Blood Neutrophil-to-Lymphocyte Ratio Predicts Tumor Recurrence in Patients with Hepatocellular Carcinoma within Milan Criteria after Hepatectomy

Abstract

PurposeThe systemic inflammation biomarker, Neutrophil-to-Lymphocyte Ratio (NLR), has been reported as one of the adverse prognostic factors for hepatocellular carcinoma (HCC) patient. The purpose of this study was to evaluate whether NLR could predict the risk of recurrence and death for the HCC patient, according to Milan criteria after hepatectomy.Materials and MethodsRetrospective analysis was performed on a database of HCC patients who underwent hepatectomy between March 2001 and December 2011. The cutoff value of NLR was decided by receiver operating characteristic (ROC) curve analysis. Univariate and multivariate regression analyses were performed to identify predictive factors of recurrence and death.ResultsA total of 213 patients were included in the present study. The median follow-up period was 48 months. One hundred and seven patients were experienced tumor recurrence; forty of them recurred within 12 months (early recurrence). NLR ≥1.505, albumin ≤3.75 g/dL, microvascular invasion and high grade of cirrhosis were found to be independent factors for adverse recurrence-free survival in multivariate regression analysis. And NLR ≥1.945 was also found as a prognosis factor for early recurrence by univariate regression analysis.ConclusionElevated preoperative NLR can be easily obtained and reliable biomarker for assessing the tumor recurrence and early recurrence of Milan criteria HCC after the initial hepatectomy.

Preoperative neutrophil-lymphocyte ratio predicts the risk of microvascular invasion in hepatocellular carcinoma: A meta-analysis

“…Finally, we identified 15 studies, all published between 2008 and 2018, which met the inclusion criteria. [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Of the 15 studies, 12 were retrospective cohort studies 16-22, 24-27, 29 and three were case-control studies 23,28,30 (Table S2). Among the 12 cohort studies, nine were from China, one from England, one from Korea and one from Thailand.…”

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

“…Patients in 18 studies received liver resection; 13 studies were about liver transplantation patients; nine studies researched patients receiving TACE; four studies were about radiofrequency ablation; and four about multiple treatments. In addition, three studies data were extracted from three same studies, which were asterisked after their study names in the tables or figures of our article …”

“…In addition, three studies data were extracted from three same studies, which were asterisked after their study names in the tables or figures of our article. 11,28,47 The detail search process and summary of studies features were shown in study flow diagram ( Figure 1) and Table 1.…”

“…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.…”

Neutrophil-to-lymphocyte ratio predicts diagnosis and prognosis of patients with hepatocellular: A systematic review and meta-analysis

“…For quality assessment of included study, baseline data of these studies were extracted and exhibited in Table 1. Regions of these 9 studies were all from East Asian with 7 from mainland China [34][35][36][37][38][39][40], 1 from Korea [41] and 1 from Taiwan [42]. All these studies were single-center trials published from 2012 to 2018.…”