Influence of Biomarkers on Mortality among Patients with Hepatic Metastasis of Colorectal Cancer Treated with FOLFOX/CAPOX and FOLFIRI/CAPIRI, Including Anti-EGFR and Anti-VEGF Therapies

Medicina (Kaunas). 2024 Jun 19;60(6):1003. doi: 10.3390/medicina60061003.

Abstract

Background and objectives: Colorectal cancer is a major global health concern, with a significant increase in morbidity and mortality rates associated with metastatic stages. This study investigates the prognostic significance of various clinical and laboratory parameters in patients with metastatic CRC. Materials and Methods: A retrospective cohort of 188 CRC patients with hepatic metastasis from the OncoHelp Association in Timisoara was analyzed from January 2016 to March 2023. Data on demographics, clinical characteristics, and biomarkers, such as lymphocyte counts, as well as various inflammation indices, were examined. Statistical analyses included univariate and multivariate logistic regression, Kaplan-Meier survival analysis, and ROC curve assessments. Results: Our findings indicate significant associations between survival outcomes and several biomarkers. Higher BMI and lymphocyte counts were linked with better survival rates, while higher values of Neutrophil-Hemoglobin-Lymphocyte (NHL) score, Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and Systemic Immune-Inflammation Index (SII) were predictors of poorer outcomes. Notably, the presence of hepatic metastasis at diagnosis was a critical factor, significantly reducing overall survival. Conclusions: The study has expanded the current understanding of prognostic factors in CRC, advocating for a multi-dimensional approach to prognostic evaluations. This approach should consider not only the traditional metrics such as tumor stage and histological grading but also incorporate a broader spectrum of biomarkers. Future studies should aim to validate these findings and explore the integration of these biomarkers into routine clinical practice, enhancing the precision of prognostic assessments and ultimately guiding more personalized treatment strategies for CRC patients.

Keywords: Body Mass Index (BMI); NHL score; NLR; PLR; ROC curve; SII; biomarkers; colorectal cancer; lymphocytes; patient demographics; survival analysis.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Biomarkers, Tumor / blood
  • Camptothecin / analogs & derivatives
  • Camptothecin / therapeutic use
  • Colorectal Neoplasms* / drug therapy
  • Colorectal Neoplasms* / mortality
  • Colorectal Neoplasms* / pathology
  • ErbB Receptors
  • Female
  • Fluorouracil* / therapeutic use
  • Humans
  • Kaplan-Meier Estimate
  • Leucovorin* / therapeutic use
  • Liver Neoplasms* / drug therapy
  • Liver Neoplasms* / mortality
  • Liver Neoplasms* / secondary
  • Male
  • Middle Aged
  • Organoplatinum Compounds* / therapeutic use
  • Prognosis
  • Retrospective Studies

Substances

  • Fluorouracil
  • Leucovorin
  • Organoplatinum Compounds
  • Camptothecin
  • Biomarkers, Tumor
  • ErbB Receptors

Supplementary concepts

  • IFL protocol
  • Folfox protocol

Grants and funding

This research received no external funding. We would like to thank Victor Babes University of Medicine and Pharmacy Timisoara for their support in covering the publication costs of this research paper.