Neutrophil–lymphocyte ratio as a predictor of outcomes for patients with hepatocellular carcinoma undergoing TAE combined with Sorafenib

Abstract

The aim of this study was to investigate the prognostic significance of blood NLR in patients with intermediate-advanced hepatocellular carcinoma (HCC) who received transcatheter arterial embolization (TAE) combined with Sorafenib. A total of 40 patients with intermediate-advanced HCC from January 1, 2010, through May 31, 2013, treated with concurrent TAE in combination with Sorafenib were admitted to this study in our hospital. Potential prognostic factors, including serum NLR, were analyzed. The pretreatment mean NLR was 3.0; 21 (52.5 %) patients with elevated high NLR (>3.0). The median survival of patients with a high NLR was 14 months (95 % CI 10.1-17.9 months) compared with 26 months (95 % CI 17.4-34.6 months) for patients with a low NLR; a significant difference was found in overall survival (P = 0 0.001). Barcelona Clinical Liver Cancer staging classification and NLR >3.0 were all predictors of poorer over survival. Multivariate analysis showed that high NLR was independent factors associated with worse survival. A high periprocedural NLR independently predicts poor survival in patients with unresectable HCC undergoing TAE combined with Sorafenib.

Prognostic Roles of Blood Inflammatory Markers in Hepatocellular Carcinoma Patients Taking Sorafenib. A Systematic Review and Meta-Analysis

“…Three of them were prospective studies (21, 23, 31) and 16 were retrospective studies. The 194 patients in two studies (22,24) had intermediate-advanced HCC, and 2,551 patients in the remaining studies were in the advanced stage of the disease. Eight studies were conducted in Asia, mainly in China and Japan, 8 studies were conducted in America and Europe, and two were multicentered covering locations in western and eastern countries (17,21).…”

Pre-radiotherapy neutrophil-to-lymphocyte ratio as an independent prognostic factor in patients with locally advanced hepatocellular carcinoma treated with radiotherapy

“…The measurement of the NLR would be helpful in predicting the prognosis of malignant cancers such as gastric [12], lung [13], breast [8], pancreatic [11], and colorectal [9] cancers. In patients with HCC, a prognostic role of the NLR has been investigated after treatments including surgical resection [10, 17], transplantation [14], RFA [16], TACE [18–20], and sorafenib [15]. In addition, a recently reported meta-analysis demonstrated the role of the NLR [26].…”

“…Several studies have shown that the pretreatment neutrophil-to-lymphocyte ratio (NLR) was an independent prognostic factor in patients with HCC treated with surgical resection, transplantation, TACE, radiofrequency ablation (RFA), and sorafenib [10, 14–20]. The NLR is the ratio of the neutrophil count to the lymphocyte count, and is a useful index that reflects systemic inflammatory response in cancer patients [21, 22].…”

The pretreatment neutrophil‐lymphocyte ratio may predict prognosis of patients with liver cancer: A systematic review and meta‐analysis

“…Subgroup analysis was conducted to find the prognostic effects 57 High stability was also found in subgroups of LR, LT, HAIC, and RFA. However, in the subgroup of TACE, sensitivity analysis revealed that several particular studies, He et al, 8 McNally et al, 12 Oh et al, 41 Pinato(T) et al, 45 Wei et al, 53 Xu et al, and Zhang et al, 55,60 significantly affected the pooled effects when the studies were omitted.…”

“…Inflammation markers, such as neutrophil‐lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), modified Glasgow prognostic score (mGPS), and prognostic nutritional index (PNI), have been evaluated for their prognostic value in patients with malignant tumors. Many researches have shown that elevated NLR could predict poor survival in patients with HCC after liver resection (LR), radiofrequency ablation (RFA), transarterial chemoembolization (TACE), and liver transplantation (LT) . However, fallaciously, their results still remained inconsistent, with several studies drawing inverse conclusions.…”