Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Predictors of Survival and Metastasis for Recurrent Hepatocellular Carcinoma after Transarterial Chemoembolization

Abstract

PurposeTo evaluate whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) predict survival and metastasis in patients after transarterial chemoembolization (TACE) for recurrent hepatocellular carcinoma (RHCC).Materials and MethodsClinical and laboratory data from 132 RHCC patients treated with TACE from January 2003 to December 2012 were retrospectively reviewed. Prognostic factors were assessed by multivariate analysis, and the predictive values of NLR and PLR for overall survival (OS) and extrahepatic metastases were compared.ResultsPretreatment mean NLR and PLR were 3.1 and 137, respectively. The 0.5-, 1-, and 2-year OS rates were 93.7%, 67.1%, and 10.1% in the low NLR group and 81.1%, 18.9%, and 3.8% in the high NLR group, respectively (P = 0.017). The corresponding OS rates in the low and high PLR groups were 92.5%, 58.1%, and 9.7% and 84.6%, 23.1%, and 2.6%, respectively (P = 0.030). The discriminatory performance predicting 1-year survival probability was significantly poorer for NLR (area under the curve [AUC] = 0.685, 95% confidence interval [CI] 0.598–0.763) than for PLR (AUC = 0.792, 95% CI 0.712–0.857; P = 0.0295), but was good for both ratios for predicting post-TACE extrahepatic metastasis. Multivariate analysis indicated that high PLR (hazard ratio [HR] = 0.373, 95% CI = 0.216-0.644, P < 0.001, vascular invasion (HR = 0.507, 95% CI = 0.310–0.832, P = 0.007), and multiple tumors (HR= 0.553, 95% CI = 0.333–0.919, P = 0.022) were independent prognostic factors for OS.ConclusionsHigh NLR and PLR were both associated with poor prognosis and metastasis in RHCC patients treated with TACE, but high PLR was a better predictor of 1-year OS. High PLR, vascular invasion, and multiple tumors were independent, unfavorable prognostic factors.

Peripheral blood neutrophil count as a prognostic factor for patients with hepatocellular carcinoma treated with sorafenib

“…In particular, the neutrophil-lymphocyte ratio (NLR) has been evaluated as a predictor of prognosis in various types of solid tumor, including gastric, colorectal, pancreatic, breast and lung cancers (16)(17)(18)(19)). An elevated NLR has already been shown to be associated with poor prognosis in patients with HCC treated by liver transplantation, surgical resection, or TACE (20)(21)(22). The present study evaluated the association between peripheral blood neutrophil count and the prognosis of HCC treated with sorafenib, and revealed peripheral neutrophil count as a prognostic factor in such cases.…”

Evaluation of the prognostic value of platelet to lymphocyte ratio in patients with hepatocellular carcinoma

“…In HCC however, the results were still conflicting regarding the prognostic value of PLR to predict overall survival and the optimal cut-off of PLR remains unclear (11,(17)(18)(19)(20).…”

Prognostic significance of preoperative neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients with gallbladder carcinoma

“…The relative changes of body inflammatory reaction and immune state are closely related to the occurrence and development of tumors, thereby affecting the prognosis of the tumors [7]. As common clinical parameters for blood system and inflammation, preoperative neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been regarded to be associated with the prognosis of various tumors, as well as used to reflect and evaluate the tumor prognosis [8][9][10][11]. However, it remains to be further investigated whether NLR and PLR are related to the prognosis of GBC.…”