Qing Pang1,2, Lei Zhou1, Kai Qu2, Rui-Xia Cui2, Hao Jin1, Hui-Chun Liu1. 1. Department of Hepatobiliary Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province. 2. Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Abstract
BACKGROUND AND OBJECTIVE: The objective of this study was to investigate the prognostic significance of several inflammation-based models in hepatitis B-associated hepatocellular carcinoma (HCC). PATIENTS AND METHODS: We retrospectively reviewed 470 cases of hepatitis B-associated HCC. Preoperative data were collected to calculate the inflammation-based markers, including systemic immune-inflammation index (neutrophil×platelets/lymphocyte), platelets-to-lymphocyte ratio, and neutrophil-to-lymphocyte ratio (NLR). Overall survival and recurrence-free survival were estimated by the Kaplan-Meier method and Cox analysis. RESULTS: During a median follow-up time of 29 months, 34.0% (160/470) of patients died and 36.0% (169/470) experienced recurrence. Compared with patients with lower scores of inflammation models, patients in the higher group had larger tumor diameter and higher risk of vascular invasion (both P<0.05). Multivariate analysis revealed that age, tumor size, platelets-to-lymphocyte ratio, NLR, and systemic immune-inflammation index were the independent predictors for both overall survival and recurrence-free survival. Furthermore, the combination of tumor size and NLR showed a significantly better discrimination ability for survival (C-index=0.716, 95% confidence interval: 0.664-0.768) than both Barcelona Clinic Liver Cancer and Cancer of Liver Italian Program. CONCLUSION: The inflammation-based markers, in particular the combination of NLR with tumor size, are effective tools for assessing prognosis in hepatitis B-associated HCC.
BACKGROUND AND OBJECTIVE: The objective of this study was to investigate the prognostic significance of several inflammation-based models in hepatitis B-associated hepatocellular carcinoma (HCC). PATIENTS AND METHODS: We retrospectively reviewed 470 cases of hepatitis B-associated HCC. Preoperative data were collected to calculate the inflammation-based markers, including systemic immune-inflammation index (neutrophil×platelets/lymphocyte), platelets-to-lymphocyte ratio, and neutrophil-to-lymphocyte ratio (NLR). Overall survival and recurrence-free survival were estimated by the Kaplan-Meier method and Cox analysis. RESULTS: During a median follow-up time of 29 months, 34.0% (160/470) of patients died and 36.0% (169/470) experienced recurrence. Compared with patients with lower scores of inflammation models, patients in the higher group had larger tumor diameter and higher risk of vascular invasion (both P<0.05). Multivariate analysis revealed that age, tumor size, platelets-to-lymphocyte ratio, NLR, and systemic immune-inflammation index were the independent predictors for both overall survival and recurrence-free survival. Furthermore, the combination of tumor size and NLR showed a significantly better discrimination ability for survival (C-index=0.716, 95% confidence interval: 0.664-0.768) than both Barcelona Clinic Liver Cancer and Cancer of Liver Italian Program. CONCLUSION: The inflammation-based markers, in particular the combination of NLR with tumor size, are effective tools for assessing prognosis in hepatitis B-associated HCC.