Young Mi Hong1,2, Ki Tae Yoon1,2, Tae Ho Hwang3, Jeong Heo2,4, Hyun Young Woo2,4, Mong Cho1,2. 1. Liver Center, Pusan National University Yangsan Hospital, Department of. 2. Internal Medicine. 3. Pharmacology, Pusan National University School of Medicine, Yangsan. 4. Gastroenterology Center, Pusan National University Hospital, Busan, Republic of Korea.
Abstract
BACKGROUND AND AIM: Although sorafenib is the first systemic therapy to show survival benefit for advanced hepatocellular carcinoma (HCC), its survival benefit is variable for HCC. Systemic inflammation may be associated with survival in HCC. We investigated the use of systemic inflammation markers, including neutrophil-to-lymphocyte ratio (NLR), in the prognosis of sorafenib-treated HCC patients. PATIENTS AND METHODS: We retrospectively analyzed data of 82 patients with advanced HCC who received sorafenib as the first-line treatment. Data on pretreatment and post-treatment (2-3 months after initiating sorafenib therapy, first tumor response evaluation day) clinical, laboratory, and tumor characteristics were collected. Survival-related prognostic factors were analyzed. RESULTS: Patients were mostly in the intermediate (12.2%) or advanced (87.8%) Barcelona Clinic Liver Cancer stages. Fifty-six (68.3%) patients had vascular invasion and 34 (41.5%) patients had extrahepatic disease. The median progression-free survival (PFS) and overall survival (OS) were 4.7 months [95% confidence interval (CI): 2.8-6.5 months] and 4.7 months (95% CI: 2.8-6.5 months). In multivariate analysis for OS, diarrhea (hazard ratio: 0.588; 95% CI: 0.348-0.993) and NLR decline (decreased compared with pretreatment) (hazard ratio: 0.479; 95% CI: 0.300-0.765) were independent factors of good OS. In the NLR decline group, the median PFS and OS were 7.1 and 7.3 months, respectively. In the NLR nondecline group, the median PFS and OS were 3.0 and 3.2 months, respectively. The difference in OS between the two groups was significant (P = 0.004). CONCLUSION: A change in NLR after sorafenib therapy was associated with a better prognosis in patients with advanced HCC.
BACKGROUND AND AIM: Although sorafenib is the first systemic therapy to show survival benefit for advanced hepatocellular carcinoma (HCC), its survival benefit is variable for HCC. Systemic inflammation may be associated with survival in HCC. We investigated the use of systemic inflammation markers, including neutrophil-to-lymphocyte ratio (NLR), in the prognosis of sorafenib-treated HCC patients. PATIENTS AND METHODS: We retrospectively analyzed data of 82 patients with advanced HCC who received sorafenib as the first-line treatment. Data on pretreatment and post-treatment (2-3 months after initiating sorafenib therapy, first tumor response evaluation day) clinical, laboratory, and tumor characteristics were collected. Survival-related prognostic factors were analyzed. RESULTS:Patients were mostly in the intermediate (12.2%) or advanced (87.8%) Barcelona Clinic Liver Cancer stages. Fifty-six (68.3%) patients had vascular invasion and 34 (41.5%) patients had extrahepatic disease. The median progression-free survival (PFS) and overall survival (OS) were 4.7 months [95% confidence interval (CI): 2.8-6.5 months] and 4.7 months (95% CI: 2.8-6.5 months). In multivariate analysis for OS, diarrhea (hazard ratio: 0.588; 95% CI: 0.348-0.993) and NLR decline (decreased compared with pretreatment) (hazard ratio: 0.479; 95% CI: 0.300-0.765) were independent factors of good OS. In the NLR decline group, the median PFS and OS were 7.1 and 7.3 months, respectively. In the NLR nondecline group, the median PFS and OS were 3.0 and 3.2 months, respectively. The difference in OS between the two groups was significant (P = 0.004). CONCLUSION: A change in NLR after sorafenib therapy was associated with a better prognosis in patients with advanced HCC.
Authors: S Colagrande; L Calistri; C Campani; G Dragoni; C Lorini; C Nardi; A Castellani; F Marra Journal: Eur Radiol Date: 2020-08-22 Impact factor: 5.315
Authors: Tim F Greten; Ghassan K Abou-Alfa; Ann-Lii Cheng; Austin G Duffy; Anthony B El-Khoueiry; Richard S Finn; Peter R Galle; Lipika Goyal; Aiwu Ruth He; Ahmed O Kaseb; Robin Kate Kelley; Riccardo Lencioni; Amaia Lujambio; Donna Mabry Hrones; David J Pinato; Bruno Sangro; Roberto I Troisi; Andrea Wilson Woods; Thomas Yau; Andrew X Zhu; Ignacio Melero Journal: J Immunother Cancer Date: 2021-09 Impact factor: 13.751