Neutrophil-to-lymphocyte ratio is associated with survival in patients with unresectable hepatocellular carcinoma treated with lenvatinib
Neutrophil-to-lymphocyte ratio is associated with survival in patients with unresectable hepatocellular carcinoma treated with lenvatinib
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DOI：
10.1111/liv.14405
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发表时间：
2020-03-01
影响因子：
6.7
通讯作者：
Hiasa, Yoichi
中科院分区：
文献类型：
--
作者：
Tada, Toshifumi;Kumada, Takashi;Hiasa, Yoichi
背景和目的 乐伐替尼（Lenvatinib）是一种新开发的分子靶向药物，已可用于不可切除的肝细胞癌（HCC）患者。据报道，中性粒细胞与淋巴细胞比率（NLR）与许多恶性肿瘤的不良预后相关。在这项研究中，我们调查了 NLR 对接受乐伐替尼治疗的 HCC 患者相关结局的影响。方法 总共纳入了 237 名接受乐伐替尼治疗的 HCC 患者。我们对该队列进行了单变量和多变量分析。此外，我们使用风险比 (HR) 样条曲线阐明了与总生存期相关的适当 NLR 截止水平。结果 100 天、200 天和 300 天的累积总生存率分别为 95.2%、83.4% 和 66.6%。多变量分析显示，NLR >= 4（HR，1.874；95% 置信区间 [CI]，1.097-3.119），甲胎蛋白 >= 400 ng/mL（HR，1.969；95% CI，1.188-3.265），改良白蛋白-胆红素 2b 或 3 级（HR，2.123；95% CI，1.188-3.265）。 95% CI, 1.267-3.555) 与总生存率独立相关。 100、200和300天的累积无进展生存率分别为72.4%、49.8%和38.7%。多变量分析显示，NLR >= 4（HR，1.897；95% CI，1.268-2.837）和 BCLC 分期 >= C（HR，1.516；95% CI，1.028-2.236）与无进展生存期独立相关。低 NLR (= 4) (67.3%) 患者之间的疾病控制率存在显着差异 (P = .007)。样条曲线分析显示，大约 3.0-4.5 的 NLR 是关联总生存期的适当截止值。结论 NLR 可能与接受乐伐替尼治疗的 HCC 患者的结局相关。
Background and aims Lenvatinib, a newly developed molecularly targeted agent, has become available for patients with unresectable hepatocellular carcinoma (HCC). Neutrophil-to-lymphocyte ratio (NLR) has been reported to be associated with poor outcomes in numerous malignancies. In this study, we investigated the impact of NLR on associating outcomes in patients with HCC treated with lenvatinib.Methods A total of 237 patients with HCC treated with lenvatinib were included. We performed univariate and multivariate analyses in this cohort. In addition, we clarified appropriate cut-off NLR levels for associating overall survival using hazard ratio (HR) spline curves.Results Cumulative overall survival at 100, 200 and 300 days was 95.2%, 83.4% and 66.6% respectively. Multivariate analysis showed that NLR >= 4 (HR, 1.874; 95% confidence interval [CI], 1.097-3.119), alpha-foetoprotein >= 400 ng/mL (HR, 1.969; 95% CI, 1.188-3.265) and modified albumin-bilirubin grade 2b or 3 (HR, 2.123; 95% CI, 1.267-3.555) were independently associated with overall survival. Cumulative progression-free survival at 100, 200 and 300 days was 72.4%, 49.8% and 38.7% respectively. Multivariate analysis showed that NLR >= 4 (HR, 1.897; 95% CI, 1.268-2.837) and BCLC stage >= C (HR, 1.516; 95% CI, 1.028-2.236) were independently associated with progression-free survival. Disease control rate was significantly different between the patients with low NLR (= 4) (67.3%) (P = .007). Spline curve analysis revealed that NLR of approximately 3.0-4.5 is an appropriate cut-off for associating overall survival.Conclusions NLR can be associated with outcomes in patients with HCC treated with lenvatinib.