Abstract
To assess the clinical outcome and prognostic factors of patients receiving Y90 radioembolization to treat colorectal liver metastases. Multi-institution retrospective study of patients with CRLM who received Y-90 radioembolization after undergoing molecular testing was performed. Patients treated between 2008 and 2019 were included from 7 institutions within the United States and Europe. Patient demographics, systemic therapy regimens, tumor characteristics, laboratory values and overall survival were analyzed between patients with differing histopathologic and genomic status. Neutrophil-Lymphocyte Ratio was calculated using pretreatment lab values. Kaplan-Meier survival estimation and multivariate Cox regression were analyzed. 445 patients treated with Y90 radioembolization fulfilled the inclusion criteria. Of the total cohort, those available patients who had documented pre-Y90 lab values available within 30 days prior to treatment were evaluated. Average age at diagnosis was found to be 59.9 years for all patients (59.4% female, 40.6% male). Decreased survival post Y90 treatment was shown in those patients with elevated Neutrophil-to-lymphocyte ratio (> 2.0). The median survival in patients with elevated NLR was 7.5 months, as compared to 11.5 months in those patients with normal NLR pretreatment (P = 0.02). Patient demographics including age, gender and race were not shown to be significant in overall survival post-Y90 treatment (P values >0.05). The average number of systemic chemotherapy treatments prior to Y90 was 2.15 and was similar between NLR subgroups (elevated vs. normal). NLR persisted as a significant predictor of survival on multivariate analysis (p = 0.038; HR 1.68 CI: 1.03-2.86.) Pretreatment neutrophil-to-lymphocyte ratio is a significant prognostic factor in patients with colorectal liver metastases receiving Y90 radioembolization.
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