Neutrophil to lymphocyte ratio as an indicator of the malignant behaviour of hepatocellular carcinoma

Okamura, Yukiyasu; Sugiura, Teiichi; Ito, Takaaki; Yamamoto, Yusuke; Ashida, Ryo; Mori, Keita; Uesaka, Katsuhiko

doi:10.1002/bjs.10123

Cited by 71 publications

(58 citation statements)

References 23 publications

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“…The high rate of recurrence remains a challenge for hepatic surgeons. Risk factors related with tumour characteristics are significantly related to early HCC recurrence, but the impact of viral status on recurrence is unclear, and some studies did not identify any role for hepatitis B viral status on prognosis, whilst other studies suggested that the presence of HBeAg was significantly correlated with prognosis . Propensity score matching analysis has been widely used in patients with HCC .…”

Section: Introductionmentioning

confidence: 99%

The prognostic significance of serum HBeAg on the recurrence and long‐term survival after hepatectomy for hepatocellular carcinoma: A propensity score matching analysis

Shen

Liu

et al. 2018

Journal of Viral Hepatitis

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The effects of serum hepatitis B e antigen (HBeAg) on the prognosis of hepatocellular carcinoma (HCC) patients after hepatectomy remain controversial. Our aim was to explore the prognostic significance of serum HBeAg on the prognosis of patients with HCC using a propensity matching model. Between January 2009 and March 2015, 953 patients with HCC who underwent hepatectomy in West China Hospital were analysed. Propensity matching analysis was applied, and survival analysis was performed using the Kaplan-Meier method. Risk factors were identified by the Cox proportional hazards model. All patients with HCC were classified into an HBeAg(-) group (n = 775, 81.3%) or an HBeAg(+) group (n = 178, 18.7%). Patients with positive serum HBeAg had poorer recurrence-free survival and overall survival before and after propensity matching. Similar results were found in patients within the Milan criteria. For patients beyond the Milan criteria, the HBeAg(+) group had poor overall survival before and after propensity matching. In term of recurrence-free survival, there was no statistically significant impact after propensity matching (P = .055), although there was a trend for HBeAg(+) patient to have reduced recurrence-free survival. Positive serum HBeAg, positive HBV-DNA load, largest tumour size, multiple tumours, microvascular invasion and a high serum level of preoperative alpha-fetoprotein were risk factors for recurrence. Our propensity model confirmed that positive serum HBeAg had a negative impact on the recurrence and long-term survival irrespective of tumour stages. HBeAg seroconversion might be beneficial for reducing the rate of recurrence.

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Section: Introductionmentioning

confidence: 99%

The prognostic significance of serum HBeAg on the recurrence and long‐term survival after hepatectomy for hepatocellular carcinoma: A propensity score matching analysis

Shen

Liu

et al. 2018

Journal of Viral Hepatitis

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“…In their study, Terashima et al set the cut-off level of the NLR as the median value [19]. Another study determined the cut-off value by comparing the survival rates between NLR groups stratified according to several candidate values from 2.6 to 3.2 [28]. Several studies determined cut-off values by using receiver-operating characteristic (ROC) curves [17, 22].…”

Section: Discussionmentioning

confidence: 99%

“…According to Okamura et al, lower AFP and smaller tumor size were associated with a low NLR [28]. Although the association between the NLR and other prognostic factors could be a valid explanation for the difference in prognosis, it was still controversial.…”

Section: Discussionmentioning

confidence: 99%

Pre-radiotherapy neutrophil-to-lymphocyte ratio as an independent prognostic factor in patients with locally advanced hepatocellular carcinoma treated with radiotherapy

