Prognostic Value of Systemic Inflammatory Indices, NLR, PLR, and MPV, for Predicting 1-Year Survival of Patients Undergoing Cytoreductive Surgery with HIPEC

Abstract

The neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and mean platelet volume (MPV) have been reported to be associated with the prognosis of various types of tumors. This study evaluated the prognostic value and clinical use of inflammatory markers for predicting 1-year survival in patients undergoing cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). This retrospective study included 160 patients who underwent CRS with HIPEC between July 2014 and April 2017. Data on NLR, PLR, and MPV were collected preoperatively and on postoperative days (POD) 1, 2, 3, 4, and 5. In a multivariate analysis using a cox proportional hazard regression model, higher values of preoperative NLR and MPV, PLR, and MPV on POD 2, 3, and 5 were associated with reduced 1-year survival after CRS with HIPEC. Patients with increased MPV showed lower rates of 1-year survival following CRS with HIPEC. In addition, elevated preoperative NLR and postoperative PLR were correlated with poor survival. These markers are able to stratify patients by risk profile, which may ultimately improve perioperative management and be helpful in improving outcomes following CRS with HIPEC.