Blood neutrophil-to-lymphocyte ratio predicts survival in patients with unresectable hepatocellular carcinoma undergoing transarterial chemoembolization

OBJECTIVE:To evaluate the inference of neutrophil-to-lymphocyte ratio(NLR) on preding survival in patients with unresectable hepatocellular carcinoma(HCC) before and after transarterial chemoembolization treatment.METHODS:From Feb 2006 to Feb 2009,clinical and laboratory datas of 154 consecutive patients underwent transarterial chemoembolization for unresectable HCC were analyzed retrospectively.Their clinical factors for survival were evaluated by univariate analysis.Cox multiple regression was used in predicting the survival.NLR≥2.5 was considered to be elevated.RESULTS:A total of 154 patients were identified.Among them,69 had an elevated NLR.The median survival of patients with NLR≥2.5 was 8 months compared with 12 months for patients with NLR2.5;a significant difference was found in overall survival(P=0.003) between the two groups.Age≥50 y,NLR≥2.5,decreased NLR after treatment,large tumor(≥5 cm),vascular invasion,and elevated AFP level all were predictors of poor survival.Multivariate analysis showed that NLR≥2.5(OR=0.678,95%CI:0.476-0.897;P=0.038) and vascular invasion(OR=1.489;95%CI:1.002-2.234;P=0.039)were independent factors for predicting worse survival.CONCLUSION:A high NLR independently predicts poor survival in patients with unresectable HCC underwent transarterial chemoembolization treatment,and an increased NLR indicates a better outcome than a decreased NLR for patients after transarterial chemoembolization.