Preoperative lymphocyte‐to‐monocyte ratio is useful for stratifying the prognosis of hepatocellular carcinoma patients with a low Cancer of the Liver Italian Program score undergoing curative resection

Abstract

Background and Aim Although the Cancer of the Liver Italian Program (CLIP) score is useful for prognostication of patients with hepatocellular carcinoma (HCC), a previous study has reported that the CLIP score was unable to stratify the postoperative outcomes of HCC patients in whom the score was low (0‐1). Recent studies have reported that the preoperative lymphocyte‐to‐monocyte ratio (LMR) is useful for prognostication of patients with various cancer. Methods We reviewed 329 HCC patients with a low CLIP score (0‐1) undergoing curative resection. This study had the approval of the Institutional Review Board (28068). Multivariate analyses were carried out to detect clinical factors correlating with overall survival (OS). Kaplan‐Meier analysis and the log‐rank test were used for comparison of OS. Results Multivariate analysis showed that LMR (<4.35/≥4.35) was significantly associated with OS (hazard ratio [HR], 2.022; 95% CI, 1.141‐3.583; P = 0.016) as well as portal vein invasion (HR, 2.410; 95%CI, 1.258‐4.618; P = 0.008). Kaplan‐Meier analysis and the log‐rank test showed a significant difference in OS and relapse‐free survival between patients with high LMR and those with low LMR. Conclusion Preoperative LMR is useful for stratifying the prognosis of HCC patients with a low CLIP score (0‐1) undergoing curative resection.

Predictors of Hepatocellular Carcinoma Early Recurrence in Patients Treated with Surgical Resection or Ablation Treatment: A Single-Center Experience

“…Regarding combined scores, recent studies have demonstrated that LMR is valid for a significant prognostic oncological factor [ 71 , 72 ]. In patients with HCC, a low LMR is associated with worse outcomes and an increased risk of recurrence [ 73 ]. However, studied LMR cut-offs are highly variable in each study, thus determining a low reproducibility [ 49 ].…”

Prognostic significance of lymphocyte monocyte ratio in patients with ovarian cancer

“…[ 9 – 11 ] Some inflammatory biomarkers in peripheral blood, such as neutrophil count, lymphocyte count, platelet lymphocyte ratio, neutrophil lymphocyte ratio, and lymphocyte monocyte ratio (LMR) have been proposed to predict cancer outcome. [ 11 – 13 ] LMR has been shown to be related to the prognosis of various cancers, such as hepatocellular carcinoma, [ 14 ] esophageal squamous cell carcinoma, [ 15 ] Hodgkin lymphoma, [ 16 ] urothelial cancers. [ 17 ] In recent years, many researchers have studied the prognostic value of LMR in patients with OC.…”

Clinicopathological and prognostic value of preoperative lymphocyte to monocyte ratio for hepatocellular carcinoma following curative resection

“…[ 10 , 37 , 38 ] Preoperative LMR, as a systemic inflammatory biomarker, has been shown to be associated with prognosis in HCC patients. [ 26 – 29 ]…”