Lymphocyte-to-C-reactive protein ratio predicts prognosis in patients with colorectal liver metastases after hepatic resection: a retrospective study

Background: Preoperative systemic inflammation has been reported to predict survival in patients with various cancers. Especially for colorectal liver metastasis (CRLM), the prognosis is poor despite therapeutic advances in the field. Here we aimed to evaluate the prognostic role of lymphocyte-to-C-reactive protein (CRP) ratio (LCR) in patients with CRLM after hepatic resection. Methods: This retrospective study included 104 patients who underwent hepatic resection for CRLM over a period of 11 years, from October 2010 and October 2021, at the National Hospital Organization Fukuyama Medical Center, Hiroshima, Japan. The association between clinicopathological variables, including various inflammation biomarkers [LCR, platelet-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), CRP-to-albumin ratio (CAR), and prognostic nutritional index (PNI)], and overall survival of the patients was investigated using univariate and multivariate analyses. Results: The optimal cut-off values of each biomarker by receiver operating characteristic analysis were as follows: LCR, 12,720; PLR, 150; NLR, 4; CAR, 0.023; and PNI, 44.8. The 1, 3, and 5 year overall survival rates were 97.0%, 71.3%, and 56.8%, respectively. In the univariate analysis, LCR < 12,720, PLR < 0.14, body mass index < 24, carbohydrate antigen 19-9 ≥ 37 U/ml, multiple tumors, and the largest hepatic tumor ≥ 5 cm were significant predictive factors. The multivariate analysis revealed that LCR < 12,720 [hazard ratio (HR): 2.156, 95% confidence interval (CI): 1.060–4.509, p = 0.034] and multiple tumors (HR: 2.336, 95% CI: 1.125–4.925, p = 0.023) were independent predictors of overall survival, whereas other inflammation biomarkers including NLR, PLR, CAR and PNI were not significant. Conclusions: Thus, LCR could be an independent prognostic predictor in patients with CRLM after hepatic resection. Therefore, the assessment of LCR as a biomarker will help in the planning of treatment strategy including surgery and adjuvant therapies.