title: Negative impact of preoperative platelet-lymphocyte ratio on outcome after hepatic resection for intrahepatic cholangiocarcinoma.
abstract: The elevated platelet-to-lymphocyte ratio (PLR), determined using an easy blood test based on platelet and lymphocyte counts, is reported to be a predictor of poor survival in patients with several cancers. The prognostic role of preoperative PLR in patients with intrahepatic cholangiocarcinoma (ICC) has, until now, been rarely investigated. The purpose of our study was to evaluate the prognostic significance of PLR in a large cohort of ICC patients after hepatic resection. We obtained data from 322 consecutive nonmetastatic ICC patients who underwent hepatectomy without preoperative therapy between 2005 and 2011. Clinicopathological parameters, including PLR, were evaluated. Overall survival (OS) and recurrence-free survival (RFS) were assessed using the Kaplan-Meier method. Using multivariate Cox regression models, the independent prognostic value of preoperative PLR was determined. Our results showed that PLR represents an independent adverse prognostic factor for OS and RFS in ICC patients using univariate and multivariate analyses. The optimal PLR cutoff value was 123 using receiver operating curve analyses. The 5-year OS and RFS rates after hepatectomy were 30.3% and 28.9% for the group with PLR 123 greater, compared with 46.2% and 39.4% for the group with PLR less than 123 (P = 0.0058 and 0.0153, respectively). In addition, high PLR values were associated with tumor size (P = 0.020). Our results suggest that preoperative PLR might represent a novel independent prognostic factor for OS and RFS in ICC patients with hepatic resection.
authors.affiliation: From the Liver Cancer Institute (QC, ZD, DY, LY, ZW, YX, JF, JZ), Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education; and Institute of Biomedical Sciences (DY, JF, JZ), Fudan University, Shanghai, People's Republic of China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Chen
authors.forename: Zhi
authors.initials: Z
authors.lastname: Dai
authors.forename: Dan
authors.initials: D
authors.lastname: Yin
authors.forename: Liu-Xiao
authors.initials: LX
authors.lastname: Yang
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.forename: Yong-Sheng
authors.initials: YS
authors.lastname: Xiao
authors.forename: Jia
authors.initials: J
authors.lastname: Fan
authors.forename: Jian
authors.initials: J
authors.lastname: Zhou
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000097:blood* / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D015415:Biomarkers; D018281:Cholangiocarcinoma / Q000097:blood* / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D053208:Kaplan-Meier Estimate; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011379:Prognosis; D016016:Proportional Hazards Models
chemical_list: D015415:Biomarkers
references.citation: Nat Rev Immunol. 2012 Apr;12(4):239-52
references.pmid: 22437937
references.citation: Br J Cancer. 2010 Sep 7;103(6):870-6
references.pmid: 20717110
references.citation: Clin Transl Oncol. 2011 Jul;13(7):499-503
references.pmid: 21775277
references.citation: J Clin Oncol. 2007 Jun 20;25(18):2586-93
references.pmid: 17577038
references.citation: Gastroenterology. 2013 Dec;145(6):1215-29
references.pmid: 24140396
references.citation: N Engl J Med. 2003 Mar 6;348(10):891-9
references.pmid: 12621133
references.citation: Ann Surg. 2009 Jul;250(1):141-51
references.pmid: 19561458
references.citation: Arch Surg. 2012 Dec;147(12):1107-13
references.pmid: 22910846
references.citation: Proc Natl Acad Sci U S A. 2012 Aug 7;109(32):E2165-72
references.pmid: 22753481
