Lymphocyte to monocyte ratio-based nomogram for predicting outcomes of hepatocellular carcinoma treated with sorafenib.
Lymphocyte to monocyte ratio-based nomogram for predicting outcomes of hepatocellular carcinoma treated with sorafenib.
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DOI：
10.1007/s12072-020-10076-4
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发表时间：
2020-09
影响因子：
6.6
通讯作者：
Kim KM
中科院分区：
文献类型：
--
作者：
Ha Y;Mohamed Ali MA;Petersen MM;Harmsen WS;Therneau TM;Lee HC;Ryoo BY;Bampoh S;Valles KA;Mady M;Missula VR;Prasai K;Roberts LR;Kim KM
治疗前淋巴细胞/单核细胞比率(LMR)预测接受索拉非尼治疗的肝细胞癌患者预后的能力尚未确定。我们在亚洲和北美的两个三级转诊中心对接受索拉非尼治疗的肝细胞癌患者进行了回顾性研究。主要终点为总生存期(OS)和无进展生存期(PFS)。结果的预测因素由COX比例风险模型确定。开发了一个风险评估工具。与北美人群相比，亚洲人群经过更严格的治疗(72.1%比35.2%；P<；0.001)，有更高的乙肝病毒感染率(87.6%比5.6%；P<；0.001)，以及更远的转移(83.2%比25.4%；P<；0.001)。亚洲队列中单核细胞计数较低(中位数462.7比600.0/μL；P=0.023)导致较高的终末期死亡率(中位数2.6vs.1.8；P<；0.001)。高LMR与OS显著相关(危险比[HR]，0.88；95%可信区间[CI]，0.81-0.97；P=0.007)。在包括仅在亚洲接受治疗的患者的敏感性分析中证实了这一点(HR，0.89；95%CI，0.81-0.97；P=0.010)。在多变量COX模型中选择以下变量构建OS诺模图：LMR、治疗位置、既往治疗、功能状态、AFP、淋巴转移和Child-Pugh评分。一致性评分为0.71(95%CI，0.67~0.75)。LMR不能预测PFS。索拉非尼治疗前测量LMR可预测晚期肝细胞癌患者的OS。我们的OS图结合了LMR，可以提供给临床医生，以提高他们评估预后的能力，加强基于预后的决策，并在临床上告知患者。
The ability of the pretreatment lymphocyte to monocyte ratio (LMR) to predict outcomes of patients with hepatocellular carcinoma (HCC) receiving sorafenib is not conclusively determined. We retrospectively studied patients treated with sorafenib for HCC in two tertiary referral centres in Asia and North America. Primary endpoints were overall survival (OS) and progression-free survival (PFS). Predictive factors for the outcomes were determined by Cox proportional hazards models. A risk-assessment tool was developed. Compared to the North America cohort, the Asia cohort was more heavily pretreated (72.1% vs. 35.2%; P<0.001), had higher hepatitis B virus infection (87.6% vs. 5.6%; P<0.001), and more distant metastases (83.2% vs. 25.4%; P<0.001). Lower monocyte count in the Asia cohort (median, 462.7 vs. 600.0/μL; P=0.023) resulted in a higher LMR (median, 2.6 vs. 1.8; P<0.001). High LMR was associated with a significantly higher OS (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.81‒0.97; P=0.007). This was confirmed in a sensitivity analysis including patients treated in Asia only (HR, 0.89; 95% CI, 0.81‒0.97; P=0.010). An OS nomogram was constructed with following variables selected in the multivariate Cox model: LMR, treatment location, previous treatment, performance status, AFP, lymph node metastasis, and Child‒Pugh score. The concordance score was 0.71 (95% CI, 0.67‒0.75). LMR did not predict PFS. LMR measured before sorafenib administration predicts OS in advanced HCC patients. Our OS nomogram, incorporating LMR, can be offered to clinicians to improve their ability to assess prognosis, strengthen the prognosis-based decision making, and inform patients in the clinic.
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影响因子：
64.8
作者：
Rosenberg, SA
通讯作者：
Rosenberg, SA
影响因子：
6.7
作者：
Cho, Ju-Yeon;Paik, Yong-Han;Yoo, Byung Chul
通讯作者：
Yoo, Byung Chul
影响因子：
158.5
作者：
Llovet, Josep M.;Ricci, Sergio;Bruix, Jordi
通讯作者：
Bruix, Jordi
DOI：
10.1007/s00432-018-2610-z
发表时间：
2018-05-01
影响因子：
3.6
作者：
Abdel-Rahman, Omar
通讯作者：
Abdel-Rahman, Omar
影响因子：
13.5
作者：
Flecken, Tobias;Schmidt, Nathalie;Hild, Sandra;Gostick, Emma;Drognitz, Oliver;Zeiser, Robert;Schemmer, Peter;Bruns, Helge;Eiermann, Thomas;Price, David A.;Blum, Hubert E.;Neumann-Haefelin, Christoph;Thimme, Robert
通讯作者：
Thimme, Robert