Postoperative neutrophil-to-lymphocyte ratio plus platelet-to-lymphocyte ratio predicts the outcomes of hepatocellular carcinoma

• Published in: The Journal of surgical research 2015-09, Vol.198 (1), p.73-79
• Main Authors: Li, Chuan, MD, Wen, Tian-Fu, MD, Yan, Lu-Nan, MD, Li, Bo, MD, Wang, Wen-Tao, MD, Yang, Jia-Yin, MD, Xu, Ming-Qing, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Blood Platelets - pathology; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Female; Hepatectomy; Hepatocellular carcinoma; Humans; Leukocyte Count; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Lymphocytes - pathology; Male; Middle Aged; Neoplasm Recurrence, Local - pathology; Neutrophil-to-lymphocyte ratio; Neutrophils - pathology; Platelet Count; Platelet-to-lymphocyte ratio; Surgery; Survival Rate
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2015.05.003

Abstract Background There is limited information regarding NLR-PLR (the combination of the neutrophil-to-lymphocyte ratio [NLR] and platelet-to-lymphocyte ratio [PLR]) in hepatocellular carcinoma (HCC). This study aimed to assess the predictive ability of NLR-PLR in patients with resectable hepatitis B virus-related HCC within Milan criteria after hepatectomy. Methods Two hundred thirty-six consecutive HCC patients were included in the study. The postoperative NLR-PLR was calculated based on the data obtained on the first postoperative month after liver resection as follows: patients with both an elevated PLR and an elevated NLR, which were detected by receiver operating characteristic curve analysis, were allocated a score of 2, and patients showing one or neither of these elevations were allocated a score of 1 or 0, respectively. Results During the follow-up period, 113 patients experienced recurrence and 41 patients died. Multivariate analyses suggested that tumor-node-metastasis stage, preoperative alpha-fetal protein, and postoperative NLR-PLR were independently associated with recurrence, whereas microvascular invasion and postoperative NLR-PLR adversely impacted the overall survival. The 5-y recurrence-free and overall survival rates of the patients with a postoperative NLR-PLR of 0, 1, or 2 were 43.6%, 35.6%, or 8.3% ( P < 0.001) and 82.1%, 73.0%, or 10.5% ( P < 0.001), respectively. Conclusions The postoperative NLR-PLR predicted outcomes of hepatitis B virus-related HCC patients within Milan criteria after liver resection.