ArticleUpdates in surgery2026
Systemic inflammation and liver fibrosis as predictors of surgical outcomes in colorectal cancer liver metastasis: a biomarker-based survival study.
Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundColorectal cancer liver metastasis remains a significant challenge, with systemic inflammation and liver fibrosis emerging as key prognostic factors. This study evaluates the individual and combined prognostic significance of the Systemic Inflammation Index and Fibrosis-4 index in CRLM patients undergoing curative liver resection after neoadjuvant chemotherapy.
methodsA retrospective cohort of 255 CRLM patients was stratified into high/low SII and FIB-4 groups based on median values. SII and FIB-4 were calculated using preoperative laboratory data. Primary outcomes included overall survival (OS) and disease-free survival (DFS), with secondary outcomes assessing postoperative complications and recurrence. Kaplan-Meier analysis and Cox regression were used for survival analysis.
resultsHigher SII levels were associated with worse DFS (HR = 0.67, p = 0.028). Similarly, higher FIB-4 levels correlated with increased recurrence rates (p = 0.03) and poorer DFS (HR = 0.69, p = 0.047). For Overall Survival (OS), no significant difference was observed between the High SII and Low SII groups, nor between the High FIB-4 and Low FIB-4 groups. The Low FIB-4 & Low SII group showed significantly better DFS (HR = 0.47, p = 0.048). In terms of postoperative outcomes, the FIB-4 Low group had more transfusions and incision infections. Additionally, the SII High group had higher recurrence rates and more R1 resections (p = 0.045).
conclusionSII and FIB-4 are valuable biomarkers for predicting DFS and recurrence in CRLM patients. Their combined use enhances risk stratification, offering a comprehensive approach to guide personalized treatment strategies. Future studies should explore targeted therapies to modulate inflammation and fibrosis, improving outcomes for high-risk patients.
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