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Neutrophil-to-Lymphocyte Ratio as a Biomarker Predicting Overall Survival after Chemoembolization for Intermediate-Stage Hepatocellular Carcinoma

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Abstract
Simple Summary

Baseline neutrophil-to-lymphocyte ratio >= 3 was a robust independent predictor of overall survival after chemoembolization for intermediate-stage hepatocellular carcinoma, with the predictive value verified by cross-validation.

The clinical impact of neutrophil-to-lymphocyte ratio (NLR) in predicting outcomes in hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE) remain unclear, and additional large-scale studies are required. This retrospective study evaluated outcomes in treatment-naive patients who received TACE as first-line treatment for intermediate-stage HCC between 2008 and 2017. Patients who underwent TACE before and after 2013 were assigned to the development (n = 495) and validation (n = 436) cohorts, respectively. Multivariable Cox analysis identified six factors predictive of outcome, including NLR, which were used to create models predictive of overall survival (OS) in the development cohort. Risk scores of 0-3, 4-7, and 8-12 were defined as low, intermediate, and high risk, respectively. Median OS times in the low-, medium-, and high-risk groups in the validation cohort were 48.1, 24.3, and 9.7 months, respectively (p < 0.001). Application to the validation cohort of time-dependent ROC curves for models predictive of OS showed AUC values of 0.72 and 0.70 at 3 and 5 years, respectively. Multivariable logistic regression analysis found that NLR >= 3 was a significant predictor (odds ratio, 3.4; p < 0.001) of disease progression 6 months after TACE. Higher baseline NLR was predictive of poor prognosis in patients who underwent TACE for intermediate-stage HCC.
Author(s)
고기영고흥규권동일김나영김진형신지훈심주현윤현기추희호
Issued Date
2021
Type
Article
Keyword
Hepatocellular carcinomaintermediate-stagetransarterial chemoembolizationneutrophil-to-lymphocyte ratio
DOI
10.3390/cancers13112830
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7988
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_dfe4ef02ce5e4e0083ff107162638445&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Neutrophil-to-Lymphocyte%20Ratio%20as%20a%20Biomarker%20Predicting%20Overall%20Survival%20after%20Chemoembolization%20for%20Intermediate-Stage%20Hepatocellular%20Carcinoma&amp;offset=0&amp;pcAvailability=true
Publisher
CANCERS
Location
스위스
Language
영어
ISSN
2072-6694
Citation Volume
13
Citation Number
2830
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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