Prognostic value of the neutrophil-to-lymphocyte ratio for hepatocellular carcinoma patients with portal/hepatic vein tumor thrombosis

• Published in: World journal of gastroenterology : WJG Vol. 23; no. 17; pp. 3122 - 3132
• Main Authors: Li, Shao-Hua, Wang, Qiao-Xuan, Yang, Zhong-Yuan, Jiang, Wu, Li, Cong, Sun, Peng, Wei, Wei, Shi, Ming, Guo, Rong-Ping
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 07-05-2017
• Subjects: Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Disease-Free Survival; Female; Follow-Up Studies; Hepatectomy; Hepatic Veins - pathology; Humans; Kaplan-Meier Estimate; Liver - blood supply; Liver - pathology; Liver - surgery; Liver Neoplasms - blood; Liver Neoplasms - complications; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Lymphocyte Count; Lymphocytes; Male; Middle Aged; Neutrophils; Portal Vein - pathology; Predictive Value of Tests; Preoperative Period; Prognosis; Retrospective Studies; Retrospective Study; Risk Factors; Venous Thrombosis - blood; Venous Thrombosis - etiology; Venous Thrombosis - pathology; Hepatocellular carcinoma; Portal/hepatic vein tumor thrombosis; Prognosis; Neutrophil-to-lymphocyte ratio
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v23.i17.3122

AIM To investigate whether the preoperative neutrophil-tolymphocyte ratio(NLR) could predict the prognosis of hepatocellular carcinoma(HCC) patients with portal/hepatic vein tumor thrombosis(PVTT/HVTT) after hepatectomy.METHODS The study population included 81 HCC patients who underwent hepatectomy and were diagnosed with PVTT/HVTT based on pathological examination. The demographics, laboratory analyses, and histopathology data were analyzed.RESULTS Overall survival(OS) and disease-free survival(DFS) were determined in the patients with a high(> 2.9) and low(≤ 2.9) NLR. The median OS and DFS duration in the high NLR group were significantly shorter than those in the low NLR group(OS: 6.2 mo vs 15.7 mo, respectively, P = 0.007; DFS: 2.2 mo vs 3.7 mo, respectively, P = 0.039). An NLR > 2.9 was identified as an independent predictor of a poor prognosis of OS(P = 0.034, HR = 1.866; 95%CI: 1.048-3.322) in uni-and multivariate analyses. Moreover, there was a significantly positive correlation between the NLR and the Child-Pugh score(r = 0.276, P = 0.015) and the maximum diameter of the tumor(r = 0.435, P < 0.001). Additionally, the NLR could enhance the prognostic predictive power of the CLIP score for DFS in these patients. CONCLUSION The preoperative NLR is a prognostic predictor after hepatectomy for HCC patients with PVTT/HVTT. NLR > 2.9 indicates poorer OS and DFS.