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Combination of neutrophil‐to‐lymphocyte ratio and early des‐γ‐carboxyprothrombin change ratio as a useful predictor of treatment response for hepatic arterial infusion chemotherapy against advanced hepatocellular carcinoma
Author(s) -
Tsunematsu Seiji,
Suda Goki,
Yamasaki Kazushi,
Kimura Megumi,
Takaaki Izumi,
Umemura Machiko,
Ito Jun,
Sato Fumiyuki,
Nakai Masato,
Sho Takuya,
Morikawa Kenichi,
Ogawa Koji,
Kamiyama Toshiya,
Taketomi Akinobu,
Sakamoto Naoya
Publication year - 2017
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12775
Subject(s) - medicine , hepatocellular carcinoma , neutrophil to lymphocyte ratio , gastroenterology , multivariate analysis , univariate analysis , progression free survival , oncology , complete response , chemotherapy , progressive disease , lymphocyte
Aim Hepatic arterial infusion chemotherapy (HAIC) is a potent therapeutic option for advanced hepatocellular carcinoma (HCC). However, there are few known predictive factors of treatment response to HAIC. We clarified the most accurate predictive factors early on in treatment. Methods Study subjects were 70 patients with advanced HCC who had been treated with HAIC. We assessed the relationships between patient characteristics, change ratios of early tumor markers, tumor response, progression‐free survival (PFS), and overall survival. Results After two courses of HAIC, 1 (1.4%), 16 (22.9%), 30 (42.8%), and 23 (32.9%) of the 70 patients showed complete response, partial response, stable disease, and progressive disease, respectively. Overall survival was related to Child–Turcotte–Pugh score, extrahepatic metastasis, and the des‐γ‐carboxyprothrombin (DCP) response. Univariate and multivariate analyses identified the neutrophil‐to‐lymphocyte ratio (NLR) and DCP response as significant determinants of treatment response and PFS. Progression‐free survival with a low NLR (<2.87) was significantly longer than with a high NLR (median, 8.4 months vs. 2.8 months, respectively). Progression‐free survival was 7.2 months for patients with a responsive DCP (<0.7) and 2.3 months for an unresponsive DCP (≥0.7). Additionally, even with baseline high NLR, patients with responsive DCP achieved better PFS. Conclusion Baseline NLR and early DCP response were significant predictors of treatment response and PFS after HAIC for patients with advanced HCC. The combination of baseline NLR and early DCP response could be accurate and useful predictive factors of response to HAIC and could help optimize treatments for patients with advanced HCC.