The systemic inflammatory response as a prognostic factor for advanced hepatocellular carcinoma with extrahepatic metastasis

Abstract

Abstract. Several indices have been proposed to evaluate the systemic inflammatory response (SIR), which has been reported to be a useful prognostic factor in various types of cancer. We investigated the usefulness of the Glasgow Prognostic Score (GPS), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic factors in patients with advanced hepatocellular carcinoma (HCC) with extrahepatic metastasis (stage IVB). Between April, 1997 and March, 2013, a total of 434 HCC patients who developed extrahepatic metastasis were enrolled in the present study. The GPS was defined on the basis of pretreatment C-reactive protein (CRP) and albumin (Alb) levels, and the subjects were grouped according to GPS 0-2. The NLR was calculated as the neutrophil count̸lymphocyte count, and the PLR was calculated as the platelet count̸lymphocyte count. A comparative examination was performed using a survival analysis with approximate median values to determine the cut-off value for both ratios. The median survival time (MST) of the 434 patients overall was 7.3 months, with cumulative survival rates of 31.8, 14.5 and 7.7% at 1, 2 and 3 years, respectively. The patient backround was as follows: The male:female ratio was 363:71, with a median age of 67. and GPS (1+2; HR=1.410; 95% CI: 1.060-1.874, P=0.018) were independent risk factors. A total of 136 patients were included in the GPS 0 group, 169 patients in the GPS 1 group and 129 patients in the GPS 2 group. The low together with the high NLR groups comprised 217 patients. The MST was 480 days in the GPS 0 group, 154 days in the GPS 1 and 2 groups, 115 days in the high NLR group and 321 days in the low NLR group; a significant difference in survival was observed for the GPS and NLR groups. Therefore, we consider GPS and NLR to be useful prognostic factors in patients with stage IVB HCC.

Value of the preoperative neutrophil‐to‐lymphocyte ratio as a prognostic factor for long‐term survival in postoperative esophageal squamous cell carcinoma patients

“…Based on these inflammatory responses, systemic inflammatory markers, which can reflect the inflammatory status of patients, such as the NLR, can predict mortality and recurrence in a variety of cancers . Sharaiha et al .…”

Elevated neutrophil‑to‑lymphocyte ratio is associated with nutritional impairment, immune suppression, resistance to S‑1 plus cisplatin, and poor prognosis in patients with stage?IV gastric cancer

“…Based on these findings, a number of inflammation-based prognostic markers such as the Glasgow Prognostic Score (GPS) and the platelet to lymphocyte ratio (PLR) have been studied (6,7). In addition, Elevated neutrophil-to-lymphocyte ratio is associated with nutritional impairment, immune suppression, resistance to S-1 plus cisplatin, and poor prognosis in patients with stage IV gastric cancer KENJI GONDA 1,2 , MASAHIKO SHIBATA there is increasing evidence that the neutrophil to lymphocyte ratio (NLR) can be an effective prognostic indicator in various types of malignant diseases (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). In cancer patients, lymphopenia reflects an impaired cell-mediated immunity, while neutrophilia is acknowledged as a response to systemic inflammation.…”

Increased neutrophil-to-lymphocyte ratio is a novel marker for nutrition, inflammation and chemotherapy outcome in patients with locally advanced and metastatic esophageal squamous cell carcinoma

“…Thus, the prognostic value of inflammation-based prognostic scores, such as the Glasgow Prognostic Score (GPS) and the platelet-to-lymphocyte ratio (6,7), has been studied. In addition, increasing evidence has indicated that the neutrophil-to-lymphocyte ratio (NLR) may be an effective prognostic indicator in various types of malignant diseases (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18).…”