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Impact of neutrophil to lymphocyte ratio on survival for hepatocellular carcinoma after curative resection
Author(s) -
Hung HaoChien,
Lee JinChiao,
Cheng ChihHsien,
Wu TsungHan,
Wang YuChao,
Lee ChenFang,
Wu TingJung,
Chou HongShiue,
Chan KunMing,
Lee WeiChen
Publication year - 2017
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.498
Subject(s) - hepatocellular carcinoma , neutrophil to lymphocyte ratio , medicine , resection , oncology , gastroenterology , lymphocyte , overall survival , surgery
Abstract Background Neutrophil‐lymphocyte ratio ( NLR ) represents a pro‐tumor inflammatory environment and host immunity. The aim of this study was to examine the effect of subsequent NLR for hepatocellular carcinoma (HCC) after liver resection. Methods A total of 672 patients had liver resection for HCC were included in this study. NLR at diagnosis of HCC and HCC recurrence were collected. NLR at 2.5 was used as cut‐off value to calculate its prognostic effect. Results According to NLR cut‐off value, the patients with NLR >2.5 had larger tumor size, higher histology grade, and higher rates of tumor multiplicity and vascular invasion. After a median follow‐up of 76.3 months, 437 (65.0%) patients had tumor recurrence. The 1‐, 3‐ and 5‐year recurrence‐free survival were 77.4%, 55.2% and 44.8% in NLR ≤2.5 group, compared to 64.1%, 45.2% and 35.5% in NLR >2.5 group ( P = 0.016). When patients had tumor recurrence, 5‐year post‐recurrent survival was best in the patients staying with NLR ≤2.5 all the time and decreased from 45.9% to 24.6% if NLR was ≤2.5 at resection and became >2.5 at recurrence ( P = 0.013). Conclusion High NLR was an independent unfavorable prognostic factor. Subsequent change of NLR between liver resection and HCC recurrence could predict post‐recurrent survival.