Inflammatory Scores: Comparison and Utility in HCC Patients Undergoing Transarterial Chemoembolization in a North American Cohort

Shamar Young,1 Isa Cam,1 Mehmet Gencturk,1 Nathan Rubin,2 Donna D’souza,1 Siobhan Flanagan,1 Jafar Golzarian,1 Tina Sanghvi3 1University of Minnesota, Department of Radiology, Division of Interventional Radiology, Minneapolis, MN, 55455, USA; 2Biostatistics Core, Masonic Cancer Center, University of...

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Autores principales:	Young S, Cam I, Gencturk M, Rubin N, D'souza D, Flanagan S, Golzarian J, Sanghvi T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	hepatocellular carcinoma chemoembolization neutrophil to lymphocyte ratio platelet to lymphocyte ratio aspartate aminotransferase to lymphocyte ratio systemic-inflammation index Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/0ffe1ea3d3b340149eff50acc7e45ed1
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spelling	oai:doaj.org-article:0ffe1ea3d3b340149eff50acc7e45ed12021-11-30T18:50:37ZInflammatory Scores: Comparison and Utility in HCC Patients Undergoing Transarterial Chemoembolization in a North American Cohort2253-5969https://doaj.org/article/0ffe1ea3d3b340149eff50acc7e45ed12021-12-01T00:00:00Zhttps://www.dovepress.com/inflammatory-scores-comparison-and-utility-in-hcc-patients-undergoing--peer-reviewed-fulltext-article-JHChttps://doaj.org/toc/2253-5969Shamar Young,1 Isa Cam,1 Mehmet Gencturk,1 Nathan Rubin,2 Donna D’souza,1 Siobhan Flanagan,1 Jafar Golzarian,1 Tina Sanghvi3 1University of Minnesota, Department of Radiology, Division of Interventional Radiology, Minneapolis, MN, 55455, USA; 2Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA; 3Minneapolis VA Medical Center, Department of Radiology, Minneapolis, MN, USACorrespondence: Shamar YoungUniversity of Minnesota, Department of Radiology, Division of Interventional Radiology, 420 Delaware St SE, Minneapolis, MN, 55455, USATel +612-624-6189Email youn1862@umn.eduBackground: The purpose of this study is to determine and compare the ability of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), aspartate-aminotransferase-to-lymphocyte ratio (ALRI), systemic-inflammation index (SII) and lymphocyte count to predict oncologic outcomes in hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE).Materials and Methods: A single-center retrospective review of 296 patients who were treated for 457 HCCs was performed. Pre- and post-treatment laboratory and treatment outcome variables were collected. Objective radiologic response (ORR), progression-free survival (PFS), and overall survival (OS) were evaluated. Patients were categorized into above and below median scores and compared.Results: The median pretreatment NLR, PLR, ALRI, SII, and lymphocyte count were 2.7 (range: 0.4– 55), 88.3 (range: 0.1– 840), 71.8 (range: 0.1– 910), 238.1 (range: 0.1– 5150.8), and 1 (range: 0.1– 5.2) 103/μL, respectively. Patients with above median ALRI scores were less likely to achieve an ORR as compared to those with below median ALRI values (132 (132/163, 81%) vs 150 (150/163, 92%), p = 0.004). On univariate analysis, patients with above median pretreatment NLR (HR 1.41, 95% CI: 1.09– 1.83, p = 0.01) and below median lymphocyte count (HR 0.69, 95% CI: 0.53– 0.92, p = 0.01) had significantly worse PFS. The relationship between PFS and NLR (p = 0.08) as well as lymphocytes (p = 0.20) no longer remained on multivariate analysis. On univariate analysis, below median pretreatment NLR (HR 1.72, 95% CI: 1.2– 2.45, p = 0.003) and ALRI (HR 1.52, 95% CI: 1.05– 2.2); p = 0.03) as well as above median lymphocyte count (HR 0.48, 95% CI: 0.34– 0.7, p < 0.0001) were associated with improved OS. The significant relationship between lymphocytes and OS remained on multivariate analysis (HR 0.50, 95% CI: 0.28– 0.9, p = 0.02), but the relationship with NLR (p = 0.94) did not persist.Conclusion: NLR is predictive of PFS and OS in patients with HCC undergoing TACE and may be superior to other inflammatory scores (PLR, ALRI, and SII) in this setting. However, lymphocyte count may be most predictive of OS.Keywords: hepatocellular carcinoma, chemoembolization, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, aspartate-aminotransferase-to-lymphocyte ratio, systemic-inflammation indexYoung SCam IGencturk MRubin ND'souza DFlanagan SGolzarian JSanghvi TDove Medical Pressarticlehepatocellular carcinomachemoembolizationneutrophil to lymphocyte ratioplatelet to lymphocyte ratioaspartate aminotransferase to lymphocyte ratiosystemic-inflammation indexNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENJournal of Hepatocellular Carcinoma, Vol Volume 8, Pp 1513-1524 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hepatocellular carcinoma chemoembolization neutrophil to lymphocyte ratio platelet to lymphocyte ratio aspartate aminotransferase to lymphocyte ratio systemic-inflammation index Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	hepatocellular carcinoma chemoembolization neutrophil to lymphocyte ratio platelet to lymphocyte ratio aspartate aminotransferase to lymphocyte ratio systemic-inflammation index Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Young S Cam I Gencturk M Rubin N D'souza D Flanagan S Golzarian J Sanghvi T Inflammatory Scores: Comparison and Utility in HCC Patients Undergoing Transarterial Chemoembolization in a North American Cohort
