Early variation of inflammatory indexes refines prognostic prediction in patients with hepatocellular carcinoma under systemic treatment

Imagem de Miniatura
Arquivos
art_FONSECA_Early_variation_of_inflammatory_indexes_refines_prognostic_prediction_.PDF (498.87 KB)
Citações na Scopus
1
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPANDIDOS PUBL LTD
Autores
Citação
MOLECULAR AND CLINICAL ONCOLOGY, v.18, n.4, article ID 29, 8p, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
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% CI:15.4-22.0) compared with the subgroup that maintained high NLR at baseline and at 1 month (4.2 months, 95% CI:3.6-5.9), 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 (HR:1.4, 95% CI: 1.1-2.0), whereas the subgroup with high NLR at baseline and low at 1 month had similar outcome (HR:1.2, 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.
Palavras-chave
liver cancer, systemic treatment, inflammation, prognosis, neutrophil-to-lymphocyte ratio
URI
https://observatorio.fm.usp.br/handle/OPI/53100
Referências
  1. Abou-Alfa GK, 2018, NEW ENGL J MED, V379, P54, DOI 10.1056/NEJMoa1717002
  2. Abou-Alfa GK., 2022, NEJM EVID, V1, pEVIDoa2100070, DOI 10.1056/EVIDoa2100070
  3. Almand B, 2001, J IMMUNOL, V166, P678, DOI 10.4049/jimmunol.166.1.678
  4. Bruix J, 2019, NAT REV GASTRO HEPAT, V16, P617, DOI 10.1038/s41575-019-0179-x
  5. Bruix J, 2017, J HEPATOL, V67, P999, DOI 10.1016/j.jhep.2017.06.026
  6. Bruix J, 2017, LANCET, V389, P56, DOI 10.1016/S0140-6736(16)32453-9
  7. Cheng AL, 2009, LANCET ONCOL, V10, P25, DOI 10.1016/S1470-2045(08)70285-7
  8. da Fonseca LG, 2014, MED ONCOL, V31, DOI 10.1007/s12032-014-0264-5
  9. Dushyanthen S, 2015, BMC MED, V13, DOI 10.1186/s12916-015-0431-3
  10. European Assoc Study Liver, 2018, J HEPATOL, V69, P182, DOI 10.1016/j.jhep.2018.03.019
  11. Finn RS, 2020, NEW ENGL J MED, V382, P1894, DOI 10.1056/NEJMoa1915745
  12. Gonzalez H, 2018, GENE DEV, V32, P1267, DOI 10.1101/gad.314617.118
  13. Grivennikov SI, 2010, CELL, V140, P883, DOI 10.1016/j.cell.2010.01.025
  14. Hanahan D, 2022, CANCER DISCOV, V12, P31, DOI 10.1158/2159-8290.CD-21-1059
  15. Hanahan D, 2012, CANCER CELL, V21, P309, DOI 10.1016/j.ccr.2012.02.022
  16. Koebel CM, 2007, NATURE, V450, P903, DOI 10.1038/nature06309
  17. Kolamunnage-Dona R, 2021, J HEPATOL, V75, P879, DOI 10.1016/j.jhep.2021.05.015
  18. Kudo M, 2018, LANCET, V391, P1163, DOI 10.1016/S0140-6736(18)30207-1
  19. Llovet JM, 2008, NEW ENGL J MED, V359, P378, DOI 10.1056/NEJMoa0708857
  20. Llovet JM, 2021, NAT REV DIS PRIMERS, V7, DOI 10.1038/s41572-020-00240-3
  21. Luen SJ, 2017, PATHOLOGY, V49, P141, DOI 10.1016/j.pathol.2016.10.010
  22. Martin D, 2017, FRONT IMMUNOL, V8, DOI 10.3389/fimmu.2017.01225
  23. Masopust D, 2013, NAT REV IMMUNOL, V13, P309, DOI 10.1038/nri3442
  24. Mathew NR, 2018, NAT MED, V24, P282, DOI 10.1038/nm.4484
  25. Reig M, 2022, J HEPATOL, V76, P681, DOI 10.1016/j.jhep.2021.11.018
  26. Rimola J, 2021, EUR J RADIOL, V135, DOI 10.1016/j.ejrad.2020.109484
  27. Romero AI, 2014, CANCER RES, V74, P68, DOI 10.1158/0008-5472.CAN-13-1186
  28. Scheiner B, 2022, J HEPATOL, V76, P353, DOI 10.1016/j.jhep.2021.09.035
  29. Szczerba BM, 2019, NATURE, V566, P553, DOI 10.1038/s41586-019-0915-y
  30. Templeton AJ, 2014, JNCI-J NATL CANCER I, V106, DOI 10.1093/jnci/dju124
  31. Vesely MD, 2013, ANN NY ACAD SCI, V1284, P1, DOI 10.1111/nyas.12105
  32. Wu WC, 2014, P NATL ACAD SCI USA, V111, P4221, DOI 10.1073/pnas.1320753111
  33. Zhou SL, 2016, GASTROENTEROLOGY, V150, P1646, DOI 10.1053/j.gastro.2016.02.040
  34. Zhu AX, 2019, LANCET ONCOL, V20, P282, DOI 10.1016/S1470-2045(18)30937-9

Coleções
Artigos e Materiais de Revistas Científicas - FM/MPT
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/07
Artigos e Materiais de Revistas Científicas - LIM/14
Carregar mais