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Inflammatory Scores: Correlation with Clinical Outcomes in Hepatocellular Carcinoma Patients Undergoing Transarterial Radioembolization

  • Clinical Investigation
  • Interventional Oncology
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the ability of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), aspartate aminotransferase-to-lymphocyte ratio (ALRI) and systemic-inflammation index (SII) to predict clinical outcomes in hepatocellular carcinoma (HCC) patients undergoing transarterial radioembolization (TARE).

Materials and Methods

One hundred forty-five patients who underwent treatment of 167 HCCs had their pretreatment and 1 month post treatment laboratory values evaluated. Overall survival (OS), progression-free survival (PFS) and local PFS models were performed with patients separated by median inflammatory scores.

Results

The median pretreatment NLR, PLR, ALRI and SII were 3.0 (range: 0.5–176), 104.4 (range: 25–830), 55.7 (range: 7.5–2090) and 360.2 (range: 51.1–7207.8), respectively. While the median post treatment NLR, PLR, ALRI and SII were 6.2 (range: 0.4–176), 180 (range: 35–2100), 125 (range: 15.9–5710) and 596.8 (range: 28.9–19,320), respectively. OS models showed significant differences when separating the groups by median post treatment NLR (p = 0.003) and SII (p = 0.003). Multivariate Cox regression models for OS with all pre and post treatment inflammatory markers (log-scale) as well as tumor size, AFP and Child–Pugh score showed significant pretreatment NLR [HR: 0.22 (95% CI:0.06–0.75), p = 0.016] and SII [3.52 (95% CI: 1.01–12.3), p = 0.048], as well as post treatment NLR [6.54 (95% CI: 1.57–27.2), p = 0.010] and SII [0.20 (95% CI: 0.05–0.82), p = 0.025] association. The post treatment ALRI (p = 0.010) correlated with PFS while, post treatment NLR (p < 0.001), ALRI (p = 0.024) and SII (p = 0.005) correlated with local PFS.

Conclusion

Pretreatment and post treatment NLR and SII may be associated with OS and post treatment ALRI may be associated with both PFS and local PFS in HCC patients undergoing TARE.

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Acknowledgements

Research reported in this publication was supported by National Institute of Health grant P30 CA77598 utilizing the Biostatistics and Bioinformatics Core shared resource of the Masonic Cancer Center, University of Minnesota and by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1-TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding

This study was not supported by any funding. SY is a consultant for Boston Scientific. JG and DD are consultants for Sirtex Medical.

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Authors and Affiliations

  1. Department of Radiology, Division of Interventional Radiology, University of Minnesota, 420 Delware St. SE, MMC 292, Minneapolis, MN, 55455, USA

    Shamar Young, Nathan Rubin, Donna D’Souza, Pranav Sharma, John Pontolillo, Siobhan Flanagan & Jafar Golzarian

  2. Department of Radiology, Minneapolis VA Medical Center, Minneapolis, MN, USA

    Tina Sanghvi

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  1. Shamar Young
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Correspondence to Shamar Young.

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Shamar Young, Nathan Rubin, Donna D′Souza, Pranav Sharma, John Pontolillio, Siobhan Flanagan, Jafar Golzarian, Tina Sanghvi declare that they have no conflict of interest.

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For this type of study formal consent is not required. This study has obtained IRB approval from University of Minnesota IRB and the need for informed consent was waived. For this type of study consent for publication is not required.

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Young, S., Rubin, N., D’Souza, D. et al. Inflammatory Scores: Correlation with Clinical Outcomes in Hepatocellular Carcinoma Patients Undergoing Transarterial Radioembolization. Cardiovasc Intervent Radiol 45, 461–475 (2022). https://doi.org/10.1007/s00270-022-03080-8

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