Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Predictors of Outcomes in Patients With Unresectable Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization Plus Sorafenib

Abstract

Objectives: To investigate the predictive value of inflammatory biomarkers in patients with unresectable hepatocellular carcinoma (HCC) for outcomes following the combination treatment of transarterial chemoembolization (TACE) plus sorafenib.Materials and Methods: A total of 314 (270 male and 44 female) treatment-naïve patients with unresectable HCC treated by TACE plus sorafenib between January 2011 and December 2018 were enrolled in the retrospective study. The primary outcome was overall survival (OS). The secondary outcome was progression-free survival (PFS). Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were obtained within 3–7 days before the initial TACE and the median value of the NLR and PLR was considered as the cut-off value.Results: The median value of NLR and PLR was 2.42 and 100, respectively. The median OS and PFS of the entire cohort were 18.7 months (95% CI: 16.8–20.6) and 9.1 months (95% CI: 8.5–9.8), respectively. The low NLR and PLR group showed improved OS and PFS compared with the high NLR and PLR group [21.8 months (95% CI: 15.2–28.5) vs. 15.4 months (95% CI: 12.4–18.3), p < 0.0001; 21.6 months (95% CI: 15.8–27.5) vs. 14.9 months (95% CI: 11.9–17.8), p = 0.00027, respectively]. In addition, the low NLR and PLR group also provided a longer PFS than the high NLR and PLR group [10.4 months (95% CI: 8.9–12.0) vs. 8.1 months (95% CI: 7.1–9.2), p = 0.00022; 10.3 months (95% CI: 8.6–11.9) vs. 8.2 months (95% CI: 7.2–9.2), p < 0.0001, respectively]. High NLR and PLR at baseline were predictive factors of poor OS (p = 0.02 and p = 0.004) and PFS (p = 0.045 and p = 0.005).Conclusion: This study showed the prognostic value of quantitative inflammatory biomarkers in correlation with OS and PFS in unresectable HCC patients undergoing TACE plus sorafenib treatment.

Prediction of Efficacy for Atezolizumab/Bevacizumab in Unresectable Hepatocellular Carcinoma with Hepatobiliary-Phase Gadolinium Ethoxybenzyl-Diethylenetriaminepentaacetic Acid MRI

“…Since our study was conducted on u-HCC, which is a different subject from the previous study, a new cutoff value needs to be established. CV ≥ 0.22, the median value for all patients, was applied in this study as a cutoff, as in previous studies [ 28 , 29 , 30 , 31 ].…”

Efficacy and Safety of Regorafenib Plus Immune Checkpoint Inhibitors with or Without TACE as a Second-Line Treatment for Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis

“…PLR is an inflammatory marker that may be used in several diseases for predicting inflammation and mortality, and a high PLR has been previously reported to be correlated with the poor survival of patients with HCC. 29,30 A high platelet count stimulates angiogenesis and tumor proliferation, 31 and a low lymphocyte count is commonly referred to "cold tumors" without significant T cell infiltration. 32 No unexpected TRAEs were found in the present study.…”

Experimental Research on the Inhibitory Effect of IFN-Lambda 3 Combined with Sorafenib on the Growth of Liver Cancer Transplanted into Nude Mice

“…Therefore, looking for a supportive treatment regimen of sorafenib to improve the survival benefit of HCC patients has become a hot topic [12] . A large number of joint research experiments have begun, of which the most concerned is the interventional targeted therapy of transarterial chemoembolization (TACE) combined with sorafenib [13] . TACE blocks the main arterial supply of HCC, thus cutting off the supply of important nutrients and growth substances, to slow down the progress of HCC, promote tissue and cell ischemia as well as hypoxia in the tumor microenvironment, in addition to accelerate its death.…”