University of Missouri Kansas City School of Medicine Overland Park, KS, United States
Adel Muhanna, MD1, Razan Mansour, MD2, Justin Amarin, MD3, Maysa Al-Hussaini, MD3 1University of Missouri Kansas City School of Medicine, Kansas City, MO; 2University of Kansas Medical Center, Kansas City, KS; 3King Hussein Cancer Center, Amman, Amman, Jordan
Introduction: Several studies have shown the role of inflammatory markers, especially the neutrophil-to-lymphocyte Ratio (NLR), as indicators of poor prognosis in various malignancies. We aimed to examine the prognostic value of NLR, among other markers, and their relationship with the presence of baseline distant metastasis in patients with hepatocellular carcinoma (HCC).
Methods: We retrospectively reviewed the charts of 73 patients with HCC treated at the King Hussein Cancer Center from 2012 to 2019. We examined the relationship between absolute eosinophilic count (AEC), absolute lymphocyte count (ALC), absolute monocytic count (AMC), absolute neutrophil count (ANC), monocyte to lymphocyte ratio (MLR), NLR, and platelet to lymphocyte ratio (PLR) with the presence distant metastases, and overall survival (OS). We used multivariable logistic regression analyses to test the association between the variables and presence of baseline distant metastases.
Results: The mean age was 60.7 ± 10.9 years, and males comprised 82.1% of the patients. The ROC value of 5.0 was determined as the cutoff value for NLR. High NLR (NLR > 5.0 µL) was significantly associated with the presence of distant metastasis at diagnosis ( p = 0.042). Other parameters as ANC (ANC > 5275.2 µL), AMC (AMC > 630 µL), and AEC (AEC > 109.5 µL) were also associated with the presence of baseline distant metastasis (p = 0.046, 0.007, and 0.002, respectively). Multivariable analysis showed that high NLR (p < 0.001, HR: 1.25, 95% CI: 1.15 to 1.36), as well as age > 62 years at diagnosis (p = 0.045, HR: 0.56, 95% CI: 0.32 to 0.98), were independent risk factors for distant metastasis at presentation.
Discussion: High NLR, PLR, MLR, ANC, and AMC were associated with poor OS (p < 0.001). Simple laboratory tests as complete blood counts can be used as markers of poor prognosis and poor OS in patients with HCC.
Figure: Figure 1: Kaplan-Meier curve for overall survival in patients with High NLR (A), PLR (B), MLR (C), ANC (D), and AMC (E).
Adel Muhanna indicated no relevant financial relationships.
Razan Mansour indicated no relevant financial relationships.
Justin Amarin indicated no relevant financial relationships.
Maysa Al-Hussaini indicated no relevant financial relationships.
Adel Muhanna, MD1, Razan Mansour, MD2, Justin Amarin, MD3, Maysa Al-Hussaini, MD3. P1771 - Prognostic Value of Systemic Inflammatory Markers in Patients With Hepatocellular Carcinoma, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.