Platelet-to-Lymphocyte Ratio and Large Tumor Size Predict Microvascular Invasion after Resection for Hepatocellular Carcinoma

Abstract

Background: Recurrence after curative resection of hepatocellular carcinoma (HCC) is associated with early death and poor prognosis. Microvascular invasion (mVI) is strongly associated with disease recurrence. Although many studies have examined the relationship between various serum inflammatory indices and post-treatment prognosis, little is known about preoperative predictors of microvascular invasion in HCC. Methods: Patients who underwent curative hepatic resection for HCC at our institute from January 2006 to December 2016 were retrospectively reviewed. The associations between mVI and various potential risk factors, including tumor size, hepatitis B and C virus infection, Child-Pugh scores, platelet-to-lymphocyte ratio, and neutrophil-to-lymphocyte ratio, were analyzed. Optimal cutoff values were determined using receiver operating characteristic curves. Results: A total of 330 HCC patients were enrolled in this study, of whom 74 (22.4%) had tumors with mVI. After univariate analysis, two parameters were significantly associated with mVI after hepatic resection: platelet-to-lymphocyte ratio ≥102 (odds ratio [OR] 2.385, p = 0.001) and tumor size ≥5 cm (OR 4.29, p < 0.001). Both variables remained significant risk factors for mVI after multivariate analysis: platelet-to-lymphocyte ratio ≥102 (OR 1.831, p = 0.034) and tumor size ≥5 cm (OR 3.791, p < 0.001). Conclusions: Large tumor size (≥5 cm) and high platelet-to-lymphocyte ratio (≥102) are independent predictive factors for mVI in HCC.

Preoperative neutrophil-lymphocyte ratio predicts the risk of microvascular invasion in hepatocellular carcinoma: A meta-analysis

“…Of the 12 studies, only 7 clearly reported the association between the preoperative NLR level and MVI. 17,19,20,22,[25][26][27] The analysis of these seven studies arrived at a consistent conclusion (OR 1.62; 95% Cl 1.39, 1.89; P < 0.001) with a less heterogeneity (I 2 = 38%; P = 0.14) (Figure 2(b)). Among the seven studies, five were from China, one from Thailand, and one from Korea.…”

“…Finally, we identified 15 studies, all published between 2008 and 2018, which met the inclusion criteria. [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Of the 15 studies, 12 were retrospective cohort studies 16-22, 24-27, 29 and three were case-control studies 23,28,30 (Table S2). Among the 12 cohort studies, nine were from China, one from England, one from Korea and one from Thailand.…”

“…Twelve studies including 5116 patients reported the relationship between preoperative NLR level and vascular invasion. [16][17][18][19][20][21][22][24][25][26][27]29 Considering the moderate heterogeneity (I 2 = 43%, P = 0.05), we used a random model. The pooled data showed that more HCC patients were complicated by vascular invasion in the high NLR group than in the low NLR group (OR 1.74; 95% Cl 1.42, 2.12; P < 0.001) (Figure 2(a)).…”

<p>Nomogram For Preoperative Prediction Of Microvascular Invasion Risk In Hepatocellular Carcinoma</p>

“…[19][20][21] Also, clinical studies showed that inflammatory indices can be used to predict the prognosis and the presence of MVI. [22][23][24][25][26][27] Therefore, it is necessary to combine inflammatory indices into the predictive models. The objective of our study was to develop nomograms based on imaging data as well as serum inflammatory data for MVI preoperative prediction in HCC.…”

A Nomogram Predicting Microvascular Invasion Risk in BCLC 0/A Hepatocellular Carcinoma after Curative Resection

“…In various studies, tumor size has been demonstrated to be an effective preoperative predictive factor for MVI [6, 9, 15]. It is well established that the prevalence of MVI in HCC is strongly influenced by tumor size [16, 17]. As the tumor grows, the risk of MVI continues to increase.…”