Utility of serum inflammatory markers for predicting microvascular invasion and survival for patients with hepatocellular carcinoma Journal Article

   


Authors: Zheng, J.; Seier, K.; Gonen, M.; Balachandran, V. P.; Kingham, T. P.; D’Angelica, M. I.; Allen, P. J.; Jarnagin, W. R.; DeMatteo, R. P.
Article Title: Utility of serum inflammatory markers for predicting microvascular invasion and survival for patients with hepatocellular carcinoma
Abstract: Background: Preoperative serum inflammatory markers have been correlated with outcome after resection of hepatocellular carcinoma (HCC), but studies have had conflicting results. This study aimed to evaluate the association of six inflammatory markers with recurrence-free survival (RFS), overall survival (OS), and microvascular invasion (MVI), a well-known prognostic factor. Methods: This study investigated 370 patients who underwent resection of HCC from 1992 to 2016, retrospectively evaluating their inflammatory indices and individual components including their neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), prognostic nutritional index (PNI), aspartate aminotransferase-to-platelet ratio index (APRI), and aspartate aminotransferase-to-neutrophil ratio index (ANRI). Uni- and multivariate analyses were performed to evaluate these markers for RFS, OS, and MVI. Results: The median RFS was 23 months, and the median OS was 60 months. Factors independently associated with worse RFS were higher PLR and alpha-fetoprotein level, male gender, and the presence of MVI as well as multiple nodules. Factors independently associated with worse OS were higher PLR and international normalized ratio, male gender, older age, presence of MVI and multiple nodules, larger tumor, presence of cirrhosis, and absence of steatosis. The study identified MVI in 47% of the patients. Lower level of albumin, higher level of alpha-fetoprotein, and larger tumor on preoperative imaging were independently associated with MVI. Conclusions: This largest Western series to evaluate the utility of preoperative inflammatory markers in patients with HCC found that only PLR was associated with RFS and OS and that albumin was associated with MVI. © 2017, Society of Surgical Oncology.
Keywords: cancer survival; aged; major clinical study; overall survival; liver cell carcinoma; liver cirrhosis; follow up; biological marker; inflammation; creatinine; retrospective study; age; aspartate aminotransferase; bilirubin; albumin; cancer size; sex difference; alpha fetoprotein; recurrence free survival; international normalized ratio; tumor invasion; microangiopathy; cancer prognosis; operative blood loss; human; male; female; article; microvascular invasion; neutrophil lymphocyte ratio; aspartate aminotransferase to neutrophil ratio index; aspartate aminotransferase to platelet ratio index; lymphocyte to monocyte ratio; platelet lymphocyte ratio
Journal Title: Annals of Surgical Oncology
Volume: 24
Issue: 12
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2017-11-01
Start Page: 3706
End Page: 3714
Language: English
DOI: 10.1245/s10434-017-6060-7
PROVIDER: scopus
PUBMED: 28840521
PMCID: PMC8457436
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85028358853&doi=10.1245%2fs10434-017-6060-7&partnerID=40&md5=20be929e46ae6f0cb138d674b2d73480
Notes: Article -- Export Date: 1 December 2017 -- Source: Scopus
Altmetric
What is Altmetric?
Citation Impact
What is Dimensions Citation Badge?
BMJ Impact Analytics
MSK Authors
  1. Ronald P DeMatteo
    637 DeMatteo
  2. Mithat Gonen
    1029 Gonen
  3. Peter Allen
    501 Allen
  4. William R Jarnagin
    903 Jarnagin
  5. Michael D'Angelica
    777 D'Angelica
  6. T Peter Kingham
    609 Kingham
  7. Vinod P Balachandran
    252 Balachandran
  8. Jian Ying Zheng
    17 Zheng
  9. Kenneth Seier
    105 Seier
Related MSK Work