Son

Park

et al. 2016

Oncotarget

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We aimed to investigate the pre-radiotherapy neutrophil-to-lymphocyte ratio (prNLR) as a prognostic factor in patients with locally advanced hepatocellular carcinoma (HCC) treated with radiotherapy (RT), and to determine the optimal cut-off value for prNLR. We retrospectively evaluated 56 patients with locally advanced HCC treated with RT (helical tomotherapy) between March 2006 and February 2012. The optimal cut-off value was determined by using a maximally selected log-rank test. Prognostic factors that influence the local progression-free survival (PFS) and overall survival (OS) were evaluated. A prNLR of 2.1 was determined to be the optimal cut-off value. In a comparison between the high-prNLR group and the low-prNLR group, there was a 13.1-month difference in the median OS (10.3 vs. 23.4 months, p = 0.003) and a 10.4-month difference in the median local PFS (7.1 vs. 17.5 months, p = 0.001). On multivariate analysis of prognostic factors for local PFS and OS, the prNLR was identified as an independent prognostic factor, and the hazard ratio was 4.2 and 2.5, respectively. We demonstrated that a low prNLR was significantly associated with better PFS and OS in patients with locally advanced HCC treated with RT, and the prNLR should be considered as an independent prognostic factor in these patients.

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“…Factors, including inflammation-based indices including neutrophil-to-lymphocyte ratio (NLR) (5), platelet-to-lymphocyte ratio (PLR) (6), prognostic nutritional index (PNI) (7) and body mass index (BMI) (8) and tumor biomarkers including topoisomerase (Topo) II-α (9) and Ki67 (10) represent independent predictors of poor OS rates in patients with HCC and enabled the refinement of current prognostic models. These novel factors may be used to determine the OS and development of preventative measures in those with high risk.…”

Section: Introductionmentioning

confidence: 99%

Prediction of long‑term survival rates in patients undergoing curative resection for solitary hepatocellular carcinoma

et al. 2017

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Abstract. The present study developed a novel laboratory-based algorithm to predict long-term survival rates in patients undergoing curative resection for solitary hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). The present study included 426 patients with solitary HBV-related HCC who underwent surgery for primary tumors at a single center between 2003 and 2012. Demographic characteristics, laboratory analysis, clinical pathology and immunohistochemistry of topoisomerase II-a and Ki67 were analyzed. A simple prognostic risk calculator was developed using regression coefficients from multivariate models. A prognostic risk calculator incorporating tumor encapsulation, neutrophil-to-lymphocyte ratio, vascular invasion, α-fetoprotein level, Edmondson-Steiner classification, Topo II-α, prognostic nutritional index and Child-Pugh grade was constructed. The prognostic model demonstrated good discrimination with a C-index prior to adjustment of 0.81 (95% confidence interval: 0.78-0.84) and a bootstrap-corrected C-index of 0.81. Kaplan-Meier curves demonstrated that the probabilities of overall survival rates in the low-risk group were increased compared with those in the high-risk group. The areas under the receiver operating characteristic curve using the method were greater compared with those under the 7th Tumor-Node-Metastasis system and Cancer of the Liver Italian Program scoring system [0.83 vs. 0.62 and 0.77 (P<0.001), respectively]. The simple prognostic model of the present study accurately predicted survival rates in patients. Such a prognostic risk calculator for staging patients undergoing curative resection for solitary HBV-related HCC facilitates clinical surveillance and therapy.

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Neutrophil to lymphocyte ratio as an indicator of the malignant behaviour of hepatocellular carcinoma

Abstract: Preoperative NLR was an important prognostic factor for TNM stage I HCC after liver resection with curative intent. These results suggest that the NLR may reflect the malignant potential of HCC.

Cited by 71 publications

References 23 publications

The prognostic significance of serum HBeAg on the recurrence and long‐term survival after hepatectomy for hepatocellular carcinoma: A propensity score matching analysis

The prognostic significance of serum HBeAg on the recurrence and long‐term survival after hepatectomy for hepatocellular carcinoma: A propensity score matching analysis

Pre-radiotherapy neutrophil-to-lymphocyte ratio as an independent prognostic factor in patients with locally advanced hepatocellular carcinoma treated with radiotherapy

Prediction of long‑term survival rates in patients undergoing curative resection for solitary hepatocellular carcinoma

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