Usefulness of neutrophil-to-lymphocyte ratio (NLR) as a prognostic predictor after treatment of hepatocellular carcinoma." Review article

Mouchli, Mohamad; Reddy, Shravani; Gerrard, Miranda; Boardman, Lisa A.; Rubio, Marrieth

doi:10.1016/j.aohep.2020.08.067

Cited by 81 publications

(54 citation statements)

References 177 publications

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“… 16 It can create a tissue microenvironment characterized by tissue rearrangement, immunosuppression, and abundant growth factors that allow the tumor to initiate, progress, and metastasize through altering the local control of tissue homeostasis, cell proliferation, and genetic stability. 17 Some inflammation-related indexes have been reported as independent risk factors for prognosis in HCC patients after liver resection, such as the neutrophil-to-lymphocyte ratio (NLR), 18 platelet-to-lymphocyte ratio (PLR), 10 lymphocyte-to-monocyte ratio (LMR), 12 neutrophil times γ-glutamyl transpeptidase-to-lymphocyte ratio (NγLR), 14 platelet times neutrophil-to-lymphocyte ratio (PNLR), 15 prognostic nutritional index (PNI). 9 However, the role of inflammation-related indexes in extrahepatic metastasis after curative hepatectomy has not been well illustrated.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Platelet-to-Lymphocyte Ratio (PLR) in Extrahepatic Metastasis of Hepatocellular Carcinoma After Curative Resection

Chen

Zeng

Guo

et al. 2021

CMAR

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Background The prognosis for patients diagnosed of hepatocellular carcinoma (HCC) who have extrahepatic metastasis after liver resection is unsatisfactory. This study aimed to find out the relationship between the inflammation-related indexes and metastasis. Methods One thousand three hundred and sixty-six patients diagnosed of HCC who underwent curative resection were included in this study and divided into metastasis group (n=180) and non-metastasis group (n=1186). A receiver operating characteristic (ROC) curve was constructed to estimate the optimal cut-off value for inflammation-related indexes. Independent risk factors were identified by Cox regression analysis. The metastasis rate was analyzed by the Kaplan-Meier method, then the subgroup analyses were taken. Results The cut-off values of NLR, PLR, LMR, NγLR, PNLR, and PNI were 2.65, 107.67, 5.47, 134.52, 335.03, and 51.23, respectively. Multivariate Cox analysis revealed that elevated serum AFP level (P=0.004), tumor size more than 5cm (P<0.001), multiple tumors (P=0.040), and higher PLR (P=0.042) were independent risk factors associated with extrahepatic metastasis. The Kaplan-Meier method showed that the high PLR group has a higher extrahepatic metastasis rate than the low PLR group. Meanwhile, the results of subgroup analyses were consistent with the conclusion. Conclusion The PLR is an independent risk factor of extrahepatic metastasis after radical hepatectomy for HCC patients. The high PLR indicates a higher rate of extrahepatic metastasis.

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Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Platelet-to-Lymphocyte Ratio (PLR) in Extrahepatic Metastasis of Hepatocellular Carcinoma After Curative Resection

Chen

Zeng

Guo

et al. 2021

CMAR

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“…In the current study, we examined not only ALC but also NLR as lymphocyte-related factors, as there are various reports describing how these factors relate to the prognosis of surgery and systemic treatment [9,10,29]. It has been reported that in ammatory cytokines are involved in cancer progression and associated with chemotherapy [30,31].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, lymphocytes, especially T-cell lymphocytes, are known to play an important role in the cancer immune system [4,5]. Some studies have reported that, in the treatment for various cancers, survival rates are associated with lymphopenia and neutrophil lymphocyte ratio (NLR) as representative markers [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the Association Between Low Dose Bone, Lung, and Heart Irradiation and Survival Rates for Patients Who Received High-dose Proton Beam Therapy With Concurrent Chemotherapy for Stage III Non-small Cell Lung Cancer

