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. 2016 Jun 7;22(21):5088-95.
doi: 10.3748/wjg.v22.i21.5088.

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

Hao-Jie Yang  1 , Zhe Guo  1 , Yu-Ting Yang  1 , Jing-Hang Jiang  1 , Ya-Peng Qi  1 , Ji-Jia Li  1 , Le-Qun Li  1 , Bang-De Xiang  1
Affiliations

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

Hao-Jie Yang et al. World J Gastroenterol. .

Abstract

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.

Keywords: Blood neutrophil-to-lymphocyte ratio; Hepatocellular carcinoma; Liver resection; Postoperative change in neutrophil-to-lymphocyte ratio; Prognosis.

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Figures

Figure 1
Figure 1
Post-hepatectomy disease-free survival (A) and overall survival (B) of hepatocellular carcinoma patients with high or low neutrophil-to-lymphocyte ratio. Separate curves are shown for the entire cohort (n = 526) and the propensity-matched cohort (n = 222). NLR: Neutrophil-to-lymphocyte ratio.
Figure 2
Figure 2
Comparison of survival of Chinese patients with hepatocellular carcinoma, stratified by preoperative neutrophil-to-lymphocyte ratio and postoperative change in neutrophil-to-lymphocyte ratio. NLR: Neutrophil-to-lymphocyte ratio.
Figure 3
Figure 3
Comparison of overall survival of hepatocellular carcinoma patients stratified based on preoperative alpha-fetoprotein level and on high or low preoperative neutrophil-to-lymphocyte ratio. Patients were grouped using alpha-fetoprotein cut-off values of 400 ng/mL (A), 200 ng/mL (B). Results are shown only for the entire cohort (n = 526). NLR: Neutrophil-to-lymphocyte ratio.
See this image and copyright information in PMC

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