High Neutrophil-Lymphocyte Ratio and Delta Neutrophil-Lymphocyte Ratio Are Associated with Increased Mortality in Patients with Hepatocellular Cancer
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature..
BACKGROUND: The neutrophil-lymphocyte ratio (NLR) has been proposed as a prognostic biomarker for cirrhosis and non-liver malignancies. We aimed to evaluate the prognostic value of NLR in a diverse cohort of patients with hepatocellular carcinoma (HCC).
METHODS: We performed a retrospective study of patients diagnosed with HCC between 2008 and 2017 at two large US health systems. We used Cox proportional hazard and multivariable ordinal logistic regression models to identify factors associated with overall survival and response to first HCC treatment, respectively. Primary variables of interest were baseline NLR and delta NLR, defined as the difference between pre- and post-treatment NLR.
RESULTS: Among 1019 HCC patients, baseline NLR was < 5 in 815 (80.0%) and ≥ 5 in 204 (20.0%). Patients with NLR ≥ 5 had a higher proportion of infiltrative tumors (36.2% vs 22.3%), macrovascular invasion (39.6% vs 25.5%), metastatic disease (20.6% vs 11.4%), and AFP > 200 ng/mL (45.6% vs 33.8%). Baseline NLR ≥ 5 was independently associated with higher mortality (median survival 4.3 vs 15.1 months; adjusted HR 1.70, 95%CI 1.41-2.06), with differences in survival consistent across BCLC stages. After adjusting for baseline covariates including NLR, delta NLR > 0.26 was also independently associated with increased mortality (HR 1.42, 95%CI 1.14-1.78). In a secondary analysis, high NLR was associated with lower odds of response to HCC treatment (20.2% vs 31.6%; adjusted OR 0.55, 95%CI 0.32-0.95).
CONCLUSIONS: In a large Western cohort of patients with HCC, high baseline NLR and delta NLR were independent predictors of mortality.
IMPACT: NLR is an inexpensive test that may be a useful component of future HCC prognostic models.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:67 |
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| Enthalten in: |
Digestive diseases and sciences - 67(2022), 6 vom: 03. Juni, Seite 2666-2676 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rich, Nicole E [VerfasserIn] |
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| Links: |
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| Themen: |
Biomarker |
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| Anmerkungen: |
Date Completed 08.06.2022 Date Revised 08.08.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s10620-021-07001-6 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Rich, Nicole E |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a High Neutrophil-Lymphocyte Ratio and Delta Neutrophil-Lymphocyte Ratio Are Associated with Increased Mortality in Patients with Hepatocellular Cancer |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Revised 08.08.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. | ||
| 520 | |a BACKGROUND: The neutrophil-lymphocyte ratio (NLR) has been proposed as a prognostic biomarker for cirrhosis and non-liver malignancies. We aimed to evaluate the prognostic value of NLR in a diverse cohort of patients with hepatocellular carcinoma (HCC) | ||
| 520 | |a METHODS: We performed a retrospective study of patients diagnosed with HCC between 2008 and 2017 at two large US health systems. We used Cox proportional hazard and multivariable ordinal logistic regression models to identify factors associated with overall survival and response to first HCC treatment, respectively. Primary variables of interest were baseline NLR and delta NLR, defined as the difference between pre- and post-treatment NLR | ||
| 520 | |a RESULTS: Among 1019 HCC patients, baseline NLR was < 5 in 815 (80.0%) and ≥ 5 in 204 (20.0%). Patients with NLR ≥ 5 had a higher proportion of infiltrative tumors (36.2% vs 22.3%), macrovascular invasion (39.6% vs 25.5%), metastatic disease (20.6% vs 11.4%), and AFP > 200 ng/mL (45.6% vs 33.8%). Baseline NLR ≥ 5 was independently associated with higher mortality (median survival 4.3 vs 15.1 months; adjusted HR 1.70, 95%CI 1.41-2.06), with differences in survival consistent across BCLC stages. After adjusting for baseline covariates including NLR, delta NLR > 0.26 was also independently associated with increased mortality (HR 1.42, 95%CI 1.14-1.78). In a secondary analysis, high NLR was associated with lower odds of response to HCC treatment (20.2% vs 31.6%; adjusted OR 0.55, 95%CI 0.32-0.95) | ||
| 520 | |a CONCLUSIONS: In a large Western cohort of patients with HCC, high baseline NLR and delta NLR were independent predictors of mortality | ||
| 520 | |a IMPACT: NLR is an inexpensive test that may be a useful component of future HCC prognostic models | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Biomarker | |
| 650 | 4 | |a Inflammation | |
| 650 | 4 | |a Liver cancer | |
| 650 | 4 | |a Prognosis | |
| 650 | 4 | |a Tumor staging | |
| 700 | 1 | |a Parvathaneni, Aarthi |e verfasserin |4 aut | |
| 700 | 1 | |a Sen, Ahana |e verfasserin |4 aut | |
| 700 | 1 | |a Odewole, Mobolaji |e verfasserin |4 aut | |
| 700 | 1 | |a Arroyo, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Mufti, Arjmand R |e verfasserin |4 aut | |
| 700 | 1 | |a Kerr, Thomas A |e verfasserin |4 aut | |
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| 700 | 1 | |a Mayo, Marlyn J |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, William M |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Ju Dong |e verfasserin |4 aut | |
| 700 | 1 | |a Yokoo, Takeshi |e verfasserin |4 aut | |
| 700 | 1 | |a Gopal, Purva |e verfasserin |4 aut | |
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| 700 | 1 | |a Marrero, Jorge A |e verfasserin |4 aut | |
| 700 | 1 | |a Singal, Amit G |e verfasserin |4 aut | |
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