Prognostic Significance of Preoperative Neutrophil-Lymphocyte Ratio in Patients Undergoing Liver Transplantation with Hepatocellular Carcinoma within Milan Criteria.
1Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
2Department of Surgery, CHA University, Bundang, Korea
Meeting: 2017 American Transplant Congress
Abstract number: A65
Keywords: Hepatocellular carcinoma, Liver transplantation, Neutrophils, Recurrence
Session Information
Session Name: Poster Session A: Clinical Science: Liver - Hepatocellular Carcinoma and Cholangiocarcinoma Malignancies
Session Type: Poster Session
Date: Saturday, April 29, 2017
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Introduction: The systemic inflammation biomarker, neutrophil-to-lymphocyte ratio (NLR) has been reported to be a predioctor of poor survival in patients with various cancers. The purpose of this study is to evaluate the prognostic value of the preoperative blood NLR in patients undergoing liver transplantation (LT) with hepatocellular carcinoma (HCC) within Milan criteria.
Methods: Retrospective analysis was performed on a database of recipients who underwent LT for HCC within Milan criteria between September 2005 and December 2015. Among 266 patients, any patients with any infection sign, history of recent blood transfusion, antibiotics and operation before transplantation, and early death after LT were excluded. The cutoff value of NLR was decided by receiver operating characteristic (ROC) curve analysis. Kaplan-Meier analyses were performed to identify the predictive value of the above factors for disease-free survival (DFS).
The results: A total of 247 patients were included finally. 26 (10.66%) patients were experienced tumor recurrence. The mean value of NLR of the HCC recurrence group is higher than no recurrence group. In the elevated NLR group above cutoff value (2.20), the recurrence rate of HCC was higher than the normal group (14.2% vs 4.5%) (HR: 3.43, 95% CI, 1.15-10.32; p=0.02). The preoperative NLR ≥2.20 was independent predictor of poor disease-free survival (p=0.010)
Conclusion: Preoperative NLR can be easily obtained. The elevation of preoperative NLR could be an effective predictors of tumor recurrence and prognosis for patients after LT with HCC.
| Table 1. Clinical characteristics with normal and elevated NLR | |||
| Variables | Elevated NLR (n=158) | Normal NLR (n=89) | p value |
| Sex male:female | 137:21 | 70:19 | 0.099 |
| Age (yrs) | 53.59±7.10 | 55.19±6.40 | 0.080 |
| NLR | 5.43±4.76 | 1.54±0.42 | <0.001 |
| Platelet counts ([times]103/mm3) | 80.24±49.93 | 90.67±40.5 | 0.94 |
| HCC recurrence no. | 22(14.2%) | 4(4.5%) | 0.020 |
| NLR: Neutrophil-to-Lymphocyte Ratio, HCC: hepatocellular carcinoma, Data are number(%) or mean±SD | |||
CITATION INFORMATION: Kwon S.-K, Lee J, Song S, Lee J, Kim D, Lee J, Kim M, Choi G, Choi J, Han D, Kim S, Joo D. Prognostic Significance of Preoperative Neutrophil-Lymphocyte Ratio in Patients Undergoing Liver Transplantation with Hepatocellular Carcinoma within Milan Criteria. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Kwon S-K, Lee J, Song S, Lee J, Kim D, Lee J, Kim M, Choi G, Choi J, Han D, Kim S, Joo D. Prognostic Significance of Preoperative Neutrophil-Lymphocyte Ratio in Patients Undergoing Liver Transplantation with Hepatocellular Carcinoma within Milan Criteria. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/prognostic-significance-of-preoperative-neutrophil-lymphocyte-ratio-in-patients-undergoing-liver-transplantation-with-hepatocellular-carcinoma-within-milan-criteria/. Accessed May 9, 2025.« Back to 2017 American Transplant Congress