Postoperative neutrophil-to-lymphocyte ratio plus platelet-to-lymphocyte ratio predicts the outcomes of hepatocellular carcinoma

Li, Chuan; Wen, Tianfu; Yan, Lü-Nan; Li, Bo; Wang, Wentao; Yang, Jiayin; Xu, Meiqing

doi:10.1016/j.jss.2015.05.003

Cited by 61 publications

(56 citation statements)

References 31 publications

(33 reference statements)

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“…All these indices can be easily calculated based on routinely performed blood tests in the clinical work-up. For PLR, it can be used to predict the prognosis of HCC patients receiving transarterial chemoembolization [24], thermal ablation [25], or partial hepatectomy [26]. Our previous work also confirmed that pre-transplant elevated PLR was associated with a high proportion of multiple tumors, large tumor size, micro- and macrovascular invasion, and predicted post-transplant tumor recurrence [12].…”

Section: Discussionmentioning

confidence: 75%

Expansion of the Milan criteria without any sacrifice: combination of the Hangzhou criteria with the pre-transplant platelet-to-lymphocyte ratio

Xia

Guo

et al. 2017

BMC Cancer

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BackgroundThe Hangzhou criteria expand the Milan criteria safely and effectively in selecting hepatocellular carcinoma (HCC) candidates for liver transplantation (LT), but some patients exceeding the Milan but fulfilling the Hangzhou criteria still show poor outcomes due to early tumor recurrence. In this study, the platelet-to-lymphocyte ratio (PLR) was employed to differentiate high-risk tumor recurrence recipients, and a new method combining PLR and the Hangzhou criteria was established.MethodsThe clinical data of 343 LT for HCC were retrospectively analyzed. Receiver operating characteristic (ROC) analysis was used to determine the PLR cut-off value to stratify patients exceeding the Milan but fulfilling the Hangzhou criteria. The recurrence-free survival (RFS) of recipients was compared after stratification. The Hangzhou criteria & PLR method was proposed and its feasibility was validated by ROC analysis.ResultsPLR 120 was the most significant cut-off value when comparing RFS of patients exceeding the Milan but fulfilling the Hangzhou criteria. After stratification, the 1-, 3-, and 5-year RFS of patients exceeding the Milan but fulfilling the Hangzhou criteria with PLR < 120 were 84.2%, 73.3%, and 73.3%, respectively, comparable with 85.7%, 73.9%, and 72.8%, respectively, in patients fulfilling the Milan criteria (P = 0.885). Patients exceeding the Milan but fulfilling the Hangzhou criteria with PLR ≥ 120 showed poor outcomes, which were similar in patients exceeding the Hangzhou criteria; 1-, 3-, and 5-year RFS were only 37.5%, 12.5%, and 12.5% vs. 32.3%, 17.6%, and 15.1%, respectively (P = 0.887). ROC analysis demonstrated that the ROC area of the Hangzhou criteria & PLR method was 0.768 for RFS. Multivariate analysis confirmed that PLR ≥ 120 was independently associated with RFS of patients exceeding the Milan but fulfilling the Hangzhou criteria.ConclusionsThe Hangzhou criteria combined with the pre-transplant PLR can accurately exclude high-risk tumor recurrence recipients; this approach expands the Milan criteria effectively without any sacrifice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-3028-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 75%

Expansion of the Milan criteria without any sacrifice: combination of the Hangzhou criteria with the pre-transplant platelet-to-lymphocyte ratio

Xia

Guo

et al. 2017

BMC Cancer

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“…However, NLR shows a peak at 24 hours after surgery,36 which is probably influenced by psychological and physiological factors. For example, surgery is a source of stress for patients and could change the systemic inflammatory state 11. Because the literature has shown that inflammation due to the surgical wound healing process ceases 1 month after the operation,37 postoperative measurements were chosen to perform at least 1 month after surgery to minimize the disturbances caused by the operation.…”

Section: Discussionmentioning

confidence: 99%

“…Although numerous studies have demonstrated associations between preoperative NLR and outcomes in primary operable patients with NSCLC,5–8 other studies have concluded the opposite 9,10. Moreover, some studies found that postoperative NLR could predict the survival of patients with hepatocellular carcinoma,11 colorectal cancer,12 and bladder cancer after complete resection 13. These results suggest that postoperative NLR might provide a more precise reflection of the balance between tumor inflammatory response and host immune response.…”

Section: Introductionmentioning

confidence: 99%

The postoperative neutrophil-to-lymphocyte ratio and changes in this ratio predict survival after the complete resection of stage I non-small cell lung cancer

