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World Journal of Surgery
Published in: World Journal of Surgery 6/2015

01-06-2015 | Original Scientific Report

Preoperative Neutrophil to Lymphocyte Ratio and Prognostic Nutritional Index Predict Overall Survival After Hepatectomy for Hepatocellular Carcinoma

Authors: Yukiyasu Okamura, Ryo Ashida, Takaaki Ito, Teiichi Sugiura, Keita Mori, Katsuhiko Uesaka

Published in: World Journal of Surgery | Issue 6/2015

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Abstract

Background and aim

Several papers have shown that preoperative inflammation-based prognostic scores and/or immunonutritional status are associated with survival in patients with hepatocellular carcinoma (HCC). However, the validity of prognostic factors of these scores remains controversial. This study aimed to validate the power of prognostic scores based on the preoperative inflammatory and immunonutritional indices of patients who underwent hepatectomy for HCC with curative intent.

Methods

Clinicopathological parameters and inflammation-based prognostic scores and immunonutritional status, including the Glasgow Prognostic Score, neutrophil to lymphocyte ratio (NLR), and prognostic nutritional index (PNI), were retrospectively analyzed to identify the predictors of overall and recurrence-free survival in 256 patients.

Results

In multivariate analysis, NLR was an independent prognostic factor for overall, and recurrence-free survival (hazard ratio [HR] 2.59, 95 % confidence interval [CI] 1.56–4.31, P < 0.001, and HR 2.11, 95 % CI 1.44–3.11, P < 0.001, respectively). Additionally, PNI was an independent predictor of overall survival (HR 2.01, CI 1.21–3.36, P = 0.007).

