Clinical significance of preoperative platelet-to-lymphocyte ratio in recurrent hepatocellular carcinoma after thermal ablation: A retrospective analysis

Abstract

Purpose: The aim of this study was to elucidate the clinical significance of preoperative Platelet-to-lymphocyte ratio (PLR) in recurrent hepatocellular carcinoma (RHCC) patients after thermal ablation.Materials and methods: We retrospectively reviewed 414 patients with RHCC treated with ultrasound-guided thermal ablation percutaneously between January 2010 and March 2014. The correlation of recurrence-free survival (RFS) with 15 clinical parameters was analysed by Cox multivariate proportional hazard model analysis. The best cut-off value of preoperative PLR was determined with time-dependent receiver operating characteristic (ROC) curve analysis. The value of PLR in predicting recurrence was analysed by Kaplan-Meier.Results: Multivariate Cox proportional hazard model analysis showed that tumour differentiation, prothrombin time (PT), absolute lymphocyte count (ALC) and PLR were risk factors for recurrence in RHCC patients. PLR ≥ 87.87 was considered for evaluation (AUROC = 0.667; P < 0.05), and 166 of 414 patients (40.1%) had PLR of more than 87.87. During the follow-up period (12–52 months), the 1- and 3-year recurrence rates were 39.9% and 54.8% in the low PLR group, which were significantly better than those in the high PLR group (56.0% and 79.5%) (P < 0.05). Kaplan-Meier analysis demonstrated that the RFS in the low PLR group was 45.2% which was significantly higher than that of the high PLR group (20.5%) (X2 = 24.019, P < 0.05). This result suggested that preoperative PLR is a predictor for recurrence followed thermal ablation in RHCC patients, and patients with PLR ≥ 87.87 indicated higher RFS, which may improve the clinical management of RHCC patients. Further studies are warranted to validated this finding and test its clinical applicability in RHCC.