TY - JOUR
T1 - A prognostic systemic inflammation score (SIS) in patients with advanced intrahepatic cholangiocarcinoma
AU - Maßmann, M.
AU - Treckmann, J.
AU - Markus, P.
AU - Schumacher, B.
AU - Albers, D.
AU - Ting, S.
AU - Mende, B.
AU - Roehrle, J.
AU - Virchow, I.
AU - Rosery, V.
AU - Laue, K.
AU - Zaun, G.
AU - Kostbade, K.
AU - Pogorzelski, M.
AU - Schmid, K. W.
AU - Baba, H.
AU - Siveke, J. T.
AU - Paul, A.
AU - Schildhaus, H. U.
AU - Schuler, M.
AU - Wiesweg, M.
AU - Kasper, S.
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2023/7
Y1 - 2023/7
N2 - Purpose: Systemic-inflammatory response parameters (SIR) are known prognostic markers in different tumour entities, but have not been evaluated in patients with iCCA treated with systemic chemotherapy. Therefore, we evaluated the impact of different SIR markers on the clinical course of patients with advanced iCCA treated at our center. Methods: SIR markers were retrospectively evaluated in 219 patients with iCCA at the West-German-Cancer-Center Essen from 2014 to 2019. Markers included neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), CRP, and the modified Glasgow-Prognostic-Score (mGPS), which were correlated with clinico-pathological findings, response to chemotherapy (ORR), progression-free (PFS) and overall survival (OS) using Kaplan–Meier analyses, and Cox proportional models. Results: Median overall survival (OS) of the entire cohort was 14.8 months (95% CI 11.2–24.4). Median disease-free survival (DFS) in 81 patients undergoing resection was 12.3 months (95% CI 9.7–23.1). The median OS from start of palliative CTX (OSpall) was 10.9 months (95% 9.4–14.6). A combined Systemic Inflammatory Score (SIS) comprising all evaluated SIR markers correlated significantly with ORR, PFS, and OSpall. Patients with a high SIS (≥ 2) vs. SIS 0 had a significantly inferior OSpall (HR 8.7 95% CI 3.71–20.38, p < 0.001). Multivariate analysis including known prognostic markers (ECOG, CA19-9, LDH, and N- and M-status) identified the SIS as an independent prognostic factor. Conclusions: Inflammatory markers associate with inferior survival outcomes in patients with iCCA. A simple SIS may guide treatment decisions in patients treated with systemic chemotherapy.
AB - Purpose: Systemic-inflammatory response parameters (SIR) are known prognostic markers in different tumour entities, but have not been evaluated in patients with iCCA treated with systemic chemotherapy. Therefore, we evaluated the impact of different SIR markers on the clinical course of patients with advanced iCCA treated at our center. Methods: SIR markers were retrospectively evaluated in 219 patients with iCCA at the West-German-Cancer-Center Essen from 2014 to 2019. Markers included neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), CRP, and the modified Glasgow-Prognostic-Score (mGPS), which were correlated with clinico-pathological findings, response to chemotherapy (ORR), progression-free (PFS) and overall survival (OS) using Kaplan–Meier analyses, and Cox proportional models. Results: Median overall survival (OS) of the entire cohort was 14.8 months (95% CI 11.2–24.4). Median disease-free survival (DFS) in 81 patients undergoing resection was 12.3 months (95% CI 9.7–23.1). The median OS from start of palliative CTX (OSpall) was 10.9 months (95% 9.4–14.6). A combined Systemic Inflammatory Score (SIS) comprising all evaluated SIR markers correlated significantly with ORR, PFS, and OSpall. Patients with a high SIS (≥ 2) vs. SIS 0 had a significantly inferior OSpall (HR 8.7 95% CI 3.71–20.38, p < 0.001). Multivariate analysis including known prognostic markers (ECOG, CA19-9, LDH, and N- and M-status) identified the SIS as an independent prognostic factor. Conclusions: Inflammatory markers associate with inferior survival outcomes in patients with iCCA. A simple SIS may guide treatment decisions in patients treated with systemic chemotherapy.
KW - Advanced disease
KW - Chemotherapy
KW - Inflammation
KW - Intrahepatic cholangiocellular carcinoma
KW - Prognosis
KW - Systemic-inflammatory response parameters
UR - http://www.scopus.com/inward/record.url?scp=85141430322&partnerID=8YFLogxK
U2 - 10.1007/s00432-022-04424-0
DO - 10.1007/s00432-022-04424-0
M3 - Article
C2 - 36334155
AN - SCOPUS:85141430322
SN - 0171-5216
VL - 149
SP - 5085
EP - 5094
JO - Journal of Cancer Research and Clinical Oncology
JF - Journal of Cancer Research and Clinical Oncology
IS - 8
ER -