Conclusions

The present study shows that the NLR and PNI based on preoperative inflammatory and immunonutritional indices are predictors of overall survival in patients who undergo hepatectomy for HCC with curative intent.
Literature
1.
Berasain C, Castillo J, Perugorria MJ et al (2009) Inflammation and liver cancer: new molecular mechanisms. Ann N Y Acad Sci 1155:206–221CrossRefPubMed
2.
Huitzil-Melendez FD, Capanu M, O’Reilly EM et al (2010) Advanced hepatocellular carcinoma: which staging system best predict prognosis? J Clin Oncol 28:2889–2895CrossRefPubMedCentralPubMed
3.
Zhou L, Rui JA, Wang SB et al (2010) LCSGJ-T classification, 6th or 5th edition TNM staging did not independently predict the long-term prognosis of HBV-related hepatocellular carcinoma after radical hepatectomy. J Surg Res 159:538–544CrossRefPubMed
4.
Llovet JM, Bru C, Bruix J (1999) Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis 19:329–338CrossRefPubMed
5.
The Cancer of the Liver Italian Program (CLIP) Investigators (1998) A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients. Hepatology 352:751–755CrossRef
6.
Hashimoto K, Ikeda Y, Korenaga D et al (2005) The impact of preoperative serum C-reactive protein on the prognosis of patients with hepatocellular carcinoma. Cancer 103:1856–1864CrossRefPubMed
7.
Nagaoka S, Yoshida T, Akiyoshi J et al (2007) Serum C-reactive protein levels predict survival in hepatocellular carcinoma. Liver Int 27:1091–1097CrossRefPubMed
8.
9.
Ishizuka M, Kubota K, Kita J et al (2012) Impact of an inflammation-based prognostic system on patients undergoing surgery for hepatocellular carcinoma: a retrospective study of 398 Japanese patients. Am J Surg 203:101–106CrossRefPubMed
10.
Pinato DJ, Stebbing J, Ishizuka M et al (2012) A novel and validated prognostic index in hepatocellular carcinoma: The inflammation based index (IBI). J Hepatol 57:1013–1020CrossRefPubMed
11.
Kinoshita A, Onoda H, Imai N et al (2012) Comparison of the prognostic value of inflammation-based prognostic scores in patients with hepatocellular carcinoma. Br J Cancer 107:988–993CrossRefPubMedCentralPubMed
12.
Mano Y, Shirabe K, Yamashita Y et al (2013) Preoperative neutrophil-to-lymphocyte ratio is a predictor of survival after hepatectomy for hepatocellular carcinoma. A retrospective analysis. Ann Surg 258:301–305CrossRefPubMed
13.
Pinato DJ, North BV, Sharma R (2012) A novel, externally validated inflammation-based prognostic algorithm in hepatocellular carcinoma: the prognostic nutritional index (PNI). Br J Cancer 106:1439–1445CrossRefPubMedCentralPubMed
14.
15.
Jung MR, Park YK, Jeong O et al (2011) Elevated preoperative neutrophil to lymphocyte ratio predicts poor survival following resection in late stage gastric cancer. J Surg Oncol 104:504–510CrossRefPubMed
16.
Shimada H, Takiguchi N, Kainuma O et al (2010) High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer 13:170–176CrossRefPubMed
17.
Malietzis G, Giacometti M, Askari A et al (2013) A preoperative neutrophil to lymphocyte ratio of 3 predicts disease-free survival after curative elective colorectal cancer surgery. Ann Surg. [Epub ahead of print]
18.
Jankova L, Dent OF, Chan C et al (2013) Preoperative neutrophil/lymphocyte ratio predicts overall survival but does not predict recurrence or cancer-specific survival after curative resection of node-positive colorectal cancer. BMC Cancer 13:442. doi:10.​1186/​1471-2407-13-442
19.
Absenger G, Szkandera J, Stotz M et al (2013) Preoperative neutrophil-to-lymphocyte ratio predicts clinical outcome in patients with stage II and III colon cancer. Anticancer Res 33:4591–4594PubMed
20.
Migita K, Takayama T, Saeki K et al (2013) The prognostic nutritional index predicts long-term outcomes of gastric cancer patients independent of tumor stage. Ann Surg Oncol 20:2649–2654CrossRef
21.
22.
Kanda M, Fujii T, Kodera Y et al (2011) Nutritional predictors of postoperative outcome in pancreatic cancer. Br J Surg 98:268–274CrossRefPubMed
23.
Onodera T, Goseki N, Kosaki G (1984) Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nippon Geka Gakkai Zasshi 85:1001–1005 [in Japanese]PubMed
24.
25.
Pugh RNH, Murray-Lyon IM, Dawson JL et al (1973) Transection of the esophagus for bleeding oesophageal varices. Br J Surg 60:646–649CrossRefPubMed
26.
Sobin LH, Gospodarowicz MK, Wittekind CH (eds) (2009) TNM classification of malignant tumours, 7th edn. Wiley-Liss, New York
27.
Halazun KJ, Hardy MA, Rana AA et al (2009) Negative impact of neutrophil-lymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma. Ann Surg 250:141–151CrossRefPubMed
28.
Motomura T, Shirabe K, Mano Y et al (2013) Neutrophil-lymphocyte ratio reflects hepatocellular carcinoma recurrence after liver transplantation via inflammatory microenvironment. J Hepatol 58:58–64CrossRefPubMed
29.
Hanley JA, McNeil BJ (1982) The meaning and use of the area under a receiver operating characteristic (roc) curve. Radiology 143:29–36CrossRefPubMed
30.
Wada Y, Nakashima O, Kutami R et al (1998) Clinicopathological study on hepatocellular carcinoma with lymphocytic infiltration. Hepatology 27:407–414CrossRefPubMed
31.
Okano K, Maeba T, Moroguchi A et al (2003) Lymphocytic infiltration surrounding liver metastases from colorectal cancer. J Surg Oncol 82:28–33CrossRefPubMed
32.
O’Keefe SJ, El-Zayadi AR, Carraher TE et al (1980) Malnutrition and immuno-incompetence in patients with liver disease. Lancet 20:615–617CrossRef
33.
Okabayashi T, Nishimori I, Sugimoto T et al (2008) Effects of branched-chain amino acids-enriched nutrient support for patients undergoing liver resection for hepatocellular carcinoma. J Gastroenterol Hepatol 23:1869–1873CrossRefPubMed
Metadata
Title
Preoperative Neutrophil to Lymphocyte Ratio and Prognostic Nutritional Index Predict Overall Survival After Hepatectomy for Hepatocellular Carcinoma
Authors
Yukiyasu Okamura
Ryo Ashida
Takaaki Ito
Teiichi Sugiura
Keita Mori
Katsuhiko Uesaka
Publication date
01-06-2015
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 6/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-015-2982-z

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