Prognostic value of advanced lung cancer inflammation index in patients with colorectal cancer liver metastases undergoing surgery

Abstract

INTRODUCTION: Recently, a new inflammatory marker, the advanced lung cancer inflammation index (ALI), was reported as a prognostic marker in patients with several cancers. We aimed to investigate the prognostic value of ALI in patients with colorectal cancer liver metastases (CLM) undergoing surgery. METHODS: From June 2009 to June 2018, 141 patients underwent a surgery for CLM at Ajou University Hospital, of whom 132 without extrahepatic metastases, systemic inflammatory diseases, or immune system diseases were enrolled in this study. The ALI was calculated using the following formula: ALI = body mass index x serum albumin/neutrophil-to-lymphocyte ratio. The patients were divided into high (n = 32) and low (n = 100) ALI groups according to the preoperative optimal cutoff value of 70.40 that was determined by X-tile software. RESULTS: Patients with low ALI had a significantly worse overall survival (OS) compared to the high ALI group (p = 0.010). Multivariate analysis showed that ALI and carcinoembryonic antigen (CEA) were independently associated with OS (p = 0.009 and p = 0.042, respectively). Among the patients with CEA >5 ng/mL, the low ALI group had a significantly worse OS compared to the high ALI group (p = 0.013). CONCLUSION: Preoperative ALI was a prognostic factor in patients with CLM undergoing surgery. In particular, the prognostic impact of ALI was more prominent in the patients with CEA >5 ng/mL.