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The following is a summary of “Prognostic importance of the neutrophil-to-lymphocyte ratio in malignant peritoneal mesothelioma patients receiving cytoreductive surgery and hyperthermic intraperitoneal chemotherapy,” published in the February 2025 issue of BMC Cancer by Xinjing et al.

Malignant peritoneal mesothelioma (MPM) is a rare but aggressive malignancy, with cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) being the preferred treatment strategy for selected patients. This study aimed to comprehensively evaluate the therapeutic impact of CRS-HIPEC and identify key prognostic factors, with a particular focus on the neutrophil-to-lymphocyte ratio (NLR). A retrospective analysis was conducted on patients with MPM who underwent CRS followed by HIPEC and adjuvant chemotherapy. Baseline clinical and pathological characteristics were collected, and univariate analysis was performed to determine significant prognostic factors. 

Kaplan-Meier survival analysis was used to estimate cumulative survival probabilities, while univariate Cox regression was employed to assess the correlation between prognostic variables, including NLR, and overall survival. A multivariate Cox proportional hazards model further examined predictive factors that demonstrated significance in univariate analysis. HRs and 95% CIs were calculated to quantify the association between survival outcomes and identified predictors. A total of 64 patients were included in the study, with observed 1-, 3-, and 5-year survival rates of 70.3%, 65.6%, and 59.4%, respectively. Multivariate Cox analysis revealed that post-operative NLR (HR: 0.180, 95% CI: 0.067–0.531), Ki-67 expression (HR: 0.184, 95% CI: 0.024–0.817), post-operative neutrophil count (HR: 0.228, 95% CI: 0.075–0.696), and bidirectional pathological type (HR: 0.375, 95% CI: 0.146–0.964) were significantly associated with patient survival. 

These findings suggest that NLR serves as a critical prognostic biomarker in patients undergoing CRS-HIPEC treatment, underscoring its potential utility in risk stratification and clinical decision-making.

Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-025-13606-1