Peer Review #2 of "Preoperative inflammatory markers of NLR and PLR as indicators of poor prognosis in resectable HCC (v0.2)"

Abstract

Background: Many recent studies have demonstrated the predominant role chronic inflammation plays in cancer cell propagation, angiogenesis and immunosuppression. Cancer-related inflammation (CRI) has been shown to correlate with poor cancer prognosis. Our study aimed to evaluate the prognostic value of the neutrophil-to lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with hepatocellularcarcinoma (HCC) who have undergone liver resection. Methods: Between 2012 and 2015, 239 patients with HCC who had undergone liver resection at XiangYa Hospital Central South University were included in this study. The values of simple inflammatory markers including the NLR and PLR, used in predicting the long-term outcomes of these patients ,were evaluated using Kaplan-Meier curves and Cox regression models. Results: The cutoff values of the NLR and PLR were 2.92 and 128.1, respectively. In multivariate Cox regression analysis, high NLR (≥ 2.92) and high PLR (≥ 128.1) were independent risk factors predicting poorer outcomes in patients with HCC. However, high NLR and high PLR were prognostic factors in tumor size and tumor number. Conclusions: In this study, we identified that high NLR (≥ 2.92) and high PLR (≥128.1) are useful prognostic factors in predicting outcomes in patients with HCC who underwent liver resection.