Sustained Systemic Inflammatory Response Predicts Survival in Patients with Hepatocellular Carcinoma After Hepatic Resection

Haruki, Koichiro; Taniai, Tomohiko; Yanagaki, Mitsuru; Furukawa, Kenei; Tsunematsu, Masashi; Onda, Shinji; Shirai, Yoshio; Matsumoto, Michinori; Okui, Norimitsu; Ikegami, Toru

doi:10.1245/s10434-022-12464-6

Cited by 10 publications

(12 citation statements)

References 29 publications

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“…Regarding preoperative NLR, non‐solving inflammatory response, which cannot be improved by surgical resection, may persist and substantially lead to cancer development and metastasis during perioperative period. A previous study reported sustained systemic inflammatory response with associated with poor oncological outcomes 7 . As a cause of postoperative inflammation, the pulmonary complication was also a risk factor.…”

Section: Discussionmentioning

confidence: 92%

“…Biomarkers represent the systemic inflammation in various malignancies; CAR, LMR, NLR, PLR, and Glasgow prognostic scores were determined as prognostic factors. 7,[11][12][13][14] Regarding esophagectomy for EC, preoperative systemic inflammation markers were reported to be of prognostic value. 4 However, the number of research regarding this is limited.…”

Section: Risk Factors For the Systemic Inflammation-highmentioning

confidence: 99%

“…Preoperative systemic inflammation markers, such as neutrophil‐to‐lymphocyte ratio (NLR), C‐reactive protein‐to‐albumin ratio (CAR), platelet‐to‐lymphocyte ratio (PLR), and lymphocyte‐to‐monocyte ratio (LMR), are also correlated with worse prognosis in esophagectomized patients for EC 4–6 . A previous study also revealed that postoperative systemic inflammatory response is also a prognostic marker of hepatocellular carcinoma 7 . Meanwhile, the association between postoperative systemic inflammatory markers and prognosis in EC remains unknown.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6] A previous study also revealed that postoperative systemic inflammatory response is also a prognostic marker of hepatocellular carcinoma. 7 Meanwhile, the association between postoperative systemic inflammatory markers and prognosis in EC remains unknown.…”

mentioning

confidence: 99%

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Postoperative inflammatory markers predict survival in patients after McKeown esophagectomy for esophageal cancer

Takahashi

Masuda

Ishikawa

et al. 2023

Journal of Surgical Oncology

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Background Preoperative C‐reactive protein‐to‐albumin ratio (CAR) and neutrophil‐to‐lymphocyte ratio (NLR) are correlated with a poor prognosis of various cancers. The significance of postoperative systemic inflammation markers for prognostic stratification of patients with esophageal cancer (EC) has not been established. Therefore, this study aimed to elucidate the impact of postoperative CAR and NLR on survival in patients with EC for prognostic stratification. Methods A total of 235 patients who received curative esophagectomy were analyzed. A Cox proportional hazard model was performed to detect prognostic factors. Results Multivariate analysis revealed that postoperative CAR ≥ 0.05 (hazard ratio [HR], 1.62; 95% confidence interval [CI], 1.01–2.57) and NLR ≥ 3.0 (HR, 2.81; 95% CI, 1.79–4.40) were independent prognostic factors for overall survival. Meanwhile, postoperative CAR ≥ 0.05 (HR, 1.61; 95% CI, 1.07–2.41) and NLR ≥ 3.0 (HR, 1.92; 95% CI, 1.29–2.85) were also significant prognostic factors for relapse‐free survival. In addition, the patient group with postoperative CAR ≥ 0.05 and NLR ≥ 3.0 had the worst survival. Conclusions Postoperative CAR ≥ 0.05 and NLR ≥ 3.0 can predict the poor survival of patients who received curative esophagectomy for EC.

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Section: Discussionmentioning

confidence: 92%

Section: Risk Factors For the Systemic Inflammation-highmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Postoperative inflammatory markers predict survival in patients after McKeown esophagectomy for esophageal cancer

Takahashi

Masuda

Ishikawa

et al. 2023

Journal of Surgical Oncology

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“…4 ALBI grade has more sensitively stratified outcomes of HCC patients. 5 A growing body of evidence suggests that the systemic inflammatory response including neutrophillymphocyte ratio (NLR), 6 platelet-lymphocyte ratio (PLR), 7 lymphocyte-monocyte ratio (LMR), 8 C-reactive protein-albumin ratio (CAR) 9 has been associated with long-term outcomes in cancer patients including HCC.…”

Section: Introductionmentioning

confidence: 99%

A novel combined C‐reactive protein‐albumin ratio and modified albumin‐bilirubin score can predict long‐term outcomes in patients with hepatocellular carcinoma after hepatic resection

