CI:17.8–29.7) and 28.9 months (95%CI:24.8–33.08) for pre-chemotherapy PNI level < 39.01 vs. PNI level ≥ 39.01, respectively(p = 0.035) The positive delta PNI was significantly higher for OS than the negative delta PNI(p < 0.009). Delta PLR and delta NLR were not significant for OS and PFS(p > 0.05 for all).

Conclusions

The results of this study clearly show that the negative delta PNI to be an independent predictor of poor OS and poor PFS in patients with colon cancer who received first line treatment. In addition, delta NLR and delta PLR were shown not to predict survival outcomes.

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Data availability

The data presented in this study can be obtained from the corresponding author.

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Authors and Affiliations

  1. Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey

    Mehmet Zahid Kocak, Murat Araz, Melek Karakurt Eryilmaz & Mehmet Artac

  2. Department of Internal Medicine, Necmettin Erbakan University, Konya, Turkey

    Seda Coban

Authors
  1. Mehmet Zahid Kocak
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  2. Seda Coban
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  3. Murat Araz
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  4. Melek Karakurt Eryilmaz
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Contributions

MA, MZK; design and the conduct of the study. MZK, SC; data colection. MZK, MKE; wrote manuscript text. MA, MA; Performed statistical analysis. MA, MZK; Performed final review and correction. All authors reviewed the manuscript.

Corresponding author

Correspondence to Mehmet Zahid Kocak.

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Ethical approval

This study was approved by Necmettin Erbakan University Research Ethics Committee (Approval no: 2022/3932).

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Informed consent was not obtained due to the retrospective design of the study.

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The authors report there are no competing interests to declare.

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Kocak, M.Z., Coban, S., Araz, M. et al. Prognostic biomarkers in metastatic colorectal cancer: delta prognostic nutritional index, delta neutrophil to lymphocyte ratio, and delta platelet to lymphocyte ratio. Support Care Cancer 31, 357 (2023). https://doi.org/10.1007/s00520-023-07829-w

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