Blood neutrophil-lymphocyte ratio predicts survival after hepatectomy for hepatocellular carcinoma: A propensity score-based analysis

• Published in: World journal of gastroenterology : WJG Vol. 22; no. 21; pp. 5088 - 5095
• Main Authors: Yang, Hao-Jie, Guo, Zhe, Yang, Yu-Ting, Jiang, Jing-Hang, Qi, Ya-Peng, Li, Ji-Jia, Li, Le-Qun, Xiang, Bang-De
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 07.06.2016
• Subjects: Adult; alpha-Fetoproteins - analysis; Blood; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; carcinoma;Liver; Chi-Square Distribution; China; Disease-Free Survival; Female; Hepatectomy - adverse effects; Hepatectomy - mortality; Humans; Kaplan-Meier Estimate; Liver Neoplasms - blood; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Lymphocyte Count; Lymphocytes; Male; Middle Aged; neutrophil-to-lymphocyte; Neutrophils; Predictive Value of Tests; Propensity Score; Proportional Hazards Models; ratio;Hepatocellular; resection;Prognosis;Postoperativ; Retrospective Studies; Retrospective Study; Risk Factors; Time Factors; Treatment Outcome; Postoperative change in neutrophil-to-lymphocyte ratio; Hepatocellular carcinoma; Liver resection; Prognosis; Blood neutrophil-to-lymphocyte ratio
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v22.i21.5088

AIM: To investigate whether an elevated preoperative neutrophil-to-lymphocyte ratio(NLR) can predict poor survival in patients with hepatocellular carcinoma(HCC).METHODS: We retrospectively reviewed 526 patients with HCC who underwent surgery between 2004 and 2011.RESULTS: Preoperative NLR ≥ 2.81 was an independent predictor of poor disease-free survival(DFS, P < 0.001) and overall survival(OS, P = 0.044). Compared with patients who showed a preoperative NLR < 2.81 and postoperative increase, patients who showed preoperative NLR ≥ 2.81 and postoperative decrease had worse survival(DFS, P < 0.001; OS, P < 0.001). Among patients with preoperative NLR ≥ 2.81, survival was significantly higher among those showing a postoperative decrease in NLR than among those showing an increase(DFS, P < 0.001; OS, P < 0.001). When elevated, alpha-fetoprotein(AFP) provided no prognostic information, and so preoperative NLR ≥ 2.81 may be a good complementary indicator of poor OS whenever AFP levels are low or high.CONCLUSION: Preoperative NLR ≥ 2.81 may be an indicator of poor DFS and OS in patients with HCC undergoing surgery. Preoperative NLR ≥ 2.81 may be a good complementary indicator of poor OS when elevated AFP levels provide no prognostic information.