Preoperative inflammatory markers as prognostic predictors after hepatocellular carcinoma resection: data from a western referral center
Abstract Background Recent studies from eastern centers have demonstrate an association between inflammatory response and long-term outcomes after hepatocellular carcinoma (HCC) resection. However, the prognostic impact of inflammatory markers in western patients, with distinct tumor and epidemiolog...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-022-01779-6 |
| _version_ | 1798004458079125504 |
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| author | João Paulo Maciel Silva Fabricio Ferreira Coelho Alex Jones Flores Cassenote Vagner Birk Jeismann Gilton Marques Fonseca Jaime Arthur Pirola Kruger José Donizeti de Meira Júnior Sérgio Carlos Nahas Paulo Herman |
| author_facet | João Paulo Maciel Silva Fabricio Ferreira Coelho Alex Jones Flores Cassenote Vagner Birk Jeismann Gilton Marques Fonseca Jaime Arthur Pirola Kruger José Donizeti de Meira Júnior Sérgio Carlos Nahas Paulo Herman |
| author_sort | João Paulo Maciel Silva |
| collection | DOAJ |
| description | Abstract Background Recent studies from eastern centers have demonstrate an association between inflammatory response and long-term outcomes after hepatocellular carcinoma (HCC) resection. However, the prognostic impact of inflammatory markers in western patients, with distinct tumor and epidemiologic features, is still unknown. Aim To evaluate the prognostic impact of preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), as well as their impact according to tumor size (< 5 cm, 5–10 cm, > 10 cm) in patients undergoing HCC resection with curative intent. Methods Optimal cut-off values for NLR, PLR, and MLR were determined by plotting the receiver operator curves. Overall survival (OS) and disease-free survival (DFS) curves were calculated using the Kaplan–Meier method and compared using the log-rank test. The Cox method was used to identify independent predictors of OS and DFS. Results In total, 161 consecutive adult patients were included. A high NLR (> 1.715) was associated with worse OS (P = 0.018). High NLR (> 2.475; P = 0.047) and PLR (> 100.25; P = 0.028) were predictors of short DFS. In HCC < 5 cm, MLR (> 1.715) was associated with worse OS (P = 0.047). In the multivariate analysis, high PLR was an independent predictor of worse DFS [hazard ratio (HR) 3.029; 95%CI 1.499–6.121; P = 0.002]. Conclusion Inflammatory markers are useful tools to predict long-term outcomes after liver resection in western patients, high NLR was able to stratify subgroups of patients with short OS and DFS, an increased PLR was an independent predictor of short DFS, while high MLR was associated with short OS in patients with early HCC. |
| first_indexed | 2024-04-11T12:24:08Z |
| format | Article |
| id | doaj.art-cd65eedd613e4e6c958d434e523ac22d |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-11T12:24:08Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-cd65eedd613e4e6c958d434e523ac22d2022-12-22T04:24:00ZengBMCBMC Surgery1471-24822022-09-0122111010.1186/s12893-022-01779-6Preoperative inflammatory markers as prognostic predictors after hepatocellular carcinoma resection: data from a western referral centerJoão Paulo Maciel Silva0Fabricio Ferreira Coelho1Alex Jones Flores Cassenote2Vagner Birk Jeismann3Gilton Marques Fonseca4Jaime Arthur Pirola Kruger5José Donizeti de Meira Júnior6Sérgio Carlos Nahas7Paulo Herman8Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São PauloInstituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São PauloInstituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São PauloInstituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São PauloInstituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São PauloInstituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São PauloInstituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São PauloInstituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São PauloInstituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São PauloAbstract Background Recent studies from eastern centers have demonstrate an association between inflammatory response and long-term outcomes after hepatocellular carcinoma (HCC) resection. However, the prognostic impact of inflammatory markers in western patients, with distinct tumor and epidemiologic features, is still unknown. Aim To evaluate the prognostic impact of preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), as well as their impact according to tumor size (< 5 cm, 5–10 cm, > 10 cm) in patients undergoing HCC resection with curative intent. Methods Optimal cut-off values for NLR, PLR, and MLR were determined by plotting the receiver operator curves. Overall survival (OS) and disease-free survival (DFS) curves were calculated using the Kaplan–Meier method and compared using the log-rank test. The Cox method was used to identify independent predictors of OS and DFS. Results In total, 161 consecutive adult patients were included. A high NLR (> 1.715) was associated with worse OS (P = 0.018). High NLR (> 2.475; P = 0.047) and PLR (> 100.25; P = 0.028) were predictors of short DFS. In HCC < 5 cm, MLR (> 1.715) was associated with worse OS (P = 0.047). In the multivariate analysis, high PLR was an independent predictor of worse DFS [hazard ratio (HR) 3.029; 95%CI 1.499–6.121; P = 0.002]. Conclusion Inflammatory markers are useful tools to predict long-term outcomes after liver resection in western patients, high NLR was able to stratify subgroups of patients with short OS and DFS, an increased PLR was an independent predictor of short DFS, while high MLR was associated with short OS in patients with early HCC.https://doi.org/10.1186/s12893-022-01779-6HepatectomyHepatocellular carcinomaInflammationPrognosisSurvival analysis |
| spellingShingle | João Paulo Maciel Silva Fabricio Ferreira Coelho Alex Jones Flores Cassenote Vagner Birk Jeismann Gilton Marques Fonseca Jaime Arthur Pirola Kruger José Donizeti de Meira Júnior Sérgio Carlos Nahas Paulo Herman Preoperative inflammatory markers as prognostic predictors after hepatocellular carcinoma resection: data from a western referral center BMC Surgery Hepatectomy Hepatocellular carcinoma Inflammation Prognosis Survival analysis |
| title | Preoperative inflammatory markers as prognostic predictors after hepatocellular carcinoma resection: data from a western referral center |
| title_full | Preoperative inflammatory markers as prognostic predictors after hepatocellular carcinoma resection: data from a western referral center |
| title_fullStr | Preoperative inflammatory markers as prognostic predictors after hepatocellular carcinoma resection: data from a western referral center |
| title_full_unstemmed | Preoperative inflammatory markers as prognostic predictors after hepatocellular carcinoma resection: data from a western referral center |
| title_short | Preoperative inflammatory markers as prognostic predictors after hepatocellular carcinoma resection: data from a western referral center |
| title_sort | preoperative inflammatory markers as prognostic predictors after hepatocellular carcinoma resection data from a western referral center |
| topic | Hepatectomy Hepatocellular carcinoma Inflammation Prognosis Survival analysis |
| url | https://doi.org/10.1186/s12893-022-01779-6 |
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