Jin¹,

Han

Shi

et al. 2016

OTT

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PurposeAlthough numerous studies have demonstrated associations between the preoperative neutrophil-to-lymphocyte ratio (NLR) and long-term outcomes in patients with non-small cell lung cancer (NSCLC), the prognostic significance of postoperative NLR and change in NLR (ΔNLR) is unknown for patients who underwent complete resection of stage I NSCLC. The aim of this retrospective study was to evaluate the prognostic significance of postoperative NLR and ΔNLR in 123 patients with stage I NSCLC.Patients and methodsThis retrospective study included preoperative and postoperative data of 123 patients who underwent surgical resection for stage I NSCLC. The relationship between disease-free survival (DFS), overall survival (OS), and clinicopathological factors, including NLR, lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio, and their changes, was analyzed using both univariate Kaplan–Meier and multivariate Cox regression methods.ResultsThe 5-year DFS and OS rates in our cohort were 60.16% and 67.48%, respectively. Univariate analysis revealed that age (P=0.045), smoking status (P=0.033), preoperative NLR (P=0.032), postoperative NLR (P<0.001), ΔNLR (P=0.004), and change in LMR (ΔLMR) (P=0.025) were significant predictors of DFS and that age (P=0.039), smoking status (P=0.042), postoperative NLR (P<0.001), ΔNLR (P=0.004), and ΔLMR (P=0.011) were independent predictors of OS. Multivariate analysis confirmed that postoperative NLR (hazard ratio [HR] =2.435, P=0.001) and ΔNLR (HR =2.103, P=0.012) were independent predictors of DFS and that postoperative NLR (HR =2.747, P=0.001) and ΔNLR (HR =2.052, P=0.018) were significant prognostic factors of OS.ConclusionOur study reported for the first time that postoperative NLR and ΔNLR – but not preoperative NLR – were independent prognostic factors of DFS and OS in patients with stage I NSCLC who underwent complete resection. This easily available biomarker might be helpful in individual risk assessment.

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“…There is growing evidence of the predictive role of NLR as prognostic marker in malignant disease [8–16, 32]. In a meta-analysis, Li et al.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, NLR represents two different immune pathways and can be easily derived directly from a standard blood test. Several studies found that NLR alone or in combination with other blood markers to not only predict patient survival for various malignant disease, including colorectal cancer [8–16], and survival after cardiac interventions [17], but also to predict surgical complications after major abdominal [18–20] and orthopedic operations [21]. Recent reports revealed the predictive value of NLR in discriminating active from inactive ulcerative colitis (UC), proclaiming cut-offs between 2.16 and 2.47, compared to the mixed results regarding the diagnostic value of CRP alone [22–24].…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of preoperative neutrophil-to-lymphocyte ratio in Crohn’s disease

Argeny

Stift

Bergmann

et al. 2018

Wien Klin Wochenschr

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SummaryBackgroundThe Neutrophil-to-lymphocyte-ratio has recently gained increased attention as a prognostic marker for malignant disease and short term outcomes. There is little data available in patients with Crohn’s disease, thus the present study was conducted to correlate preoperative Neutrophil-to-lymphocyte-ratio values with disease phenotype and postoperative course.MethodsWe comprised 373 patients, who underwent intestinal resection for symptomatic Crohn’s disease at an academic tertiary referral centre between 2000 and 2014. Preoperative Neutrophil-to-lymphocyte-ratio values were calculated and analyzed in regard to disease phenotype and 30-day morbidity rate. All relevant data were obtained from the institutional database and individual chart review.ResultsMale patients had significantly higher preoperative Neutrophil-to-lymphocyte-ratio values compared to female patients (5 vs. 4; p = 0.0075). A higher Neutrophil-to-lymphocyte-ratio was also found in patients with an acute indication for surgery (6.15 vs. 4.3; p = 0.0374), presenting with abscesses (5.36 vs. 4.28; p = 0.0254), inflammatory masses (5.23 vs. 4.08; p = 0.0294) or malignancy in the resected specimen (9.06 vs. 4.35, p = 0.0231). Surprisingly, patients developing postsurgical complications showed significantly lower Neutrophil-to-lymphocyte-ratio values (3.77 vs. 4.67; p = 0.0461).ConclusionsElevated preoperative Neutrophil-to-lymphocyte-ratio in symptomatic Crohn’s disease is not predictive for complications. However, Neutrophil-to-lymphocyte-ratio showed a significant correlation with specific disease phenotypes. Most strikingly, Neutrophil-to-lymphocyte-ratio was highly elevated in patients with a colorectal cancer in the resected specimen, which needs to be addressed in future studies.

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Postoperative neutrophil-to-lymphocyte ratio plus platelet-to-lymphocyte ratio predicts the outcomes of hepatocellular carcinoma

Cited by 61 publications

References 31 publications

Expansion of the Milan criteria without any sacrifice: combination of the Hangzhou criteria with the pre-transplant platelet-to-lymphocyte ratio

Expansion of the Milan criteria without any sacrifice: combination of the Hangzhou criteria with the pre-transplant platelet-to-lymphocyte ratio

The postoperative neutrophil-to-lymphocyte ratio and changes in this ratio predict survival after the complete resection of stage I non-small cell lung cancer

Prognostic value of preoperative neutrophil-to-lymphocyte ratio in Crohn’s disease

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