Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as predictors of survival and metastasis for recurrent hepatocellular carcinoma after transarterial chemoembolization.
OBJECTIVE
To evaluate whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) predict survival and metastasis in patients after transarterial chemoembolization (TACE) for recurrent hepatocellular carcinoma (RHCC).


METHODS
Clinical and laboratory data from 132 RHCC patients treated with TACE from January 2003 to December 2012 were retrospectively reviewed. Prognostic factors were assessed by multivariate analysis, and the predictive values of NLR and PLR for overall survival (OS) and extrahepatic metastases were compared.


RESULTS
Pretreatment mean NLR and PLR were 3.1 and 137, respectively. The 0.5-, 1-, and 2-year OS rates were 93.7%, 67.1%, and 10.1% in the low NLR group and 81.1%, 18.9%, and 3.8% in the high NLR group, respectively (P = 0.017). The corresponding OS rates in the low and high PLR groups were 92.5%, 58.1%, and 9.7% and 84.6%, 23.1%, and 2.6%, respectively (P = 0.030). The discriminatory performance predicting 1-year survival probability was significantly poorer for NLR (area under the curve [AUC] = 0.685, 95% confidence interval [CI] 0.598-0.763) than for PLR (AUC = 0.792, 95% CI 0.712-0.857; P = 0.0295), but was good for both ratios for predicting post-TACE extrahepatic metastasis. Multivariate analysis indicated that high PLR (hazard ratio [HR] = 0.373, 95% CI = 0.216-0.644, P < 0.001, vascular invasion (HR = 0.507, 95% CI = 0.310-0.832, P = 0.007), and multiple tumors (HR= 0.553, 95% CI = 0.333-0.919, P = 0.022) were independent prognostic factors for OS.


CONCLUSIONS
High NLR and PLR were both associated with poor prognosis and metastasis in RHCC patients treated with TACE, but high PLR was a better predictor of 1-year OS. High PLR, vascular invasion, and multiple tumors were independent, unfavorable prognostic factors.
Department of Interventional Oncology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China.
Wenzhe
W
Fan
Department of Interventional Oncology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China.
Yingqiang
Y
Zhang
Department of Interventional Oncology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China.
Yu
Y
Wang
Department of Interventional Oncology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China.
Xuehua
X
Yao
Department of Medical Imaging, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China.
Jianyong
J
Yang
Department of Interventional Oncology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China.
Jiaping
J
Li
D001792:Blood Platelets / Q000473:pathology*; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009504:Neutrophils / Q000473:pathology*