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

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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.

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Conflict of interest

None declared.

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Authors and Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan

    Yukiyasu Okamura, Ryo Ashida, Takaaki Ito, Teiichi Sugiura & Katsuhiko Uesaka

  2. Clinical Trial Coordination Office Biostatistician, Shizuoka Cancer Center Hospital, Shizuoka, 411-8777, Japan

    Keita Mori

Authors
  1. Yukiyasu Okamura
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  2. Ryo Ashida
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  3. Takaaki Ito
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  4. Teiichi Sugiura
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  5. Keita Mori
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  6. Katsuhiko Uesaka
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Correspondence to Yukiyasu Okamura.

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Okamura, Y., Ashida, R., Ito, T. et al. Preoperative Neutrophil to Lymphocyte Ratio and Prognostic Nutritional Index Predict Overall Survival After Hepatectomy for Hepatocellular Carcinoma. World J Surg 39, 1501–1509 (2015). https://doi.org/10.1007/s00268-015-2982-z

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  • DOI: https://doi.org/10.1007/s00268-015-2982-z

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