World Journal of Surgery

, Volume 43, Issue 5, pp 1351–1359 | Cite as

Preoperative Leucocyte-Based Inflammatory Scores in Patients with Colorectal Liver Metastases: Can We Count on Them?

  • Aurélien DupréEmail author
  • Robert P. Jones
  • Rafael Diaz-Nieto
  • Stephen W. Fenwick
  • Graeme J. Poston
  • Hassan Z. Malik
Original Scientific Report



Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) have been identified as potential prognostic factors for overall survival (OS) in primary colorectal cancer, and there is a growing interest in their use in colorectal liver metastases (CLMs). However, optimal cut-off values for these ratios have not been defined by making comparison between series difficult. This study aimed to confirm the prognostic value of inflammatory scores in patients undergoing resection for CLM.


We retrospectively analysed data from 376 consecutive patients who underwent liver surgery for CLM between June 2010 and August 2015. We assessed the reproducibility of previously published ratios and determined new cut-off values using the Cut-off Finder web-based tool. Relations between cut-off values and OS were analysed with Kaplan–Meier log-rank survival analysis and multivariate Cox models.


Three hundred and forty-three patients had full preoperative blood tests for calculation of NLR, PLR and LMR. The number of cut-off values which showed a significant discrimination for OS was 49/249 (19.7%) for NLR, 28/316 (8.9%) for PLR and 22/214 (10.3%) for LMR, all with a scattered nonlinear distribution.


This study showed that inflammatory scores expressed as ratios do not seem to be consistently reliable prognostic markers in patients with resectable CLM.



Dr. Aurélien Dupré is the recipient of a grant from the European Society of Surgical Oncology (ESSO) and from the Nuovo-Soldati foundation.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

268_2019_4914_MOESM1_ESM.docx (119 kb)
Supplementary material 1 (DOCX 119 kb)
268_2019_4914_MOESM2_ESM.docx (83 kb)
Supplementary material 2 (DOCX 82 kb)


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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  1. 1.Liverpool Hepatobiliary CentreAintree University HospitalLiverpoolUK
  2. 2.Department of Surgical OncologyCentre Léon BérardLyonFrance
  3. 3.Institute of Translational Medicine, School of Cancer StudiesUniversity of LiverpoolLiverpoolUK

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