description	Shamar Young,1 Isa Cam,1 Mehmet Gencturk,1 Nathan Rubin,2 Donna D’souza,1 Siobhan Flanagan,1 Jafar Golzarian,1 Tina Sanghvi3 1University of Minnesota, Department of Radiology, Division of Interventional Radiology, Minneapolis, MN, 55455, USA; 2Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA; 3Minneapolis VA Medical Center, Department of Radiology, Minneapolis, MN, USACorrespondence: Shamar YoungUniversity of Minnesota, Department of Radiology, Division of Interventional Radiology, 420 Delaware St SE, Minneapolis, MN, 55455, USATel +612-624-6189Email youn1862@umn.eduBackground: The purpose of this study is to determine and compare the ability of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), aspartate-aminotransferase-to-lymphocyte ratio (ALRI), systemic-inflammation index (SII) and lymphocyte count to predict oncologic outcomes in hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE).Materials and Methods: A single-center retrospective review of 296 patients who were treated for 457 HCCs was performed. Pre- and post-treatment laboratory and treatment outcome variables were collected. Objective radiologic response (ORR), progression-free survival (PFS), and overall survival (OS) were evaluated. Patients were categorized into above and below median scores and compared.Results: The median pretreatment NLR, PLR, ALRI, SII, and lymphocyte count were 2.7 (range: 0.4– 55), 88.3 (range: 0.1– 840), 71.8 (range: 0.1– 910), 238.1 (range: 0.1– 5150.8), and 1 (range: 0.1– 5.2) 103/μL, respectively. Patients with above median ALRI scores were less likely to achieve an ORR as compared to those with below median ALRI values (132 (132/163, 81%) vs 150 (150/163, 92%), p = 0.004). On univariate analysis, patients with above median pretreatment NLR (HR 1.41, 95% CI: 1.09– 1.83, p = 0.01) and below median lymphocyte count (HR 0.69, 95% CI: 0.53– 0.92, p = 0.01) had significantly worse PFS. The relationship between PFS and NLR (p = 0.08) as well as lymphocytes (p = 0.20) no longer remained on multivariate analysis. On univariate analysis, below median pretreatment NLR (HR 1.72, 95% CI: 1.2– 2.45, p = 0.003) and ALRI (HR 1.52, 95% CI: 1.05– 2.2); p = 0.03) as well as above median lymphocyte count (HR 0.48, 95% CI: 0.34– 0.7, p < 0.0001) were associated with improved OS. The significant relationship between lymphocytes and OS remained on multivariate analysis (HR 0.50, 95% CI: 0.28– 0.9, p = 0.02), but the relationship with NLR (p = 0.94) did not persist.Conclusion: NLR is predictive of PFS and OS in patients with HCC undergoing TACE and may be superior to other inflammatory scores (PLR, ALRI, and SII) in this setting. However, lymphocyte count may be most predictive of OS.Keywords: hepatocellular carcinoma, chemoembolization, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, aspartate-aminotransferase-to-lymphocyte ratio, systemic-inflammation index
format	article
author	Young S Cam I Gencturk M Rubin N D'souza D Flanagan S Golzarian J Sanghvi T
author_facet	Young S Cam I Gencturk M Rubin N D'souza D Flanagan S Golzarian J Sanghvi T
author_sort	Young S
title	Inflammatory Scores: Comparison and Utility in HCC Patients Undergoing Transarterial Chemoembolization in a North American Cohort
title_short	Inflammatory Scores: Comparison and Utility in HCC Patients Undergoing Transarterial Chemoembolization in a North American Cohort
title_full	Inflammatory Scores: Comparison and Utility in HCC Patients Undergoing Transarterial Chemoembolization in a North American Cohort
title_fullStr	Inflammatory Scores: Comparison and Utility in HCC Patients Undergoing Transarterial Chemoembolization in a North American Cohort
title_full_unstemmed	Inflammatory Scores: Comparison and Utility in HCC Patients Undergoing Transarterial Chemoembolization in a North American Cohort
title_sort	inflammatory scores: comparison and utility in hcc patients undergoing transarterial chemoembolization in a north american cohort
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/0ffe1ea3d3b340149eff50acc7e45ed1
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Inflammatory Scores: Comparison and Utility in HCC Patients Undergoing Transarterial Chemoembolization in a North American Cohort

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