Inflammation scores predict the survival of patients with hepatocellular carcinoma who were treated with transarterial chemoembolization and recombinant human type-5 adenovirus H101

Abstract

BackgroundThe systemic inflammatory response plays an important role in cancer development and progression. An original inflammation-based staging system for predicting survival in patients undergoing transarterial chemoembolization (TACE) combined with recombinant human type-5 adenovirus H101 is not available. This study aimed to validate the prognostic value of inflammation scores for patients with hepatocellular carcinoma (HCC) who were treated with TACE combined with H101.MethodsThe data from 216 patients with HCC who underwent TACE combined with H101 from January 2007 to July 2015 were retrospectively collected, and the association of the inflammation scores with overall survival (OS) was analyzed. Univariate and multivariate analyses were performed to identify variables associated with OS. The prognostic value of the inflammation scores, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil/ platelet-to-lymphocyte ratio (NLR-PLR), modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI), prognostic index (PI), tumor-node-metastasis (TNM), Barcelona Clinic Liver Cancer (BCLC) and Cancer of the Liver Italian Program (CLIP) staging systems were analyzed and compared using the areas under the receiver operating characteristic curves (AUROCs).ResultsThe estimated 1-, 2-, and 3-year OS rates were 61.3%, 44.2%, and 40.5% for the entire study cohort, respectively; the median OS was 17 months. According to the multivariate Cox proportional hazards model, the pretreatment NLR, tumor diameter and pretreatment alpha-fetoprotein (AFP) levels were independent predictors of OS. The CLIP score had superior discriminative abilities compared with other staging systems, and the NLR-PLR score consistently displayed a higher AUROC value than the other inflammation-based prognostic scores. The combination of the NLR-PLR and CLIP scores exhibited a superior prognostic ability for OS compared to the NLR-PLR or CLIP scores alone.ConclusionsThe NLR-PLR score is a more powerful predictive system than the other inflammation-based scores for patients with HCC who were treated with TACE and H101. The predictive ability may be improved by utilizing a combination of the NLR-PLR and CLIP scores.

The Predictive Value of Staging Systems and Inflammation Scores for Patients with Combined Hepatocellular Cholangiocarcinoma After Surgical Resection: a Retrospective Study

“…The HBV-positive rate of patients in the present study was similar to that of patients with HCC. 10 It is likely that the high prevalence of HBV in the entire population contributed to the strikingly high rate of HBV-positive patients with cHCC-CC. In addition, imaging or pathological analysis showed that most patients were allocated into the IHD or PHD group in the present study, suggesting that there were more similarities shared by both cHCC-CC and HCC.…”

“…Numerous staging systems, such as the Barcelona Clinic Liver Cancer (BCLC) staging score, Cancer of the Liver Italian Program (CLIP) score, and Okuda staging system, have been developed for HCC. [7][8][9][10] Moreover, there are specific tumor-node-metastasis (TNM) staging systems for HCC (HCC-TNM) and ICC (ICC-TNM) according to the 2010 World Health Organization (WHO) classification, 1 while the staging system for cHCC-CC is undefined and controversial. The characteristics of patients with cHCC-CC might substantially differ from those of patients with HCC or ICC.…”

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

“…Recently, several studies have reported that the systemic inflammatory responses were associated closely with the prognosis of liver cancer . Chronic inflammation was found to be an important prognostic factor even at an early stage of cancer progression.…”

“…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.…”

“…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). 4,[6][7][8][9]11,12, However, fallaciously, their results still remained inconsistent, with several studies drawing inverse conclusions. For example, the association between the inflammatory scores NLR, PLR, and inflammation-based index (IBI) at various time points was failed to demonstrate in the study of Parisi et al 13 Therefore, we designed a meta-analysis based on relevant studies to analyze and evaluate the prognostic role of pretreatment NLR in patients with liver cancer.…”