title: Postoperative neutrophil-to-lymphocyte ratio plus platelet-to-lymphocyte ratio predicts the outcomes of hepatocellular carcinoma.
abstract: BACKGROUND
  There is limited information regarding NLR-PLR (the combination of the neutrophil-to-lymphocyte ratio [NLR] and platelet-to-lymphocyte ratio [PLR]) in hepatocellular carcinoma (HCC). This study aimed to assess the predictive ability of NLR-PLR in patients with resectable hepatitis B virus-related HCC within Milan criteria after hepatectomy.
  
  
  METHODS
  Two hundred thirty-six consecutive HCC patients were included in the study. The postoperative NLR-PLR was calculated based on the data obtained on the first postoperative month after liver resection as follows: patients with both an elevated PLR and an elevated NLR, which were detected by receiver operating characteristic curve analysis, were allocated a score of 2, and patients showing one or neither of these elevations were allocated a score of 1 or 0, respectively.
  
  
  RESULTS
  During the follow-up period, 113 patients experienced recurrence and 41 patients died. Multivariate analyses suggested that tumor-node-metastasis stage, preoperative alpha-fetal protein, and postoperative NLR-PLR were independently associated with recurrence, whereas microvascular invasion and postoperative NLR-PLR adversely impacted the overall survival. The 5-y recurrence-free and overall survival rates of the patients with a postoperative NLR-PLR of 0, 1, or 2 were 43.6%, 35.6%, or 8.3% (P < 0.001) and 82.1%, 73.0%, or 10.5% (P < 0.001), respectively.
  
  
  CONCLUSIONS
  The postoperative NLR-PLR predicted outcomes of hepatitis B virus-related HCC patients within Milan criteria after liver resection.
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Chuan
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, China. Electronic address: aderwe@163.com.
authors.forename: Tian-Fu
authors.initials: TF
authors.lastname: Wen
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Lu-Nan
authors.initials: LN
authors.lastname: Yan
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Wen-Tao
authors.initials: WT
authors.lastname: Wang
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Jia-Yin
authors.initials: JY
authors.lastname: Yang
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Ming-Qing
authors.initials: MQ
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000473:pathology*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007958:Leukocyte Count; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009504:Neutrophils / Q000473:pathology*; D010976:Platelet Count; D015996:Survival Rate
keywords: Hepatocellular carcinoma; Neutrophil-to-lymphocyte ratio; Platelet-to-lymphocyte ratio