Open Access

Early variation of inflammatory indexes refines prognostic prediction in patients with hepatocellular carcinoma under systemic treatment

  • Authors:
    • Leonardo G. Da Fonseca
    • Lucas Fernando Uratani
    • Gabriella Fernandes Soares
    • Paulo Siqueira Do Amaral
    • Regiane Saraiva De Souza Melo Alencar
    • Aline Lopes Chagas
    • Venancio Avancini Ferreira Alves
    • Flair Jose Carrilho
  • View Affiliations

  • Published online on: February 21, 2023     https://doi.org/10.3892/mco.2023.2625
  • Article Number: 29
  • Copyright: © Da Fonseca et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Prognostic markers in advanced hepatocellular carcinoma (HCC) are relevant for clinical decisions. Variations in inflammatory indexes, such as neutrophil‑to‑lymphocyte ratio (NLR) or platelet‑to‑lymphocyte ratio (PLR), may correlate with outcomes. In the present study, it was aimed to assess the prognostic role of inflammation indexes in patients with HCC and the evolutionary behavior of these variables within the first month of treatment in a cohort of patients treated with sorafenib from 2009‑2021. Subgroups were divided based on the median of each variable (‘low’ or ‘high)’. Survival was estimated using the Kaplan‑Meier method. Hazard Ratio (HR) with 95% confidence interval (CI) were estimated using Cox regression models. A total of 373 patients were included, most Child‑Pugh‑A (83.1%) and BCLC‑C (74%). Child‑Pugh‑A (P=0.011), performance status 0 (P<0.001), no ascites (P<0.001) and NLR<2.6 (P<0.001) were independently associated with improved survival. Baseline PLR was not correlated with survival (P=0.137). Patients who maintained low NLR at baseline and at 1 month (reference subgroup) had improved survival (18.6 months, 95% CI:15.4‑22.0) compared with the subgroup that maintained high NLR at baseline and at 1 month (4.2 months, 95% CI:3.6‑5.9), with HR: 3.80 (95% CI: 2.89‑4.96). The subgroup with low NLR at baseline and high NLR at 1 month had a worse prognosis compared with the reference group (HR:1.4, 95% CI: 1.1‑2.0), whereas the subgroup with high NLR at baseline and low at 1 month had similar outcome (HR:1.2, 95% CI: 0.8‑1.6). It was concluded that evolutionary variation of NLR has a prognostic role in HCC patients under systemic therapy. This finding suggested that systemic inflammation and early modulation of the immune environment during treatment may correlate with outcomes.
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April-2023
Volume 18 Issue 4

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Spandidos Publications style
Da Fonseca LG, Uratani LF, Soares GF, Do Amaral PS, De Souza Melo Alencar RS, Chagas AL, Alves VA and Carrilho FJ: Early variation of inflammatory indexes refines prognostic prediction in patients with hepatocellular carcinoma under systemic treatment. Mol Clin Oncol 18: 29, 2023
APA
Da Fonseca, L.G., Uratani, L.F., Soares, G.F., Do Amaral, P.S., De Souza Melo Alencar, R.S., Chagas, A.L. ... Carrilho, F.J. (2023). Early variation of inflammatory indexes refines prognostic prediction in patients with hepatocellular carcinoma under systemic treatment. Molecular and Clinical Oncology, 18, 29. https://doi.org/10.3892/mco.2023.2625
MLA
Da Fonseca, L. G., Uratani, L. F., Soares, G. F., Do Amaral, P. S., De Souza Melo Alencar, R. S., Chagas, A. L., Alves, V. A., Carrilho, F. J."Early variation of inflammatory indexes refines prognostic prediction in patients with hepatocellular carcinoma under systemic treatment". Molecular and Clinical Oncology 18.4 (2023): 29.
Chicago
Da Fonseca, L. G., Uratani, L. F., Soares, G. F., Do Amaral, P. S., De Souza Melo Alencar, R. S., Chagas, A. L., Alves, V. A., Carrilho, F. J."Early variation of inflammatory indexes refines prognostic prediction in patients with hepatocellular carcinoma under systemic treatment". Molecular and Clinical Oncology 18, no. 4 (2023): 29. https://doi.org/10.3892/mco.2023.2625