Nakamura

Ishikawa

Ohnishi

et al. 2021

Preprint

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Background: Lymphocytes play an important role in the cancer immune system. We investigated influences of irradiated doses and volumes of the bone on lymphopenia and survivals in chemoradiotherapy for stage III non-small cell lung cancer (NSCLC).Methods: Data from 41 patients with stage III unresectable NSCLC who received definitive proton beam therapy (PBT) of 74 GyE with concurrent chemotherapy between 2007 and 2017 were retrospectively reviewed. The correlation between dosimetry parameters obtained from dose-volume histograms (DVHs) of the bone, lung, and heart and lymphopenia during PBT were analyzed. Maximum and minimum absolute lymphocyte counts (ALCmax and ALCmin) and maximum neutrophil/lymphocyte ratio (NLRmax) were used as indicators of lymphopenia. Clinical factors, dosimetry parameters, and indicators of lymphopenia were also evaluated for the correlation with overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS).Results: Significant inverse correlations were observed between bone V5 and ALCmax (ρ = -0.377, p = 0.015) and ALCmin (ρ = -0.441, p = 0.003) during the treatment period. Also, significant correlation between bone V5 and NLRmax (ρ = 0.398, p = 0.010) was observed, but bone V5 exhibited no significant association with OS, PFS, or DMFS. On the other hand, heart V5 (Hazard ratio [HR]: 1.032, p = 0.023), ALCmax (HR: 0.999, p = 0.049), and NLRmax (HR: 1.035, p = 0.007) were significantly associated with OS in univariable analysis. Lung V5 tended to be associated with PFS in univariable analysis (HR: 1.047, p = 0.056) and was significantly associated with DMFS (HR: 1.075, p =0.005). In multivariable analysis, heart V5 was not associated with OS, whereas ALCmax was significantly associated with OS (HR: 0.999, p = 0.022). Lung V5 was not a factor associated with PFS, but it was significantly associated with DMFS (HR: 1.062, p = 0.027).Conclusions: In PBT with chemotherapy for stage III NSCLC, lymphopenia was correlate with irradiation doses to the bone and lung, and lung dose but not bone dose was associated with DMFS.

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“…Although the underlying mechanism is unclear, such relation may explain the association between CRP and recurrence after resection. The NLR, TAM levels, inflammatory and immunologic markers have also been associated with recurrence after resection [ 117 , 118 , 119 , 120 ]. A high NLR (cutoff value 2–3) was an independent prognostic factor for recurrence and has been associated with increased infiltration of TAMs [ 118 , 121 ].…”

Section: Surgical Resectionmentioning

confidence: 99%

Immunological Markers, Prognostic Factors and Challenges Following Curative Treatments for Hepatocellular Carcinoma

Lee

Jang

et al. 2021

IJMS

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Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortalities worldwide. Patients with early-stage HCC are eligible for curative treatments, such as surgical resection, liver transplantation (LT) and percutaneous ablation. Although curative treatments provide excellent long-term survival, almost 70–80% of patients experience HCC recurrence after curative treatments. Tumor-related factors, including tumor size, number and differentiation, and underlying liver disease, are well-known risk factors for recurrence following curative therapies. Moreover, the tumor microenvironment (TME) also plays a key role in the recurrence of HCC. Many immunosuppressive mechanisms, such as an increase in regulatory T cells and myeloid-derived suppressor cells with a decrease in cytotoxic T cells, are implicated in HCC recurrence. These suppressive TMEs are also modulated by several factors and pathways, including mammalian target of rapamycin signaling, vascular endothelial growth factor, programmed cell death protein 1 and its ligand 1. Based on these mechanisms and the promising results of immune checkpoint blockers (ICBs) in advanced HCC, there have been several ongoing adjuvant studies using a single or combination of ICB following curative treatments in HCC. In this review, we strive to provide biologic and immunological markers, prognostic factors, and challenges associated with clinical outcomes after curative treatments, including resection, LT and ablation.

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Usefulness of neutrophil-to-lymphocyte ratio (NLR) as a prognostic predictor after treatment of hepatocellular carcinoma." Review article

Cited by 81 publications

References 177 publications

Prognostic Significance of Platelet-to-Lymphocyte Ratio (PLR) in Extrahepatic Metastasis of Hepatocellular Carcinoma After Curative Resection

Prognostic Significance of Platelet-to-Lymphocyte Ratio (PLR) in Extrahepatic Metastasis of Hepatocellular Carcinoma After Curative Resection

Analysis of the Association Between Low Dose Bone, Lung, and Heart Irradiation and Survival Rates for Patients Who Received High-dose Proton Beam Therapy With Concurrent Chemotherapy for Stage III Non-small Cell Lung Cancer

Immunological Markers, Prognostic Factors and Challenges Following Curative Treatments for Hepatocellular Carcinoma

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