SYSTEMIC INFLAMMATION AND NUTRITIONAL STATUS AS PROGNOSTIC FACTORS IN HEPATOCELLULAR CARCINOMA PATIENTS TREATED WITH SORAFENIB

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is frequently diagnosed at advanced stages, resulting in poor prognosis. Systemic inflammation, assessed by the neutrophil-to-lymphocyte ratio (NLR), has been associated with tumor progression and reduced survival; however, its prognostic value in HCC patients treated with sorafenib remains incompletely defined. To evaluate the association between systemic inflammation, assessed by NLR, and clinical and nutritional characteristics with overall survival in patients with HCC treated with sorafenib. This retrospective single-cohort study included patients with HCC treated with sorafenib at the oncology outpatient clinic of the Hospital de Clínicas, Universidade Estadual de Campinas, between 2010 and 2018. Systemic inflammation was defined by NLR using the median value (2.3) as the cutoff. Clinical and nutritional variables were collected and recorded in REDCap. Overall survival was estimated using Kaplan–Meier analysis and compared using the log-rank test. Prognostic factors were evaluated using Cox proportional hazards models adjusted for relevant clinical variables. Statistical analyses were performed using Jamovi®, with p-values 5%), particularly >10% (26.5% vs. 15.2%; p=0.031), and lower skeletal muscle radiodensity (p=0.043), while muscle mass and adipose tissue parameters did not differ. Median NLR values were significantly higher in the inflammatory group (3.09 vs. 1.65; p10%. Systemic inflammation assessed by NLR is independently associated with greater tumor aggressiveness, impaired nutritional status, and reduced overall survival in patients with HCC treated with sorafenib.