(P 055) PROGNOSTIC VALUE AND USEFULNESS OF HAEMATOLOGICAL BIOMARKERS IN LIPOSARCOMAS.

Objective: Soft tissues sarcomas (STS) are a heterogeneous group of tumors that represent 1% of all cancers. STS have low incidence, high recurrence rates and they suppose 2% of cancer deaths. Liposarcomas (LPS) are the most frequent histological subtype.
There is no doubt that the identification of prognostic factors to guide decisions about treatment and surveillance in these patients could improve oncological outcomes.
In this sense, several clinical factors associated with survival have been reported in this type of tumors, such as size, depth, location, grade or resection margins. However, these markers are only available after surgery and their measurement can be complex.
In recent years, the growing interest in blood biomarkers in oncological disease has shown that they can be useful as prognostic factors in various types of tumors and even in sarcomas. The evaluation of serum inflammatory markers is an easy and relatively cost-effective method in daily clinical practice, which can be performed routinely as an additional prognostic indicator of overall survival, and may offer the opportunity to improve prognosis by adding strategies more effective therapy and/or follow-up.
However, their prognostic role in the most frequent histological STS subtype is still unstudied.
The aim of our study was:
1. Calculate serological indicators and immuno-inflammatory indices in patients diagnosed with LPS.
2. Establish cut-off points for these indices that are related to histological type, disease-specific survival (DSS), disease-free survival (DFS), and disease-specific survival after first recurrence (DSSR).
3. Determine if these indices have prognostic value.

Methods: We designed a retro- and prospective single-center study that included patients diagnosed with liposarcomas of any location between January 2004 and January 2022 at the Department of Mesenchymal Tumors-Sarcomas, “La Arrixaca” Clinical University Hospital. Follow up was performed until March 2022. All patients were included in the follow-up program of the Department of Mesenchymal Tumors-Sarcomas, “La Arrixaca” Clinical University Hospital, providing follow-up examinations in regular intervals (3 month intervals in years 1–3, 6 months intervals in years 4–5 and 12 month intervals in years 6–15 after diagnosis).
The laboratory data, including pre-operative plasma neutrophil, monocyte, platelet, lymphocyte and leukocyte count were obtained by pre-operative determination 28 days before any treatment was performed. Follow-up investigations included clinical check-up and radiological analyses (computed tomography alternating with X-ray of the chest, local magnetic resonance imaging, and abdominal ultrasound). Clinico-pathological data including histopathological diagnosis and tumor grade were retrospectively obtained from the patient's history. For the present study, all histological specimens were centrally reviewed by an independent experienced soft tissue pathologist. All sarcomas were diagnosed according to the current WHO classification of soft tissue and bone tumors.
All statistical analyses were performed using the Statistical Package for Social Sciences version 22.0 (SPSS Inc., Chicago, IL, USA). We performed a descriptive analysis, followed by the calculation of cut-off points using ROC curves. Patients' clinical endpoints were calculated using Kaplan–Meier curves and compared by the log-rank test. A two-sided p < 0.05 was considered statistically significant.

Results: A total of 135 patients were included, 68.1% men, mean age of 56.03 years (SD 16.15). Serological variables (albumin, CRP, hemoglobin and leukocytes) and immuno-inflammatory indices (PLR, LMR, PMR, NLR, dNLR, IBS, PNI, GNRI) were analyzed. After performing the ROC (Receiver Operating Characteristic) curves, the optimal cut-off points were obtained for disease-specific survival (DSS), disease-free survival (DFS) and disease-specific survival after first recurrence (DSSR) of the different variables.
Patients with a liposarcoma greater than 17.5 cm in size (HR 6.06; 95% CI 2.231 – 16.277; p < 0.001), a CRP greater than 4.115 mg/dL (HR 11.957; 95% CI 1.235 – 115.81; p = 0.032), a NLR greater than 3.89 (HR 5.435; 95% CI 1951 – 15.147; p = 0.001), a PLR greater than 150.46 (HR 7.771; 95% CI 2.203 – 27.409; p = 0.001), an SII greater than 668.98 (HR 6.997; 95% CI 1.972 – 24.828; p = 0.003) and a grade 2 of the ACBS index (HR 17.691; 95% CI 1.727 – 181.204; p = 0.016) have a higher risk of dying from causes related to the tumor.

Conclusion: There are independent prognostic immuno-inflammatory indices for patients diagnosed with liposarcomas in terms of DSS, DFS and DSSR. PCR, NLR and GPS are the most relevant.

Table X.pdf