references.citation: Cancer Cell. 2006 Nov;10(5):355-62
references.pmid: 17097558
references.citation: Crit Rev Immunol. 1991;10(5):393-416
references.pmid: 2021423
references.citation: Cancer Cell. 2011 Nov 15;20(5):576-90
references.pmid: 22094253
references.citation: Ann Surg Oncol. 2012 Aug;19(8):2506-14
references.pmid: 22411204
references.citation: Proc Natl Acad Sci U S A. 1997 Jan 21;94(2):663-8
references.pmid: 9012841
references.citation: Nature. 2002 Dec 19-26;420(6917):860-7
references.pmid: 12490959
references.citation: Br J Surg. 2001 Jul;88(7):969-74
references.pmid: 11442529
references.citation: Eur J Cardiothorac Surg. 2010 Jul;38(1):21-6
references.pmid: 20359903
references.citation: PLoS One. 2013;8(5):e65023
references.pmid: 23741443
references.citation: Ann Surg. 2013 Aug;258(2):301-5
references.pmid: 23774313
references.citation: Gastroenterology. 2014 May;146(5):1397-407
references.pmid: 24503127
references.citation: Trends Mol Med. 2010 Mar;16(3):133-44
references.pmid: 20163989
references.citation: Cancer. 1983 Jul 1;52(1):126-30
references.pmid: 6850535
references.citation: Transpl Int. 2014 Jan;27(1):32-41
references.pmid: 24118272
references.citation: J Clin Oncol. 2011 Aug 10;29(23):3140-5
references.pmid: 21730269
references.citation: J Am Coll Surg. 1997 Nov;185(5):429-36
references.pmid: 9358085
references.citation: Cancer. 2005 May 1;103(9):1856-64
references.pmid: 15779015
references.citation: Ann Surg. 2011 Nov;254(5):824-29; discussion 830
references.pmid: 22042474
references.citation: Biomarkers. 2012 May;17(3):216-22
references.pmid: 22424597
references.citation: Cancer. 2006 Apr 1;106(7):1443-52
references.pmid: 16502408
references.citation: J Surg Oncol. 2008 May 1;97(6):513-8
references.pmid: 18335453
references.citation: Am J Surg. 2010 Aug;200(2):197-203
references.pmid: 20122680
references.citation: Lancet. 2001 Feb 17;357(9255):539-45
references.pmid: 11229684
references.citation: Lancet. 2012 Apr 28;379(9826):1602-12
references.pmid: 22440946
references.citation: Cancer Metastasis Rev. 2008 Mar;27(1):11-8
references.pmid: 18066650
references.citation: Br J Cancer. 2012 Sep 4;107(6):988-93
references.pmid: 22878374
references.citation: Cancer Res. 1999 Mar 15;59(6):1295-300
references.pmid: 10096562
references.citation: Br J Cancer. 2014 May 13;110(10):2524-30
references.pmid: 24675383
references.citation: J Clin Oncol. 2013 Mar 20;31(9):1188-95
references.pmid: 23358969
references.citation: Cancer Res. 2012 Jan 15;72(2):440-8
references.pmid: 22127925
references.citation: J Surg Oncol. 2003 Jan;82(1):28-33
references.pmid: 12501166
references.citation: CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
references.pmid: 21296855
references.citation: Ann Oncol. 2011 Jul;22(7):1644-52
references.pmid: 21212156
references.citation: Cancer. 2002 Apr 1;94(7):2040-6
references.pmid: 11932907
references.citation: Am J Surg. 2002 Jun;183(6):679-85
references.pmid: 12095601
references.citation: Semin Liver Dis. 2004 May;24(2):115-25
references.pmid: 15192785
references.citation: Am J Clin Oncol. 2003 Apr;26(2):135-40
references.pmid: 12714883
references.citation: Biometrics. 2000 Jun;56(2):337-44
references.pmid: 10877287
references.citation: J Am Coll Surg. 2001 Oct;193(4):384-91
references.pmid: 11584966
references.citation: Nature. 2009 Jan 1;457(7225):36-7
references.pmid: 19122629
references.citation: J Hepatol. 2006 Aug;45(2):246-53
references.pmid: 16580084
references.citation: Blood. 2005 Jan 1;105(1):178-85
references.pmid: 15367435
references.citation: Br J Haematol. 2008 Jun;141(6):792-8
references.pmid: 18410454
references.citation: Cancer Res. 1981 Feb;41(2):430-2
references.pmid: 6256066