# Biomarkers of Survival in Patients with Colorectal Liver Metastases Treated with Percutaneous Microwave Ablation

## TL;DR

This study identifies blood-based biomarkers that predict survival in patients with colorectal liver metastases treated with microwave ablation.

## Contribution

The study is the first to evaluate the prognostic value of biomarkers in patients undergoing microwave ablation for colorectal liver metastases.

## Key findings

- Higher CEA and LMR levels were linked to worse survival in patients.
- Higher NLR levels and left-sided primary colon cancer were positive prognostic factors.
- Multivariable analysis confirmed most findings except for LMR significance.

## Abstract

According to international guidelines, thermal ablation and surgery are the two main radical treatment possibilities for colorectal liver metastases. The aim of this study was to assess the prognostic value of simple laboratory-based biomarkers in patients undergoing microwave ablation for colorectal liver metastases. In a cohort of 57 patients, with a mean follow-up time of 30.9 months, higher levels of carcinoembryonic antigen and lymphocyte-to-monocyte ratio were linked to worse survival, while higher neutrophil-to-lymphocyte ratio levels and left-sided primary colon cancer were positive prognostic factors. A multivariable analysis confirmed most of the findings, except the lymphocyte-to-monocyte ratio’s significance.

Background/Objectives: To evaluate the prognostic value of easily obtainable biomarkers for patients undergoing percutaneous microwave ablation (MWA) for colorectal liver metastases (CLMs). Prior studies showed that simple biomarkers, such as the lymphocyte-to-monocyte ratio (LMR), albumin-to-globulin ratio (AGR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR), as well as cancer-specific markers, like carcinoembryonic antigen (CEA), might have a prognostic role in various malignancies; however, none of these were assessed in patients undergoing MWA for CLMs. Methods: Based on the simple laboratory results, which were determined prior to the ablation, several biomarkers, including the LMR, AGR, PLR, and NLR, were calculated. The log-rank test’s optimal cutoff points for continuous variables were determined. Subsequently, univariable and multivariable Cox regression models were utilized to determine the association between various features and overall survival (OS). Results: This study included 57 CLM patients with a mean age of 63 ± 12.5 years at the time of ablation with a mean follow up of 30.9 months. The univariable model demonstrated that a high level of CEA (cutoff: 29.1 ng/mL; HR: 3.70) and a high LMR (cutoff: 5.32; HR: 4.05) were related to worse OS, whereas a high NLR (cutoff: 2.05; HR: 0.31) and primary left-sided colon cancer (HR: 0.36) were positive prognostic factors. The multivariable regression model confirmed these findings, with the exception of the LMR, which was no longer significantly associated with OS. Conclusions: This study demonstrates the feasibility of overall survival prediction and thus patient stratification based on easily obtainable biomarkers and clinicopathological features in CLM patients undergoing MWA.