Early variation of inflammatory indexes refines prognostic prediction in patients with hepatocellular carcinoma under systemic treatment
| Autor: | Leonardo G Fonseca, Lucas Fernando Uratani, Gabriella Fernandes Soares, Paulo Siqueira Amaral, Regiane Saraiva Souza Melo Alencar, Aline Lopes Chagas, Venancio Avancini Ferreira Alves, Flair Jose Carrilho |
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| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Molecular and Clinical Oncology. 18 |
| ISSN: | 2049-9469 2049-9450 |
| Popis: | Background: The search for prognostic markers in hepatocellular carcinoma (HCC) is essential for clinical decisions. In addition to established variables such as liver function and tumor extent, cancer-associated inflammation can impact clinical outcomes. Evolutionary variation in inflammatory indexes, such as the neutrophil-to-lymphocyte ratio (NLR) or platelet-to-lymphocyte ratio (PLR), may correlate with therapeutic benefit. Our aim is to assess the prognostic role of immune cell counts and inflammation indexes in HCC patients treated with systemic therapy and the evolutionary behavior of these variables within the first month of treatment. Methods: We analyzed a cohort of patients consecutively treated with first-line sorafenib from 2009 to 2021. Subgroups were divided based on the median value of each variable/index in “low” or “high”. Survival was estimated using the Kaplan-Meier method and compared using log-rank. Hazard Ratio (HR) with 95% confidence interval (CI) were estimated using Cox regression models and Harrell´s C indexes were calculated to define their accuracy. Results: 373 patients were included, most of them male (75.6%), Child-Pugh A (83.1%) and BCLC C (74%). Median survival was 9.7 months (95%CI: 8.7-10.8 months). The following factors were independently associated with a better prognosis: Child-Pugh A (p=0.011), ECOG-PS 0 (pConclusion: Evolutionary variation of NLR has a prognostic role in HCC patients under systemic therapy. This finding suggests that systemic inflammation and early modulation of the immune environment during treatment may correlate with survival. |
| Databáze: | OpenAIRE |
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