Abstract
BackgroundThe systemic inflammatory response plays an important role in cancer development and progression. An original inflammation-based staging system for predicting survival in patients undergoing transarterial chemoembolization (TACE) combined with recombinant human type-5 adenovirus H101 is not available. This study aimed to validate the prognostic value of inflammation scores for patients with hepatocellular carcinoma (HCC) who were treated with TACE combined with H101.MethodsThe data from 216 patients with HCC who underwent TACE combined with H101 from January 2007 to July 2015 were retrospectively collected, and the association of the inflammation scores with overall survival (OS) was analyzed. Univariate and multivariate analyses were performed to identify variables associated with OS. The prognostic value of the inflammation scores, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil/ platelet-to-lymphocyte ratio (NLR-PLR), modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI), prognostic index (PI), tumor-node-metastasis (TNM), Barcelona Clinic Liver Cancer (BCLC) and Cancer of the Liver Italian Program (CLIP) staging systems were analyzed and compared using the areas under the receiver operating characteristic curves (AUROCs).ResultsThe estimated 1-, 2-, and 3-year OS rates were 61.3%, 44.2%, and 40.5% for the entire study cohort, respectively; the median OS was 17 months. According to the multivariate Cox proportional hazards model, the pretreatment NLR, tumor diameter and pretreatment alpha-fetoprotein (AFP) levels were independent predictors of OS. The CLIP score had superior discriminative abilities compared with other staging systems, and the NLR-PLR score consistently displayed a higher AUROC value than the other inflammation-based prognostic scores. The combination of the NLR-PLR and CLIP scores exhibited a superior prognostic ability for OS compared to the NLR-PLR or CLIP scores alone.ConclusionsThe NLR-PLR score is a more powerful predictive system than the other inflammation-based scores for patients with HCC who were treated with TACE and H101. The predictive ability may be improved by utilizing a combination of the NLR-PLR and CLIP scores.
Highlights
Liver cancer is the most prevalent primary malignant hepatic tumor, in East and Southeast Asia and northern and western Africa
Inflammation scores predict survival of patients with hepatocellular carcinoma who were treated with Transarterial chemoembolization (TACE) and adenovirus alpha-fetoprotein (AFP) levels were independent predictors of overall survival (OS)
The neutrophil-to-lymphocyte ratio (NLR)-platelet-to-lymphocyte ratio (PLR) score is a more powerful predictive system than the other inflammationbased scores for patients with hepatocellular carcinoma (HCC) who were treated with TACE and H101
Summary
Liver cancer is the most prevalent primary malignant hepatic tumor, in East and Southeast Asia and northern and western Africa. Transarterial chemoembolization (TACE), which focuses on delivering chemotherapeutic drugs at the tumor while blocking tumor-feeding arteries, is the most frequently used treatment for these patients [4, 5]. In patients with poor liver function, large tumors and portal vein involvement, TACE is less effective when it is administered for longer than 6 months and is associated with a 2-year survival rate of 24–63% [6]. The poor prognosis of patients with intermediate-advanced HCC who are treated with TACE suggests that new strategies for intermediate-advanced HCC are necessary. An original inflammation-based staging system for predicting survival in patients undergoing transarterial chemoembolization (TACE) combined with recombinant human type-5 adenovirus H101 is not available. This study aimed to validate the prognostic value of inflammation scores for patients with hepatocellular carcinoma (HCC) who were treated with TACE combined with H101
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