title: Neutrophil/lymphocyte ratio as a prognostic indicator of hepatic arterial infusion chemotherapy with arterial cisplatin plus continuous 5-fluorouracil.
abstract: OBJECTIVE
  Hepatic arterial infusion (HAIC) therapy may be a therapeutic option for advanced hepatocellular carcinoma (HCC) in addition to administration of sorafenib, which is the only currently established standard regimen for this disease. Survival benefit of HAIC has been reported in patients positive for antitumor response. Therefore, the prediction of antitumor response is important in decision-making for HAIC treatment.
  
  
  METHODS
  Twenty-six consecutive patients with advanced HCC treated by HAIC using arterial cisplatin plus continuous 5-fluorouracil were retrospectively analyzed in this study. Neutrophil/lymphocyte ratio (NLR) was assessed to determine its effectiveness as a prognostic indicator of HAIC.
  
  
  RESULTS
  The median time to progression and overall survival time (OS) were 5.0 and 17.0 months, respectively. The overall response rate (RR) among the 26 patients was 42.3%, and RR was independent of liver function. Interestingly, RR was significantly lower in patients with NLR of 4 or more (odds ratio, 0.49; P = 0.04). When we investigated factors that influenced OS, treatment effect and NLR of less than 4 were associated with prolonged OS. No serious adverse events were found in treatment with HAIC.
  
  
  CONCLUSIONS
  HAIC is a candidate for treatment of advanced HCC, and NLR may be a useful prognostic indicator for suitability of HAIC.
authors.affiliation: The Third Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Tajiri
authors.affiliation: The Third Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Kawai
authors.affiliation: The Third Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Minemura
authors.affiliation: The Third Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasumura
authors.affiliation: The Third Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
authors.forename: Ayumu
authors.initials: A
authors.lastname: Hosokawa
authors.affiliation: Department of Radiology, Toyama University Hospital, Toyama, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Kawabe
authors.affiliation: Department of Radiology, Toyama University Hospital, Toyama, Japan.
authors.forename: Gakuto
authors.initials: G
authors.lastname: Tomizawa
authors.affiliation: The Third Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Sugiyama
keywords: 5-fluorouracil; arterial cisplatin; hepatic arterial infusion chemotherapy; neutrophil/lymphocyte ratio