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. 2021 Dec 8:13:123-134.
doi: 10.2147/HMER.S333980. eCollection 2021.

The Prognostic Values of Neutrophil-to-lymphocyte Ratio and Platelet-to-Lymphocyte Ratio at Baseline in Predicting the In-hospital Mortality in Black African Patients with Advanced Hepatocellular Carcinoma in Palliative Treatment: A Comparative Cohort Study

Alassan Kouame Mahassadi  1 , Henriette Anzouan-Kacou Kissi  1 , Alain Koffi Attia  1
Affiliations

The Prognostic Values of Neutrophil-to-lymphocyte Ratio and Platelet-to-Lymphocyte Ratio at Baseline in Predicting the In-hospital Mortality in Black African Patients with Advanced Hepatocellular Carcinoma in Palliative Treatment: A Comparative Cohort Study

Alassan Kouame Mahassadi et al. Hepat Med. .

Abstract

Background: The prognostic values of the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) in predicting the in-hospital mortality of Black African patients with advanced hepatocellular carcinoma (HCC) in palliative treatment is unknown.

Aim: To determine the prognostic value of NLR and PLR compared with that of Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD) scores and the Barcelona clinic liver cancer staging system (BCLC).

Methods: The cutoffs, accuracies and association with the mortality of these prognostic scores were determined using a time-dependent area under receiver operating characteristic curves (AUC), the log rank test and Cox proportional hazards ratio.

Results: A total of 104 patients with advanced HCC (median age=49.5 years, males=58.7%) were enrolled. All were hospitalized for an enlarged liver mass of at least 15.4 cm in size in the right thoracic quadrant. Overall, 46 (44.2%) patients died in hospital during follow-up. Patients with NLR >2.5 (log rank test=7.11, p=0.01) or PLR >92 (log rank test=5.63, p=0.02) had poor survival. Factors associated with the in-hospital mortality were the MELD score (p=0.01), NLR (p=0.03) and hemoglobin level (p=0.02). NLR exhibits better and stable accuracy in predicting the in hospital mortality at time points of 30 (AUC=0.618), 60 (AUC=0.680) and 90 (AUC=0.613) days of follow-up, compared with CTP, MELD scores, BCLC and PLR. However, PLR displayed an enhanced accuracy over 90 days of follow up (AUC=0.688).

Conclusion: NLR is useful in predicting the in-hospital mortality in Black African patients with advanced stage HCC in clinical practice. NLR and PLR may be used concomitantly for long-term follow-up.

Keywords: hepatocellular carcinoma; neutrophil-to-lymphocyte ratio; prognosis; sub-Saharan Africa.

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Conflict of interest statement

Dr Alassan Kouame Mahassadi reports personal fees from Sanofi Aventis, outside the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Survival probabilities of patients with advanced hepatocellular carcinoma in palliative treatment according to the prognostic scores.
Figure 2
Figure 2
Receiver operating characteristic curves depicting the accuracy of the Child–Turcotte–Pugh (A) and MELD (B) scores, Barcelona clinic liver cancer staging system (C), neutrophil-to-lymphocyte ratio (D) and platelet-to-lymphocyte ratio (E) in predicting the in-hospital mortality among patients with advanced hepatocellular carcinoma in palliative treatment at different time points during follow-up.
See this image and copyright information in PMC

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