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Inflammatory Markers are Associated with Outcome in Patients with Unresectable Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The serum neutrophil–lymphocyte ratio (NLR) is associated with outcomes in several solid organ cancers, including hepatocellular carcinoma (HCC).

Methods

We reviewed our experience in patients with HCC who underwent transarterial chemoembolization (TACE) as the initial treatment. Serum complete blood counts were used to calculate the NLR before and after TACE. The Kaplan–Meier method was used to determine survival and significant differences between groups by the log-rank test.

Results

There were 103 patients identified who underwent TACE for HCC. The median age was 60.5 years. Median overall survival was 12.6 (95 % confidence interval 8.3–17) months. Median survival in patients with a high preprocedural NLR was 4.2 months compared to 15 months in those with a normal NLR (p = 0.021). In those whose NLR either rose 1 month after treatment or remained elevated, survival was worse compared to those who normalized or remained normal (18.6 vs. 10.6 months, p = 0.026). The same was true at 6 months (21.3 vs. 9.5 months, p = 0.002). An unresponsive NLR was associated with very poor outcome (median survival 3.7 months). Multivariate analysis of clinicopathologic factors showed that presence of extrahepatic disease and high NLR were independent factors associated with worse survival.

Conclusions

Our study demonstrates that periprocedural trends of serum NLR are associated with outcome in unresectable HCC undergoing TACE. Serum NLR is easy to calculate from a routine complete blood count with differential. Along with liver function, serum NLR may be helpful to clinicians in providing prognostic information and monitoring response to therapy.

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Authors and Affiliations

  1. Department of Surgery, The Ohio State University Medical Center, Columbus, OH, USA

    Megan E. McNally MD, Mark Bloomston MD & Carl R. Schmidt MD

  2. The Ohio State University College of Medicine, Columbus, OH, USA

    Antonio Martinez MS

  3. Department of Radiology, The Ohio State University Medical Center, Columbus, OH, USA

    Hooman Khabiri MD & Gregory Guy MD

  4. Department of Medicine, Division of Gastroenterology, The Ohio State University Medical Center, Columbus, OH, USA

    Anthony J. Michaels MD, James Hanje MD & Robert Kirkpatrick MD

Authors
  1. Megan E. McNally MD
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  2. Antonio Martinez MS
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  3. Hooman Khabiri MD
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  4. Gregory Guy MD
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  5. Anthony J. Michaels MD
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  6. James Hanje MD
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  7. Robert Kirkpatrick MD
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  8. Mark Bloomston MD
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  9. Carl R. Schmidt MD
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Correspondence to Carl R. Schmidt MD.

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McNally, M.E., Martinez, A., Khabiri, H. et al. Inflammatory Markers are Associated with Outcome in Patients with Unresectable Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization. Ann Surg Oncol 20, 923–928 (2013). https://doi.org/10.1245/s10434-012-2639-1

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  • DOI: https://doi.org/10.1245/s10434-012-2639-1

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