Anthony W H Chan1, Stephen L Chan2,3, Grace L H Wong2,4, Vincent W S Wong2,4, Charing C N Chong5, Paul B S Lai5, Henry L Y Chan2,4, Ka-Fai To6,7,8. 1. Department of Anatomical and Cellular Pathology, State Key Laboratory in Oncology in South China, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong. 2. Institute of Digestive Disease, Partner State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong. 3. Department of Clinical Oncology, State Key Laboratory in Oncology in South China, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong. 4. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong. 5. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong. 6. Department of Anatomical and Cellular Pathology, State Key Laboratory in Oncology in South China, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong. kfto@cuhk.edu.hk. 7. Institute of Digestive Disease, Partner State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong. kfto@cuhk.edu.hk. 8. Li Ka Shing Institute of Health Science, Sir Y.K. Pao Cancer Centre, The Chinese University of Hong Kong, Shatin, Hong Kong. kfto@cuhk.edu.hk.
Abstract
BACKGROUND: Approximately one-quarter of patients with Barcelona Clinic Liver Cancer (BCLC) stage 0/A hepatocellular carcinoma (HCC) suffer from tumor relapse within the first year after surgical resection. Little data is available for inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI), in predicting the clinical outcome of patients with very early/early stage HCC who underwent curative surgery. METHODS: A retrospective cohort study of 324 patients with BCLC stage 0/A primary HCC undergoing surgical resection was conducted to investigate the prognostic impacts of NLR, PLR, and PNI. RESULTS: The low-PNI group (<45) had an adverse overall survival (1-year survival rate of 92 vs. 97 %; 5-year survival rate of 57 vs. 82 %; p < 0.001) and disease-free survival (1-year survival rate of 69 vs. 85 %; 5-year survival rate of 39 vs. 63 %; p < 0.001). It was an independent predictor for disease-specific death, and early and late tumor relapses, with hazard ratios of 2.78 (p < 0.001), 1.82 (p = 0.011), and 2.55 (p = 0.013), respectively. Neither NLR nor PLR had any prognostic significance. CONCLUSIONS: The PNI is a significant prognostic factor for OS and DFS of patients with very early/early stage HCC receiving curative surgery.
BACKGROUND: Approximately one-quarter of patients with Barcelona Clinic Liver Cancer (BCLC) stage 0/A hepatocellular carcinoma (HCC) suffer from tumor relapse within the first year after surgical resection. Little data is available for inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI), in predicting the clinical outcome of patients with very early/early stage HCC who underwent curative surgery. METHODS: A retrospective cohort study of 324 patients with BCLC stage 0/A primary HCC undergoing surgical resection was conducted to investigate the prognostic impacts of NLR, PLR, and PNI. RESULTS: The low-PNI group (<45) had an adverse overall survival (1-year survival rate of 92 vs. 97 %; 5-year survival rate of 57 vs. 82 %; p < 0.001) and disease-free survival (1-year survival rate of 69 vs. 85 %; 5-year survival rate of 39 vs. 63 %; p < 0.001). It was an independent predictor for disease-specific death, and early and late tumor relapses, with hazard ratios of 2.78 (p < 0.001), 1.82 (p = 0.011), and 2.55 (p = 0.013), respectively. Neither NLR nor PLR had any prognostic significance. CONCLUSIONS: The PNI is a significant prognostic factor for OS and DFS of patients with very early/early stage HCC receiving curative surgery.
Authors: Yuxin Guo; Darren W Chua; Ye-Xin Koh; Ser-Yee Lee; Peng-Chung Cheow; Juinn-Huar Kam; Jin-Yao Teo; Pierce K Chow; Alexander Y Chung; London L Ooi; Chung-Yip Chan; Brian K P Goh Journal: World J Surg Date: 2019-10 Impact factor: 3.352
Authors: Jian Zheng; Deborah Kuk; Mithat Gönen; Vinod P Balachandran; T Peter Kingham; Peter J Allen; Michael I D'Angelica; William R Jarnagin; Ronald P DeMatteo Journal: Ann Surg Oncol Date: 2016-12-05 Impact factor: 5.344