Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
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Do changes in inflammatory markers predict hepatocellular carcinoma recurrence and survival after liver transplantation?

  • Lucas Jose Caram (Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires) ;
  • Francisco Calderon (Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires) ;
  • Esteban Masino (Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires) ;
  • Victoria Ardiles (Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires) ;
  • Ezequiel Mauro (Department of Internal Medicine and Hepatology, Hospital Italiano de Buenos Aires) ;
  • Leila Haddad (Department of Internal Medicine and Hepatology, Hospital Italiano de Buenos Aires) ;
  • Juan Pekolj (Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires) ;
  • Jimena Vicens (Department of Internal Medicine and Statistics, Hospital Italiano de Buenos Aires) ;
  • Adrian Gadano (Department of Internal Medicine and Hepatology, Hospital Italiano de Buenos Aires) ;
  • Eduardo de Santibanes (Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires) ;
  • Martin de Santibanes (Division of Hepato Pancreatic Biliary Surgery and Liver Transplant Unit, Department of General Surgery, Hospital Italiano de Buenos Aires)
  • Received : 2021.06.23
  • Accepted : 2021.09.21
  • Published : 2022.02.28
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Abstract

Backgrounds/Aims: The role of inflammation in malignant cell proliferation has been well described. High values of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers of systemic inflammation have shown associations with unfavorable long-term outcomes. The purpose of this study was to determine values of NLR and PLR evaluated prior to and after surgery and their associations with mortality and recurrence rates of liver transplant patients with hepatocellular carcinoma (HCC). Methods: A total of 105 patients with HCC who underwent orthotopic liver transplantation (OLT) were retrospectively reviewed. NLR and PLR values were obtained from complete blood counts prior to and after surgery. Overall survival (OS) and recurrence-free survival (RFS) in relation with delta NLR and PLR were estimated. Results: Serum alpha-fetoprotein levels > 100 ng/mL (p = 0.014) and lymphovascular emboli in the specimen (p = 0.048) were identified to be significant predictors of RFS. Child-Pugh score (p = 0.016) was found to be an independent factor associated with poorer OS. An increasing delta PLR was associated with worse RFS, although it showed no significant association with OS. Conclusions: The analysis of PLR as a continuous variable may predict recurrence outcomes in patients undergoing OLT for HCC. It is more representative than isolated values.

Keywords

Acknowledgement

The funding involved in this work has been provided by the National Cancer Institute of Argentina.

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