Therapeutic effect of postoperative adjuvant transcatheter arterial chemoembolization based on the neutrophil-to-lymphocyte ratio

作者全名："Feng, Guo-Ying; Shi, Zheng-Rong; Zhao, Yu-Fei; Chen, Kai; Tao, Jie; Wei, Xu-Fu; Cheng, Yu"

作者地址："[Feng, Guo-Ying; Shi, Zheng-Rong; Zhao, Yu-Fei; Chen, Kai; Tao, Jie; Wei, Xu-Fu] Chongqing Med Univ, Dept Hepatobiliary Surg, Affiliated Hosp 1, Chongqing, Peoples R China; [Feng, Guo-Ying] Army Med Univ, Daping Hosp, Dept Hepatobiliary Surg, Chongqing, Peoples R China; [Cheng, Yu] Chongqing Med Univ, Univ Town Hosp, Nursing Dept, Chongqing, Peoples R China"

通信作者："Cheng, Y (通讯作者)，Chongqing Med Univ, Univ Town Hosp, Nursing Dept, Chongqing, Peoples R China."

来源：FRONTIERS IN SURGERY

ESI学科分类：　

WOS号：WOS:000915970100001

JCR分区：Q2

影响因子：1.8

年份：2023

卷号：9

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：hepatic carcinoma; neutrophil-to-lymphocyte ratio; postoperative adjuvant transcatheter arterial chemoembolization; prognosis; propensity score matching

摘要："AimTo evaluate the feasibility of the preoperative neutrophil-to-lymphocyte ratio (NLR) as an index to guide postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) in patients with liver cancer. MethodsWe recruited a total of 166 patients with liver cancer who underwent surgery alone or surgery plus PA-TACE between January 2013 and June 2017 and compared the 1, 2, and 3-year recurrence-free survival (RFS) and overall survival (OS) between patients with high and low NLRs, surgery and surgery plus PA-TACE groups, and relevant subgroups using the Kaplan-Meier method. We also evaluated the independent factors affecting the prognosis of liver cancer after surgery using a Cox risk ratio model and correlation between NLR levels and high-risk recurrence factors of liver cancer with logistic regression analysis. ResultsThe 1, 2, and 3-year RFS rates were all significantly higher in the low-NLR group compared to the high-NLR group (P < 0.05). However, the 1, 2, and 3-year OS rates were similar in the low- and high-NLR groups (P > 0.05). After propensity score matching, the 1, 2, and 3-year RFS and OS rates were significantly better in patients treated with surgery plus PA-TACE compared with surgery alone (P < 0.05). The 1, 2, and 3-year RFS and OS rates were also significantly better in the surgery plus PA-TACE subgroup compared with the surgery-alone subgroup in the high-NLR group (P < 0.05), but there was no significant difference in RFS or OS between the surgery plus PA-TACE and surgery-alone subgroups at 1, 2, and 3 years in the low-NLR group (P > 0.05). Multivariate analysis in the high-NLR group showed that a poorly differentiated or undifferentiated tumor was an independent risk factor for postoperative RFS. Multiple tumors were an independent risk factor for postoperative OS (P < 0.05), while PA-TACE was an independent protective factor for postoperative RFS and OS (P < 0.05). In the low-NLR group, AFP > 400 mu g/L was an independent risk factor for postoperative OS (P < 0.05). Multivariate logistic regression indicated that patients with a maximum tumor diameter of >5 cm were at increased risk of having high NLR levels compared to patients with a maximum tumor diameter of <5 cm (P < 0.05). ConclusionPA-TACE can improve the prognosis of patients with a high preoperative NLR (>= 2.5), but has no obvious benefit in patients with low preoperative NLR (<2.5). This may provide a reference for clinical selection of PA-TACE."

基金机构：Chongqing medical scientific research project (Chongqing Health Commission) [2021MSXM056]; Chongqing medical scientific research project (Science and Technology Bureau) [2021MSXM056]; In vitro high-throughput drug sensitivity screening with patient-derived primary cells as a guide for clinical practice in hepatocellular carcinoma [2019GDRC002]; Differentiation of adipose mesenchymal stem cells into hepatocytes induced by HNF-4a combined with HNF-3? [cstc2019jcyj-msxmX0837]

基金资助正文："This work was supported by In vitro high-throughput drug sensitivity screening with patient-derived primary cells as a guide for clinical practice in hepatocellular carcinoma (2019GDRC002), Differentiation of adipose mesenchymal stem cells into hepatocytes induced by HNF-4a combined with HNF-3? (cstc2019jcyj-msxmX0837) and Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau) (2021MSXM056)."