Predictive Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Patients with Hepatocellular Carcinoma after Transarterial Chemoembolization Combined With Radiofrequency Ablation

Abstract

Purpose

To determine the predictive value of preoperative inflammatory markers in hepatocellular carcinoma (HCC) prognosis after transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA).

Materials and methods

A total of 161 patients with HCC who underwent TACE combined with RFA were enrolled in this retrospective study. Receiver operating characteristic (ROC) curve analysis was used to decide the cutoff value of the neutrophil-to-lymphocyte ratio (NLR), the lymphocyte-to-monocyte ratio (LMR), the platelet-to-lymphocyte ratio (PLR), and the prognostic nutritional index (PNI). The relationship between preoperative NLR, LMR, PLR, PNI, and survival outcomes was analyzed using Kaplan–Meier curves and multivariate Cox regression analyses.

Results

The cutoff value of NLR for the best discrimination of HCC prognosis was 2.95. The median recurrence-free survival (RFS) of the low NLR (≤2.95) group was longer than that of the high NLR (>2.95) group (29 months vs. 20 months, p = 0.013). The median overall survival (OS) of the low NLR group was longer than that of the high NLR group (60 months vs. 38 months, p = 0.006). Multivariate analysis showed that the tumor size (≤3 cm vs. >3cm), tumor number (single vs. multiple), and NLR (≤2.95 vs. >2.95) were independent predictors of the PFS and OS. LMR, PLR, and PNI did not have any prognostic significance.

Conclusion

NLR was confirmed as an independent predictive biomarker for hepatocellular carcinoma prognosis after TACE combined with RFA.

Keywords:

• Neutrophil-to-lymphocyte ratio
• survival
• hepatocellular carcinoma
• transarterial chemoembolization
• radiofrequency ablation

Disclosure statement

The authors declare no conflicts of interest.

Additional information

Funding

This study was supported by Sichuan Science and Technology Plan Project [No. 18YYJC0665], Sichuan Medical Research Project [No. Q18004], Wu Jieping Medical Funding [NO. 320.6750.2020-10-122], and Beijing Medical Award Funding [NO. YXJL-2020-0972-0424], Specical Research Funding Project of Tumor Intervention [NO. 2020S04].