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- W2891211220 abstract "Background: The use of tumor morphology alone for determining liver transplantation (LT) in patients with hepatocellular carcinoma (HCC) poorly estimates post-LT outcomes. Previous studies have shown that biological factors, such as neutrophil to lymphocyte ratio (NLR), are important predictors of recurrence-free survival (RFS). Pre-LT NLR, however, is a factor that fluctuates from time of listing until transplant according to clinical situations. Furthermore, some studies have denied the prognostic value of pre-LT NLR. This study investigated the chronological change of NLR in patients on the waiting list and the prognostic impacts of NLR at different time points, such as time at listing, highest overall NLR and nearest to LT. Methods: A total of 394 patients undergoing liver transplant for HCC at the Cleveland Clinic were identified between 2002 and 2014. NLR was collected at multiple time points from the time of diagnosis until transplant (median 3-time points). Chronological change in NLR over time and prognostic impacts of high NLR (≥5) at three different points were investigated using multivariate Cox proportional hazard regression. Results: Chronological change of NLR while on the waiting list showed significant fluctuation over time. The percentage of patients with NLR ≥5 were 21.5%, 42.4%, and 22.8% at listing, highest overall, and pre-LTx respectively. The hazard ratio of high NLR on RFS were 1.24 (p = .36), 1.50 (p = .04), and 1.39 (p = .15) at listing, highest overall, and pre-LTx. There was a total of 227 patients with a highest overall NLR <5 and 167 patients with highest overall NLR ≥5. Highest overall NLR showed a mild correlation with MELD-Na at time of operation (R = .26). Conclusion: Although pre-LT NLR was not a significant indicator of RFS, highest overall NLR is a significant indicator of RFS in patients with HCC seeking liver transplant." @default.
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- W2891211220 date "2018-03-01" @default.
- W2891211220 modified "2023-09-27" @default.
- W2891211220 title "Highest overall neutrophil to lymphocyte ratio on waiting list predicts recurrence-free survival in liver transplantation for hepatocellular carcinoma" @default.
- W2891211220 doi "https://doi.org/10.1016/j.hpb.2018.02.304" @default.
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