The SENECA study: Prognostic role of serum biomarkers in older patients with metastatic colorectal cancer

Camilla Lisanti, Debora Basile, Annamaria Parnofiello, Elisa Bertoli, Victoria Josephine Andreotti, Silvio Ken Garattini, Michele Bartoletti, Monica Cattaneo, Paola Di Nardo, Marta Bonotto, Mariaelena Casagrande, Lucia Da Ros, Marika Cinausero, Luisa Foltran, Nicoletta Pella, Angela Buonadonna, Giuseppe Aprile, Gianpiero Fasola, Fabio Puglisi

Research output: Contribution to journalArticlepeer-review


Background: Aging induces meaningful changes in the immune system and inflammation response with increase in monocyte-lymphocyte ratio (MLR) and serum lactate dehydrogenase (LDH) levels. Aim of this study was to explore the prognostic role of MLR and LDH levels in older patients (pts) with metastatic colorectal cancer (mCRC). Methods: We conducted a retrospective analysis of a consecutive cohort of 168 older (>70 years) patients with mCRC. The prognostic impact of MLR and LDH levels on overall survival (OS) was investigated through uni-and multivariate Cox regression analyses. Moreover, we categorized patients into three groups according to MLR and LDH levels (group 1: MLR-low and LDH-low; group 2: MLR-high or LDH-high; group 3: MLR-high and LDH-high). Results: By univariate analysis, high LDH level (HR 1.74, 95% CI 1.05–2.90) and high MLR level (HR 2.19, 95% CI 1.48–3.44) were significantly associated with a worse OS. Conversely, primary tumor resection and left-sidedness were significantly associated with a longer OS. By multivariate analysis, high LDH level (HR 2.00, 95% CI 1.13–3.55) and high MLR level (HR 2.99, 95% CI 1.68–5.33) were independent prognostic factors of worse prognosis. Compared to group 1, a shorter survival was reported for patients included in group 2 (HR 1.97, 95% CI 1.21–3.23 in univariate; HR 2.54, 95% CI 1.43–4.51 in multivariate) or in group 3 (HR 2.42, 95% CI 24–4.74, p =.010 in univariate; HR 5.59, 95% CI 2.15-14.54 in multivariate) Conclusions: High baseline levels of LDH, MLR or both are independent unfavorable prognostic factors in older patients treated with first-line chemotherapy for mCRC.

Original languageEnglish
Pages (from-to)1268-1273
Number of pages6
JournalJournal of Geriatric Oncology
Issue number8
Publication statusPublished - Nov 2020


  • Immune biomarkers
  • LDH
  • Metastatic colorectal cancer
  • MLR
  • Older patients with cancer

ASJC Scopus subject areas

  • Oncology
  • Geriatrics and Gerontology


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