title: Preoperative neutrophil to lymphocyte ratio and prognostic nutritional index predict overall survival after hepatectomy for hepatocellular carcinoma.
abstract: OBJECTIVE
  Several papers have shown that preoperative inflammation-based prognostic scores and/or immunonutritional status are associated with survival in patients with hepatocellular carcinoma (HCC). However, the validity of prognostic factors of these scores remains controversial. This study aimed to validate the power of prognostic scores based on the preoperative inflammatory and immunonutritional indices of patients who underwent hepatectomy for HCC with curative intent.
  
  
  METHODS
  Clinicopathological parameters and inflammation-based prognostic scores and immunonutritional status, including the Glasgow Prognostic Score, neutrophil to lymphocyte ratio (NLR), and prognostic nutritional index (PNI), were retrospectively analyzed to identify the predictors of overall and recurrence-free survival in 256 patients.
  
  
  RESULTS
  In multivariate analysis, NLR was an independent prognostic factor for overall, and recurrence-free survival (hazard ratio [HR] 2.59, 95% confidence interval [CI] 1.56-4.31, P < 0.001, and HR 2.11, 95% CI 1.44-3.11, P < 0.001, respectively). Additionally, PNI was an independent predictor of overall survival (HR 2.01, CI 1.21-3.36, P = 0.007).
  
  
  CONCLUSIONS
  The present study shows that the NLR and PNI based on preoperative inflammatory and immunonutritional indices are predictors of overall survival in patients who undergo hepatectomy for HCC with curative intent.
authors: Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan, yu.okamura@scchr.jp.
authors: Yukiyasu
authors: Y
authors: Okamura
authors: Ryo
authors: R
authors: Ashida
authors: Takaaki
authors: T
authors: Ito
authors: Teiichi
authors: T
authors: Sugiura
authors: Keita
authors: K
authors: Mori
authors: Katsuhiko
authors: K
authors: Uesaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D007249:Inflammation / Q000097:blood; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality* / Q000601:surgery; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils; D015596:Nutrition Assessment; D009752:Nutritional Status; D011237:Predictive Value of Tests; D057234:Preoperative Period; D012189:Retrospective Studies; D015996:Survival Rate