Preoperative monoclonal antibodies do not impact early and long-term outcomes of patients with resectable colorectal liver metastases

Abstract

Objective: Several inflammatory markers such as neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), have been linked to prognosis of several malignancies including hepatocellular carcinoma (HCC). We aim to assess NLR and PLR as potential predictors of extrahepatic spread of HCC. Methods: Retrospective analysis of prospectively collected data on newly diagnosed patients with HCC between 2011 and 2015 was done. Results: A total of 180 patients were included. The mean age at the time of diagnosis was 58.8 (range: 31e82) years. HCV was found to be the most common cause of liver cirrhosis 108 (60%). 22 (12.2%) patients were classified as class C according to Child-Pugh criteria. The follow up of patients ranged from 0.1 to 4.4 years (mean = 1.0 AE 1.1 years).During follow-up 80 patients died (overall survival of 51.1%). Forty seven patients (26%) had at least one extrahepatic metastasis at the time of diagnosis (Single site-10 vs Multiple sites-37).Comparativeanalysisbetweenthosewhodevelopedmetastasis and those who didn't included several variable including inflammatory markers. Potential risk factors, at significance level of P < 0.05, included higher serum platelets, lower PLR, bigger tumor diameter, bigger total tumor volume, multiple/ bilobar HCC and macroscopic vascular invasion. However, multi-variate regression analysis revealed that tumor diameter larger than 5 cm (OR = 6.10, 95% CI = 1.85e20.12) (P = 0.003), and bilobar liver involvement (OR = 5.49, 95% CI = 1.10e27.30) (P = 0.037) were the only predictors of met-astaticbehaviorofHCC. Conclusion: Tumors size (>5 cm) and bilobar involvement are determinants of the extra-hepatic metastasis in HCC patients while NLR and PLR ratios are not.