Aida

Haruki

Akaoka

et al. 2023

Annals of Gastroent Surgery

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BackgroundSystemic inflammatory response represented by C‐reactive protein and albumin ratio (CAR) and modified albumin‐bilirubin (mALBI) grade both have been associated with long‐term outcome in patients with hepatocellular carcinoma (HCC). In this study, we investigated the prognostic utility of combined score of CAR and mALBI score to predict the prognosis of HCC patients after hepatic resection.MethodsThis study included 214 patients who had undergone primary hepatic resection for HCC between 2008 and 2018. Systemic inflammatory response and mALBI were evaluated preoperatively and patients were classified into three groups based on the combination of CAR and mALBI score: low CAR and low mALBI grade (score 0), either high CAR or high mALBI grade (score 1), and both high CAR and high mALBI grade ≥2b (score 2). Multivariate Cox proportional hazard models were conducted to assess disease‐free and overall survival.ResultsIn multivariate analysis, sex (p < 0.01), HBsAg positivity (p < 0.01), serum AFP level ≥20 ng/mL (p < 0.01), microvascular invasion (p = 0.02), multiple tumors (p < 0.01), type of resection (p < 0.01), and CAR‐mALBI score ≥2 (HR 2.19, 95% CI 1.39–3.44, p < 0.01) were independent prognostic factors of disease‐free survival, while sex (p = 0.01), HBsAg positivity (p < 0.01), poor tumor differentiation (p = 0.03), multiple tumors (p < 0.01), CAR‐mALBI score ≥2 (HR 2.70, 95% CI 1.51–4.83, p < 0.01) were independent prognostic factors of overall survival.ConclusionsCAR‐mALBI score is associated with disease‐free and overall survival in patients with HCC after hepatic resection, suggesting the importance of evaluating both hepatic functional reserve and host‐inflammatory state in the risk assessment of HCC patients.

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The prognostic impact of perioperative dynamic changes in cachexia index in patients with hepatocellular carcinoma

Akaoka,

Haruki,

Yamahata

et al. 2024

Annals of Gastroent Surgery

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BackgroundThe cachexia index (CXI), which consists of skeletal muscle, inflammation, and nutritional status, has been associated with prognosis in patients with hepatocellular carcinoma (HCC). We hypothesized that dynamic changes in CXI might be associated with long‐term outcomes in HCC.MethodsThis study comprised 131 patients who had undergone primary hepatic resection for HCC between 2008 and 2019. Preoperative CXI (pre‐CXI) and postoperative CXI (post‐CXI) were calculated by the following formula: skeletal muscle index x serum albumin level / neutrophil‐to‐lymphocyte ratio. Pre‐ and post‐CXI were classified into two groups (high vs. low). We retrospectively investigated the association of perioperative dynamic changes in CXI with disease‐free and overall survival.ResultsIn multivariate analyses, negative HBs‐antigen (p = 0.02), high serum PIVKA‐II level (p < 0.01), poor tumor differentiation (p = 0.02), multiple tumors (p < 0.01), microvascular invasion (p < 0.01), partial resection (p < 0.01), postoperative complications (p < 0.01), and low‐pre‐CXI (p < 0.01) were significant predictors of disease‐free survival, while high ICGR15 (p = 0.01), poor tumor differentiation (p < 0.01), multiple tumors (p = 0.01), postoperative complications (p < 0.01), low‐pre‐CXI (p < 0.01), and low‐post‐CXI (p < 0.01) were significant predictors of overall survival. Low‐post‐CXI was associated with older age (p = 0.045), larger tumor (p < 0.01), longer operation time (p = 0.047), greater intraoperative bleeding (p < 0.01), and intraoperative blood transfusion (p < 0.01). Moreover, dynamic changes in CXI were associated with overall survival in each subgroup of patients with low‐pre‐CXI (p = 0.02) or high‐pre‐CXI (p = 0.03).ConclusionsNot only post‐CXI but also dynamic changes in CXI from pre‐ to post‐hepatectomy can be a prognostic indicator of HCC, providing a compelling rationale for aggressive perioperative nutritional and physical interventions to improve long‐term outcomes.

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Sustained Systemic Inflammatory Response Predicts Survival in Patients with Hepatocellular Carcinoma After Hepatic Resection

Cited by 10 publications

References 29 publications

Postoperative inflammatory markers predict survival in patients after McKeown esophagectomy for esophageal cancer

Postoperative inflammatory markers predict survival in patients after McKeown esophagectomy for esophageal cancer

A novel combined C‐reactive protein‐albumin ratio and modified albumin‐bilirubin score can predict long‐term outcomes in patients with hepatocellular carcinoma after hepatic resection

The prognostic impact of perioperative dynamic changes in cachexia index in patients with hepatocellular carcinoma

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