Abstract
ObjectivesTo investigate the association between inflammatory indices and clinical outcomes of hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE) by performing meta-analysis.MethodsA systematic literature search for relevant studies published up to August 2019 was performed by using PubMed, Web of Science, EMBASE, China National Knowledge Internet (CNKI) and Wanfang databases. Pooled hazard ratios (HR) or odds ratio (OR) and 95% confidence intervals (95% CI) were calculated.ResultsA total of 5280 patients from 22 studies were finally enrolled in the meta-analysis. The results demonstrated that elevated preoperative NLR, PLR, and CRP was associated with poor OS in HCC patients treated by TACE (HR = 1.81, P<0.00001; HR = 1.56, P = 0.007; HR = 1.45, P<0.00001, respectively). In addition, high NLR was significantly correlated with the presence of tumor vascular invasion (OR = 1.49, P = 0.002). Elevated PLR tended to be correlated with higher incidence of tumor size>3 cm (OR = 2.42, P = 0.005).ConclusionsElevated preoperative NLR, PLR, and CRP are associated with poor prognosis in HCC patients treated with TACE. These inflammatory indices may be convenient, accessible, affordable and dependable biomarkers with prognostic potential for HCC patients treated by TACE.
Highlights
Hepatocellular carcinoma (HCC), a highly aggressive and prevalent tumor with increasing incidence rate over the last several decades, is the seventh most common malignant tumors worldwide and the fourth leading cause of cancer-related mortality[1]
The results demonstrated that elevated preoperative neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and C-reactive protein (CRP) was associated with poor overall survival (OS) in HCC patients treated by Transarterial chemoembolization (TACE) (HR = 1.81, P
Elevated preoperative NLR, PLR, and CRP are associated with poor prognosis in HCC patients treated with TACE
Summary
Hepatocellular carcinoma (HCC), a highly aggressive and prevalent tumor with increasing incidence rate over the last several decades, is the seventh most common malignant tumors worldwide and the fourth leading cause of cancer-related mortality[1]. Transarterial chemoembolization (TACE) is considered to be the standard treatment for patients at intermediate stage according to the Barcelona Clinic Liver Cancer classification (BCLC) stage[4]. TACE can be used to treat well-compensated cirrhosis patients, which can reduce their burden of disease and potentially prolong their life. It is a non-surgical, minimally invasive and well-tolerated procedure with acceptable morbidity[5]. Due to the tedious content of these standards, there are many inconveniences in practical applications These criteria are mostly efficient in predict patients prognosis, they add a lot of burden to clinicians and patients, which explains why they are rarely used in routine clinical practice[6]. It is essential to identify effective, common and easy-obtained prognostic biomarkers, especially simple serum biomarkers for prognosis of HCC undergoing TACE
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