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Early variation of inflammatory indexes refines prognostic prediction in patients with hepatocellular carcinoma under systemic treatment.
Da Fonseca, Leonardo G; Uratani, Lucas Fernando; Soares, Gabriella Fernandes; Do Amaral, Paulo Siqueira; De Souza Melo Alencar, Regiane Saraiva; Chagas, Aline Lopes; Alves, Venancio Avancini Ferreira; Carrilho, Flair Jose.
Afiliação
  • Da Fonseca LG; Department of Oncology, ICESP - Institute of Cancer of Sao Paulo, University of Sao Paulo School of Medicine, 01246-000 Sao Paulo-SP, Brazil.
  • Uratani LF; Sao Paulo Clínicas Liver Cancer Group, University of São Paulo School of Medicine, 01246-000 Sao Paulo-SP, Brazil.
  • Soares GF; Department of Oncology, ICESP - Institute of Cancer of Sao Paulo, University of Sao Paulo School of Medicine, 01246-000 Sao Paulo-SP, Brazil.
  • Do Amaral PS; Department of Oncology, ICESP - Institute of Cancer of Sao Paulo, University of Sao Paulo School of Medicine, 01246-000 Sao Paulo-SP, Brazil.
  • De Souza Melo Alencar RS; Department of Oncology, ICESP - Institute of Cancer of Sao Paulo, University of Sao Paulo School of Medicine, 01246-000 Sao Paulo-SP, Brazil.
  • Chagas AL; Sao Paulo Clínicas Liver Cancer Group, University of São Paulo School of Medicine, 01246-000 Sao Paulo-SP, Brazil.
  • Alves VAF; Division of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, University of São Paulo School of Medicine, 01246-000 Sao Paulo-SP, Brazil.
  • Carrilho FJ; Sao Paulo Clínicas Liver Cancer Group, University of São Paulo School of Medicine, 01246-000 Sao Paulo-SP, Brazil.
Mol Clin Oncol ; 18(4): 29, 2023 Apr.
Article em En | MEDLINE | ID: mdl-36908977
ABSTRACT
Prognostic markers in advanced hepatocellular carcinoma (HCC) are relevant for clinical decisions. Variations in inflammatory indexes, such as neutrophil-to-lymphocyte ratio (NLR) or platelet-to-lymphocyte ratio (PLR), may correlate with outcomes. In the present study, it was aimed to assess the prognostic role of inflammation indexes in patients with HCC and the evolutionary behavior of these variables within the first month of treatment in a cohort of patients treated with sorafenib from 2009-2021. Subgroups were divided based on the median of each variable ('low' or 'high)'. Survival was estimated using the Kaplan-Meier method. Hazard Ratio (HR) with 95% confidence interval (CI) were estimated using Cox regression models. A total of 373 patients were included, most Child-Pugh-A (83.1%) and BCLC-C (74%). Child-Pugh-A (P=0.011), performance status 0 (P<0.001), no ascites (P<0.001) and NLR<2.6 (P<0.001) were independently associated with improved survival. Baseline PLR was not correlated with survival (P=0.137). Patients who maintained low NLR at baseline and at 1 month (reference subgroup) had improved survival (18.6 months, 95% CI15.4-22.0) compared with the subgroup that maintained high NLR at baseline and at 1 month (4.2 months, 95% CI3.6-5.9), with HR 3.80 (95% CI 2.89-4.96). The subgroup with low NLR at baseline and high NLR at 1 month had a worse prognosis compared with the reference group (HR1.4, 95% CI 1.1-2.0), whereas the subgroup with high NLR at baseline and low at 1 month had similar outcome (HR1.2, 95% CI 0.8-1.6). It was concluded that evolutionary variation of NLR has a prognostic role in HCC patients under systemic therapy. This finding suggested that systemic inflammation and early modulation of the immune environment during treatment may correlate with outcomes.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article