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The MIMIC Study: Prognostic Role and Cutoff Definition of Monocyte-to-Lymphocyte Ratio and Lactate Dehydrogenase Levels in Metastatic Colorectal Cancer
- Source :
- Oncologist
- Publication Year :
- 2020
- Publisher :
- Oxford University Press (OUP), 2020.
-
Abstract
- Background Monocyte-to-lymphocyte ratio (MLR) and lactate dehydrogenase (LDH) levels are circulating biomarkers that provide information about tumor-related inflammation and immune suppression. This study aimed to evaluate the prognostic role of MLR and LDH in metastatic colorectal cancer (mCRC). Material and Methods This multicentric study analyzed a consecutive cohort of 528 patients with mCRC treated in 2009–2017. The whole population was randomly divided in training and validation cohort. The first was used to identify a threshold for MLR and to create the prognostic model with MLR and MLR-LDH combined (group 1: MLR-LDH low; group 2: MLR or LDH high; group 3: MLR-LDH high). The second cohort was used to validate the model. Results At the median follow-up of 55 months, median overall survival (OS) was 22 months. By multivariate analysis, high MLR >0.49 (hazard ratio [HR], 2.37; 95% confidence interval [C.I.], 1.39–4.04), high LDH (HR, 1.73; 95% C.I., 1.03–2.90) in the first model, group 2 (HR, 2.74; 95% C.I.; 1.62–4.66), and group 3 (HR, 3.73; 95% C.I., 1.94–7.18) in the combined model, had a worse prognosis in terms of OS. These data were confirmed both in the validation set and then in the whole cohort. Conclusion MLR and LDH are circulating cost-effective biomarkers, readily available in clinical practice, that can be useful for predicting the prognosis of patients with mCRC. Implications for Practice High monocyte-to-lymphocyte ratio (MLR) and lactate dehydrogenase (LDH) levels could be a sign of a tumor's recruitment of suppressive and inflammatory cells worsening prognosis of different types of cancer, including colorectal cancer (CRC). Currently, no data are available for metastatic CRC regarding a cutoff definition for MLR or the prognostic impact of MLR and MLR-LDH combined. The present study showed in the training cohort and confirmed in the validation and whole cohort that MLR is a reliable and independent laboratory biomarker, which is easy to use, to predict clinical outcomes in patients with mCRC. Moreover, MLR and composite MLR-LDH could potentially result in an incremental improvement in the prognostic value of these biomarkers, being used as stratification tools for patients with mCRC.
- Subjects :
- 0301 basic medicine
Oncology
Cancer Research
medicine.medical_specialty
Circulating biomarkers
LDH
Neutrophils
Colorectal cancer
Population
chemical and pharmacologic phenomena
Monocytes
MLR
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Internal medicine
Lactate dehydrogenase
Gastrointestinal Cancer
Humans
Medicine
Lymphocytes
education
Lactate Dehydrogenases
Retrospective Studies
education.field_of_study
Metastatic colorectal cancer
business.industry
fungi
Hazard ratio
Cancer
hemic and immune systems
Prognosis
medicine.disease
Confidence interval
Immune biomarkers
030104 developmental biology
chemistry
030220 oncology & carcinogenesis
Colonic Neoplasms
Cohort
Biomarker (medicine)
Colorectal Neoplasms
business
Subjects
Details
- ISSN :
- 1549490X and 10837159
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- The Oncologist
- Accession number :
- edsair.doi.dedup.....4379781846d0bb57bdd94b8c1c9ac675