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

• Published in: Hepatic medicine: evidence and research 2021-01, Vol.13, p.123-134
• Main Authors: Mahassadi, Alassan Kouame, Anzouan-Kacou Kissi, Henriette, Attia, Alain Koffi
• Format: Article
• Language: English
• Subjects: Ablation; Ascites; Blood platelets; Cohort analysis; Comparative analysis; Creatinine; Development and progression; Esophagus; Gastroenterology; Hemoglobin; Hepatitis B; Hepatocellular carcinoma; Hepatoma; Hospitalization; Hospitals; Infections; Leukocytes (neutrophilic); Liver; Liver cancer; Liver diseases; Lymphocytes; Medical prognosis; Mortality; neutrophil-to-lymphocyte ratio; Neutrophils; Original Research; Pain; Palliation; Patient outcomes; Patients; Platelets; Prognosis; Serology; Sub-Saharan Africa; Thorax; Thrombosis; Tomography; Tumor staging; Ultrasonic imaging; Variables; Viral infections
• ISSN: 1179-1535; 1179-1535
• DOI: 10.2147/HMER.S333980

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. 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). 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. 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, =0.01) or PLR >92 (log rank test=5.63, =0.02) had poor survival. Factors associated with the in-hospital mortality were the MELD score ( =0.01), NLR ( =0.03) and hemoglobin level ( =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). 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.