Ann Hepatobiliary Pancreat Surg.  2022 Feb;26(1):40-46. 10.14701/ahbps.21-094.

Do changes in inflammatory markers predict hepatocellular carcinoma recurrence and survival after liver transplantation?

• Caram LJ
• Calderon F
• Masino E
• Ardiles V
• Mauro E
• Haddad L
• Pekolj J
• Vicens J
• Gadano A
• Santibañes Ed
• Santibañes Md

• KMID: 2526831
• DOI: http://doi.org/10.14701/ahbps.21-094

Abstract

Backgrounds/Aims
The role of inf lammation 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 inf lammation 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.

Keyword

Transplantation; Liver neoplasms; Recurrence; Neutrophils; Platelets

Figure

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  Fig. 1 Selection of patients included in this study. OLT, orthotopic liver transplantation.

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  Fig. 2 The Kaplan–Meier curve showing recurrence-free survival (RFS) of orthotopic liver transplantation (OLT) patients.

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  Fig. 3 The Kaplan–Meier curve showing overall survival of orthotopic liver transplantation patients.

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  Fig. 4 The Kaplan–Meier curve showing recurrence-free survival (RFS) according to delta platelet-lymphocyte ratio (PLR) trends.

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