Inflammatory markers in intrahepatic cholangiocarcinoma: Effects of advanced liver disease

Abstract

Background To investigate the neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and systemic immune‐inflammation index (SII) as prognostic biomarkers in intrahepatic cholangiocarcinoma (ICC) with a focus on viral hepatitis and liver status. Methods In this retrospective cohort study, patients from the institutional cancer registry with ICC from 2005 to 2016 were stratified by treatment group. Baseline inflammatory markers were dichotomized at the median. Overall survival (OS) was assessed via Kaplan‐Meier curves and Cox proportional hazard models. Multiple patient, liver, and tumor factors were included in the multivariable analysis (MVA). Results About 131 patients (median age 65 years, 52% male, 76% Caucasian) had a median OS of 13.0 months. Resection/interventional oncology with/without systemic therapy had improved survival vs systemic therapy alone in Child‐Pugh A patients (P < 0.01). In Child‐Pugh B/C patients, this survival difference became nonsignificant (P = 0.22). Increased NLR and SII were associated with decreased survival (P < 0.01), while dichotomized PLR was not (P = 0.3). On MVA, increased NLR remained an independent prognostic factor (HR 1.6, P < 0.05). In Child‐Pugh class A (n = 94), low‐NLR had higher OS vs high‐NLR (25.4 vs 12.2 months, P < 0.01). In Child‐Pugh class B/C (n = 28), NLR did not have a significant effect on median OS (low‐ vs high‐NLR: 6.7 vs 2.9 months, P = 0.2). Child‐Pugh class acted as an effect modifier on MVA for NLR (P = 0.0124). Conclusions The NLR has a stronger impact as a prognostic marker in ICC over the PLR and SII. This survival effect is decreased in advanced liver disease.

Investigating effects of preoperative inflammatory biomarkers on predicting survival outcomes of peripheral intrahepatic cholangiocarcinoma after curative resection.

“…Two previous studies have also investigated the role of SII in OS among ICC patients. 18,19 Their results both indicated higher SII was associated with poorer patient survival in ICC, which was consistent with our results.…”

<p>Inflammation-Based Prognostic Scores in Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma After Liver Transplantation</p>

“…10 Recently, several inflammation-based scores, mainly including SII, NLR and PLR, have been served as useful prognostic biomarkers for multiple solid tumors. 11,12 A novel indicator known as the SII was developed recently and has been demonstrated to be an effective and powerful prognostic indicator for several types of tumors, which combines lymphocyte, neutrophil, and platelet counts. 13,14 However, the relationship between preoperative SII and prognosis in patients with HBV-related HCC after LT remains unclear.…”

Prognostic value of the systemic immune-inflammation index in patients with biliary tract cancer: a systematic review and meta-analysis

“…Finally, a total of 8 [16][17][18][19][20][21][22][23] studies were included for the meta-analysis ( Fig. 1).…”

“…The 8 [16][17][18][19][20][21][22][23] included studies were all retrospective and published during 2016-2020. 3 studies were conducted in china, 3 studies were conducted in Korea, 1 study were conducted in America and 1 study was an international multi-institutional analysis.…”