Inflammatory Markers are Associated with Outcome in Patients with Unresectable Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization

McNally, Megan E.; Martı́nez, Antonio; Khabiri, Hooman; G, Guy; Michaels, Anthony; Hanje, James; Kirkpatrick, Robert M.; Bloomston, Mark; Schmidt, Carl

doi:10.1245/s10434-012-2639-1

Cited by 63 publications

(70 citation statements)

References 25 publications

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“…Therefore, 15 studies [24-27,29-39] with 3094 patients which met our inclusion criteria were selected for our meta-analysis finally. Three studies were performed in USA [27,29,38], Japan [24,30,31], China [25,34,37], and UK [32,33,39] , respectively, one in Taiwan [35], Korea [26] and in Italy [36], respectively. Liver transplantation as initial treatment for HCC was reported in 5 studies [27,30,34,36,37].…”

Section: Resultsmentioning

confidence: 99%

“…Liver transplantation as initial treatment for HCC was reported in 5 studies [27,30,34,36,37]. Mixed treatment (including locoregional, systemic treatments or supportive care) [26,31,32] and TACE [29,33,37] were reported in 3 studies, respectively. Surgical resection [24,39] and radiofrequency ablation [25,35] were reported in 2 studies, respectively.…”

Section: Resultsmentioning

confidence: 99%

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Prognostic significance of neutrophil-lymphocyte ratio in hepatocellular carcinoma: a meta-analysis

et al. 2014

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BackgroundsNeutrophil-lymphocyte ratio (NLR) has recently been reported as a predictor of Hepatocellular carcinoma (HCC). However, its prognostic value in HCC still remains controversial. In this study, we aimed to evaluate the association between NLR and clinical outcome of HCC patients by performing meta-analysis.MethodsA comprehensive literature search for relevant studies published up to August 2013 was performed by using PubMed, Ovid, the Cochrane Library and Web of Science databases. Meta-analysis was performed using hazard ratio (HR) or odds ratio (OR) and 95% confidence intervals (95% CIs) as effect measures.ResultsA total of 15 studies encompassing 3094 patients were included in this meta-analysis. Our pooled results showed that high NLR was associated with poor overall survival (OS) and disease free survival (DFS) in HCC initially treated by liver transplantation (HR = 3.42, 95% CI:2.41-4.85,P = 0.000; HR = 5.90, 95% CI:3.99-8.70,P = 0.000, respectively) and surgical resection (HR = 3.33, 95% CI:2.23-4.98, P = 0.000; HR = 2.10, 95% CI: 2.06–2.14, respectively). High NLR was also associated with poor OS in HCC treated by radiofrequency-ablation (HR = 1.28, 95%CI: 1.10-1.48, P = 0.000), TACE (HR = 2.52, 95% CI: 1.64-3.86, P = 0.000) and mixed treatment (HR = 1.85, 95% CI: 1.40-2.44, P = 0.000), respectively. In addition, high NLR was significantly correlated with the presence of vascular invasion (OR = 2.69, 95% CI: 2.01–3.59, P = 0.000), tumor multifocality (OR = 1.74, 95% CI: 1.30–2.34, P = 0.000) and higher incidence of AFP ≥ 400 ng/ml (OR = 1.46, 95% CI: 1.01–2.09, P = 0.04).ConclusionElevated NLR indicates a poor prognosis for patients with HCC. NLR may be a convenient, easily-obtained, low cost and reliable biomarker with prognostic potential for HCC.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Prognostic significance of neutrophil-lymphocyte ratio in hepatocellular carcinoma: a meta-analysis

et al. 2014

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“…Even if the majority of studies evaluate this marker in the preoperative setting, its prognostic value has been associated also with postoperative value, in terms of short-term morbidity and long-term mortality [20, 23, 28, 39, 43, 46, 49]. …”

Section: Resultsmentioning

confidence: 99%

“…Other scores reflect cancer-associated immune changes focusing on specific mechanisms connected with host-defense and tumour progression (NLR, thrombocytosis); regarding NLR, initial findings about a correlation with tumour aggressiveness were retrieved [52], and a possible role not only of the preoperative value itself, but also of the whole NLR trend during patient history was observed [28, 39, 43, 46, 49], suggesting a possible role as a follow-up marker (to be demonstrated in proper designed trials).…”

Section: Discussionmentioning

confidence: 99%

Inflammation-Based Scores: A New Method for Patient-Targeted Strategies and Improved Perioperative Outcome in Cancer Patients

Bugada

Allegri

Lavand’homme

et al. 2014

BioMed Research International

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Systemic inflammatory response (SIR) has actually been shown as an important prognostic factor associated with lower postoperative survival in several types of cancer. Thus, the challenge for physicians is to find specific, low-cost, and highlyreliable inflammatory markers, clearly correlated with prognosis and able to preoperatively stratify patient's risk. Inflammation is a promising target to improve perioperative outcome, and data show that anti-inflammation techniques have a great potential in the perioperative period of cancer surgery. Inflammation scores could be useful to stratify patients with a potential better response to anti-inflammation strategies. Furthermore, inflammation scores could prevent failure of clinical trials by a better definition of patients to be included in such trials; inflammation scoring could clarify the real role of different drugs and techniques on outcome after cancer surgery, defining if different therapies are required for different patients. The role of this review is to focus on the currently available scores, in order to clarify their rationale and to analyze the actual evidence and limits, providing physicians with an updated overview of the possible inflammation-based prognostic scores for cancer patients undergoing surgery.

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“…In that study, patients whose NLR rose 1 month after TACE or remained elevated had significantly worse survival than those whose NLR normalized or remained normal. 30 NLR trend may be another potentially useful biomarker for HPB and other cancers. Other potential uses of NLR besides survival outcomes may include identifying patients who might benefit from adjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

Elevated NLR in gallbladder cancer and cholangiocarcinoma – making bad cancers even worse: results from the US Extrahepatic Biliary Malignancy Consortium

Beal

Wei

Ethun

et al. 2016

HPB

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Inflammatory Markers are Associated with Outcome in Patients with Unresectable Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization

Cited by 63 publications

References 25 publications

Prognostic significance of neutrophil-lymphocyte ratio in hepatocellular carcinoma: a meta-analysis

Prognostic significance of neutrophil-lymphocyte ratio in hepatocellular carcinoma: a meta-analysis

Inflammation-Based Scores: A New Method for Patient-Targeted Strategies and Improved Perioperative Outcome in Cancer Patients

Elevated NLR in gallbladder cancer and cholangiocarcinoma – making bad cancers even worse: results from the US Extrahepatic Biliary Malignancy Consortium

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