AUTHOR=Deme Daniel , Kovacs Sandor , Telekes Andras 

TITLE=Overall Survival Prediction of Advanced Cancer Patients by Selection of the Most Significant Baseline Serum Biomarker Combination

JOURNAL=Pathology and Oncology Research

VOLUME=Volume 28 - 2022

YEAR=2022

URL=https://www.por-journal.com/journals/pathology-and-oncology-research/articles/10.3389/pore.2022.1610004

DOI=10.3389/pore.2022.1610004

ISSN=1532-2807

ABSTRACT=INTRODUCTION: Consistent association between elevated baseline serum values each of the C-reactive protein (CRP), cross linked fibrin degradation products (D-dimer), lactate dehydrogenase (LDH), decreased baseline serum albumin, absolute lymphocyte count to absolute monocyte count ratio (LMR), elevated absolute neutrophil count to absolute lymphocyte count ratio (NLR), elevated platelet count to absolute lymphocyte count ratio (PLR), furthermore between some combinations of these biomarkers and the short overall survival of patients with malignant diseases has already been reported. These biomarkers are independent prognostic factors for cancer. Here, the most significant biomarker combination of these values was searched and studied in real-life advanced cancer patients of a single center.
METHODS: The authors retrospectively analyzed the association of the aformentioned biomarkers and their combination and OS of 75 consecutive cancer patients with locally advanced, recurrent or metastatic diseases. Validated cut-off determination was used.
RESULTS: CRP, albumin and PLR showed marked association with OS. Cut-off values for significant shorter OS were 30.65 mg/L (p < 0.001), 44.35 g/L (p < 0.001) and 168.20 (p < 0.001), respectively. Based on assessed biomarker cut-offs, four patient groups were created whether biomarker values are out of range (ORV) compared to cut-off: (1) No ORV biomarkers (n = 24; OS = 26.07 months); (2) One ORV biomarker (n = 21; OS =  13.50 months); (3) Two ORV biomarkers (n = 20; OS = 7.97 months) and (4) Three ORV biomarkers (n = 10; OS = 3.91 months). Significant differences in OS were detected between the groups: for 1. vs. 2. hazard ratio (HR) = 3.0 (95% CI: 1.5 – 6.2), p = 0.003; for 1. vs. 3. HR = 4.1 (95% CI: 2.0 – 8.3), p < 0.001; for 1 vs. 4. HR = 10.2 (95% CI: 4.2 – 24.6), p < 0.001.
CONCLUSIONS: Based on our analyzis we can confirm, that the complex monitoring of CRP, albumin and PLR would provide a good estimation of OS. Large scale prospective studies are warranted to explore this and other useful combination of prognostic biomarkers and their relationship to the well-established prognostic systems in real-life.