The platelet-to-lymphocyte ratio predicts poor survival in patients with huge hepatocellular carcinoma that received transarterial chemoembolization

Abstract

Inflammation is particularly strong in huge hepatocellular carcinoma (HCC). However, it is unclear whether the platelet-to-lymphocyte ratio (PLR), as an inflammatory-related marker, can predict survival of patients with huge HCC. In this study, we enrolled 291 patients with huge HCC (diameter over 10 cm) who were undergoing repeated transarterial chemoembolization (TACE) at our institute. The baseline PLR was calculated from complete serum blood counts before the first chemoembolization. We found that a baseline PLR cutoff value over 150 best predicted huge HCC survival. The 12, 24, and 36 months survival rates in the high PLR group (22.6, 8.1, and 4.1 %, respectively) were significantly lower than in the low PLR group (35.6, 22.4, and 14 %, respectively). Thus, a significant difference was found in overall survival (log-rank test, p < 0.0001). Univariate analyses indicated a high PLR (p < 0.0001) was predictor of poor survival, and multivariate Cox analyses further showed that a high PLR (p = 0.002) was an independent factor that predicted worse survival. In conclusion, for patients with huge HCC, a high baseline PLR is a useful predictor of poor survival in patients undergoing chemoembolization. Additional anti-inflammatory or anti-platelet treatments, in combination with TACE, may improve survival in HCC patients with high PLR.

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

“…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].…”

Clinicopathological and prognostic significance of platelet-to-lymphocyte ratio in patients with hepatocellular carcinoma

“…Nine studies did not meet the inclusion criteria and were therefore excluded. Ultimately, 11 eligible studies, comprising a total of 2,507 patients, were considered eligible for the meta-analysis [16–26]. The PRISMA flow diagram of the study selection process was shown in Figure 1.…”

Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio as Prognostic Predictors for Hepatocellular Carcinoma Patients with Various Treatments: a Meta-Analysis and Systematic Review

“…In colorectal cancer and cervical cancer, a higher PLR was associated with a higher rate of lymph node metastasis [10, 42]. Xue TC et al observed that a high PLR predicts poor survival in patients with advanced hepatocellular carcinoma who received TACE [23]. To the best of our knowledge, this is the first meta-analysis to integrate recent studies of the relationship between these two inflammatory markers (the NLR and PLR) and the survival of HCC patients receiving diverse treatments.…”