The Prognostic Role of Inflammation on Hepatocellular Carcinoma

Background/Aim: Advanced hepatocellular carcinoma has dismal prognosis. The choice of optimal therapy for each patient is not characterized well. There is a growing need to describe the relation of predictive and prognostic factors with survival. In this study, we aimed to examine the impact of clinical factors and inflammatory markers on the prognosis. Patients and Methods: A total of 125 patients who were diagnosed between January 2011-April 2018 were enrolled retrospectively. Patients' demographics, performance status, tumoral characteristics and inflammation-based prognostic scores (neutrophil/lymphocyte ratio (NLR), prognostic nutritional index (PNI), aspartate aminotransferase/platelet count ratio (APRI)) were recorded. Univariate and multivariate analyses were performed to determine the prognostic factors for survival. Results: =105; 84%). Etiology was hepatitis B virus in 74 patients, and hepatitis C virus in 9 cases. Median overall survival (mOS) of the overall study population was 11.9 months (95% CI=7.1-16.9). Local treatment options yielded a median OS of 24.8 months (95% CI=12.8-36.8) in intermediate BCLC stage B patients. Patients who received sorafenib had an OS of 19.7 (95% CI=11.2-28.2 months). Initial ECOG performance status, Child Pugh Score, tumor size, presence of portal vein thrombosis was found to be significantly associated with worse OS in univariate analyses. Conclusion: Inflammation based scores, NLR and APRI were found to be associated with worse mOS. Larger tumor size, older age and ECOG PS were found to be independent prognostic factors.