TY - JOUR
T1 - A comparison of prognostic performance of perioperative inflammation markers in surgical resection for hepatocellular carcinoma
AU - Wu, Hsiang Ling
AU - Kuo, Hsien Cheng
AU - Li, Chun Cheng
AU - Wu, Yu Ming
AU - Lin, Shih Pin
AU - Chang, Kuang Yi
AU - Hou, Ming Chih
AU - Tsou, Mei Yung
AU - Cherng, Yih Giun
AU - Chen, Jui Tai
AU - Tai, Ying Hsuan
N1 - Funding Information:
This work was supported by the grants from Taipei Veterans General Hospital (V104C-096), Taipei, Taiwan, ROC, Shuang Ho Hospital (109IIT-02), Taipei Medical University, New Taipei City, Taiwan, ROC, and Ministry of Science and Technology (MOST104-2314-B-075-015; MOST109-2314-B-038-024), Taipei, Taiwan, Taiwan, ROC.
Publisher Copyright:
Copyright © 2021, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
PY - 2021/6/1
Y1 - 2021/6/1
N2 - Background: Systemic inflammation correlates closely with tumor invasion and may predict survival in cancer patients. We aimed to compare the prognostic value of various inflammation-based markers in patients with hepatocellular carcinoma. Methods: We consecutively enrolled 1450 patients with primary hepatocellular carcinoma undergoing surgical resection at the medical center between 2005 and 2016 and assessed them through September 2018. Prognostic nutritional index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio along with their perioperative dynamic changes were analyzed regarding their predictive ability of postoperative disease-free survival and overall survival. We calculated the adjusted hazard ratio (HR) and 95% CI of the association between inflammation-based markers and survival using multiple Cox proportional hazards models. Youden's index of receiver operating characteristics curves was used to determine optimal cut-off points. Results: Prognostic nutritional index was an independent predictor for both disease-free survival (<50.87 vs ≥50.87, HR: 1.274, 95% CI, 1.071-1.517, p = 0.007) and overall survival (<46.65 vs ≥46.65, HR: 1.420, 95% CI, 1.096-1.842, p = 0.008). Besides, the relative change of neutrophil-to-lymphocyte ratio predicted overall survival (<277% vs ≥277%, HR: 1.634, 95% CI, 1.266-2.110, p < 0.001). Combination of both markers offered better prognostic performance for overall survival than either alone. Body mass index, liver cirrhosis, chronic kidney disease, and tumor diameter were significantly associated with both markers. Conclusion: Prognostic nutritional index and perioperative relative change of neutrophil-to-lymphocyte ratio independently predict postoperative survival in patients undergoing surgical resection of hepatocellular carcinoma. These results provided important evidence for risk stratification and individualized anti-cancer therapy.
AB - Background: Systemic inflammation correlates closely with tumor invasion and may predict survival in cancer patients. We aimed to compare the prognostic value of various inflammation-based markers in patients with hepatocellular carcinoma. Methods: We consecutively enrolled 1450 patients with primary hepatocellular carcinoma undergoing surgical resection at the medical center between 2005 and 2016 and assessed them through September 2018. Prognostic nutritional index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio along with their perioperative dynamic changes were analyzed regarding their predictive ability of postoperative disease-free survival and overall survival. We calculated the adjusted hazard ratio (HR) and 95% CI of the association between inflammation-based markers and survival using multiple Cox proportional hazards models. Youden's index of receiver operating characteristics curves was used to determine optimal cut-off points. Results: Prognostic nutritional index was an independent predictor for both disease-free survival (<50.87 vs ≥50.87, HR: 1.274, 95% CI, 1.071-1.517, p = 0.007) and overall survival (<46.65 vs ≥46.65, HR: 1.420, 95% CI, 1.096-1.842, p = 0.008). Besides, the relative change of neutrophil-to-lymphocyte ratio predicted overall survival (<277% vs ≥277%, HR: 1.634, 95% CI, 1.266-2.110, p < 0.001). Combination of both markers offered better prognostic performance for overall survival than either alone. Body mass index, liver cirrhosis, chronic kidney disease, and tumor diameter were significantly associated with both markers. Conclusion: Prognostic nutritional index and perioperative relative change of neutrophil-to-lymphocyte ratio independently predict postoperative survival in patients undergoing surgical resection of hepatocellular carcinoma. These results provided important evidence for risk stratification and individualized anti-cancer therapy.
KW - Hepatocellular carcinoma
KW - Neutrophil-to-lymphocyte ratio
KW - Platelet-to-lymphocyte ratio
KW - Prognostic nutritional index
KW - Recurrence
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U2 - 10.1097/JCMA.0000000000000534
DO - 10.1097/JCMA.0000000000000534
M3 - Article
C2 - 33883464
AN - SCOPUS:85107710871
SN - 1726-4901
VL - 84
SP - 614
EP - 622
JO - Journal of the Chinese Medical Association
JF - Journal of the Chinese Medical Association
IS - 6
ER -
