Abstract
Inflammation plays an important role in cancer progression. In this study, we aimed to investigate the prognostic value of the systemic inflammatory biomarkers in hepatocellular carcinoma (HCC) patients undergoing curative resection. Data from 271 HCC patients who underwent curative resection in Zhongshan Hospital between 2008 and 2011 were included. Kaplan-Meier survival analysis showed that gamma-glutamyltransferase (GGT) and lymphocyte-to-monocyte ratio (LMR) were significantly associated with overall survival(OS) and time to recurrence(TTR). We created a systemic inflammation score (SIS) basing on preoperative serum GGT and LMR. Low SIS was also significantly associated with increased OS and TTR. Univariate and multivariate analyses revealed the LMR, GGT and SIS were independent predictors for OS and TTR. The predictive ability of the SIS, as assessed by area under the receiver operating characteristic curve, was 0.682 (95% CI, 0.618-0.746) for OS, which was higher than GGT and LMR. In conclusion, low preoperative LMR and high preoperative GGT were associated with a poor prognosis in HCC patients after hepatectomy. Our results confirmed that the SIS qualifies as a novel prognostic predictor of HCC patients after hepatectomy.
Highlights
Univariate analysis indicated that alanine aminotransferase (ALT), aspartate transaminase (AST), tumor size, tumor encapsulation, vascular invasion, TNM stage, absolute lymphocyte counts, absolute monocyte counts, lymphocyte-to-monocyte ratio (LMR), GGT and systemic inflammation score (SIS) were www.impactjournals.com/oncotarget significant prognostic factors for overall survival (OS), and tumor number, tumor encapsulation, vascular invasion, TNM stage, LMR, GGT and SIS were significant prognostic factors for time to recurrence (TTR)
Multivariate analysis indicated that ALT, tumor encapsulation, vascular invasion, TNM stage, LMR, GGT
Nowadays, increasing evidence indicating systemic inflammatory response plays an important role in cancer progression [5]
Summary
Systemic inflammatory response is increasingly recognized to play decisive roles at different stages of tumor development, including initiation, promotion, malignant conversion, invasion, and metastasis [4].Previous studies reported the systemic inflammatory response was associated with cancer progression [5].Recently there has been increasing interest in improving cancer prognostication using inflammatory biomarkers.The neutrophil-to-lymphocyte ratio (NLR) and plateletto-lymphocyte ratio (PLR), have both been demonstrated to be prognostic markers for patients with various types of tumors [6,7,8,9,10,11,12,13,14]. Systemic inflammatory response is increasingly recognized to play decisive roles at different stages of tumor development, including initiation, promotion, malignant conversion, invasion, and metastasis [4]. Previous studies reported the systemic inflammatory response was associated with cancer progression [5]. There has been increasing interest in improving cancer prognostication using inflammatory biomarkers. The neutrophil-to-lymphocyte ratio (NLR) and plateletto-lymphocyte ratio (PLR), have both been demonstrated to be prognostic markers for patients with various types of tumors [6,7,8,9,10,11,12,13,14]. Surgery is the only potentially curative treatment option for patients who have resectable HCC. Even after surgery, the 5-year overall survival (OS) rate is estimated to 50% and the 5-year recurrence rate exceeds
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