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Negative impact of preoperative platelet-lymphocyte ratio on outcome after hepatic resection for intrahepatic cholangiocarcinoma.

Chen Q, Dai Z, Yin D, Yang LX, Wang Z, Xiao YS, Fan J, Zhou J - Medicine (Baltimore) (2015)

Bottom Line: Our results showed that PLR represents an independent adverse prognostic factor for OS and RFS in ICC patients using univariate and multivariate analyses.The optimal PLR cutoff value was 123 using receiver operating curve analyses.In addition, high PLR values were associated with tumor size (P = 0.020).

View Article: PubMed Central - PubMed

Affiliation: From the Liver Cancer Institute (QC, ZD, DY, LY, ZW, YX, JF, JZ), Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education; and Institute of Biomedical Sciences (DY, JF, JZ), Fudan University, Shanghai, People's Republic of China.

ABSTRACT
The elevated platelet-to-lymphocyte ratio (PLR), determined using an easy blood test based on platelet and lymphocyte counts, is reported to be a predictor of poor survival in patients with several cancers. The prognostic role of preoperative PLR in patients with intrahepatic cholangiocarcinoma (ICC) has, until now, been rarely investigated. The purpose of our study was to evaluate the prognostic significance of PLR in a large cohort of ICC patients after hepatic resection. We obtained data from 322 consecutive nonmetastatic ICC patients who underwent hepatectomy without preoperative therapy between 2005 and 2011. Clinicopathological parameters, including PLR, were evaluated. Overall survival (OS) and recurrence-free survival (RFS) were assessed using the Kaplan-Meier method. Using multivariate Cox regression models, the independent prognostic value of preoperative PLR was determined. Our results showed that PLR represents an independent adverse prognostic factor for OS and RFS in ICC patients using univariate and multivariate analyses. The optimal PLR cutoff value was 123 using receiver operating curve analyses. The 5-year OS and RFS rates after hepatectomy were 30.3% and 28.9% for the group with PLR 123 greater, compared with 46.2% and 39.4% for the group with PLR less than 123 (P = 0.0058 and 0.0153, respectively). In addition, high PLR values were associated with tumor size (P = 0.020). Our results suggest that preoperative PLR might represent a novel independent prognostic factor for OS and RFS in ICC patients with hepatic resection.

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Comparison of overall survival rates in the low (<123) and high (≥123) PLR groups. The 1-, 3-, and 5-year overall survival rates were 82.5%, 55.6%, and 46.2%, respectively, in the low (<123) PLR group, which were significantly higher compared with the high (≥123) PLR group (70.0%, 42.7%, and 30.3%, respectively, P = 0.0058). PLR = platelet-to-lymphocyte ratio.
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Figure 3: Comparison of overall survival rates in the low (<123) and high (≥123) PLR groups. The 1-, 3-, and 5-year overall survival rates were 82.5%, 55.6%, and 46.2%, respectively, in the low (<123) PLR group, which were significantly higher compared with the high (≥123) PLR group (70.0%, 42.7%, and 30.3%, respectively, P = 0.0058). PLR = platelet-to-lymphocyte ratio.

Mentions: In the 322 ICC patients undergoing hepatic resection, the median survival time was 33.8 ± 3.6 months and median RFS was 18.0 ± 3.1 months. We found that an elevated PLR was associated with worse OS (PLR < 123 vs. PLR ≥ 123, median OS 40.5 ± 5.3 vs. 20.7 ± 3.2 months). The patients with liver cirrhosis are always present with hypersplenism, which may accelerate platelet turnover and reduce platelet production. We divided the low PLR and high PLR patients into 4 subgroups: PLR low, PLR low + liver cirrhosis, PLR high, and PLR high + liver cirrhosis. When compared with the OS and RFS rates in 4 groups, there were no significant difference between PLR low + liver cirrhosis and PLR high + liver cirrhosis groups, as shown in the Figures 1 and 2. We found that the 1-, 3-, and 5-year OS rates were 82.5%, 55.6%, and 46.2%, respectively, in the low PLR group, which were significantly higher compared with the high PLR group (70.0%, 42.7%, and 30.3%, respectively, P = 0.0058, Figure 3). In addition, elevated PLR values significantly correlated with ICC recurrence following hepatic resection. High preoperative PLR was also associated with worse RFS (PLR < 123 vs. PLR ≥ 123, median RFS 24.0 ± 5.6 vs. 12.3 ± 2.2 months). The 1-, 3-, and 5-year RFS rates were significantly lower in the high PLR group (50.9%, 32.6%, and 28.9%, respectively) compared with the low PLR group (66.1%, 49.4%, and 39.4%, respectively, P = 0.0153, Figure 4). These data suggest that high PLR may be a marker of early ICC recurrence after hepatic resection.


Negative impact of preoperative platelet-lymphocyte ratio on outcome after hepatic resection for intrahepatic cholangiocarcinoma.

Chen Q, Dai Z, Yin D, Yang LX, Wang Z, Xiao YS, Fan J, Zhou J - Medicine (Baltimore) (2015)

Comparison of overall survival rates in the low (<123) and high (≥123) PLR groups. The 1-, 3-, and 5-year overall survival rates were 82.5%, 55.6%, and 46.2%, respectively, in the low (<123) PLR group, which were significantly higher compared with the high (≥123) PLR group (70.0%, 42.7%, and 30.3%, respectively, P = 0.0058). PLR = platelet-to-lymphocyte ratio.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554024&req=5

Figure 3: Comparison of overall survival rates in the low (<123) and high (≥123) PLR groups. The 1-, 3-, and 5-year overall survival rates were 82.5%, 55.6%, and 46.2%, respectively, in the low (<123) PLR group, which were significantly higher compared with the high (≥123) PLR group (70.0%, 42.7%, and 30.3%, respectively, P = 0.0058). PLR = platelet-to-lymphocyte ratio.
Mentions: In the 322 ICC patients undergoing hepatic resection, the median survival time was 33.8 ± 3.6 months and median RFS was 18.0 ± 3.1 months. We found that an elevated PLR was associated with worse OS (PLR < 123 vs. PLR ≥ 123, median OS 40.5 ± 5.3 vs. 20.7 ± 3.2 months). The patients with liver cirrhosis are always present with hypersplenism, which may accelerate platelet turnover and reduce platelet production. We divided the low PLR and high PLR patients into 4 subgroups: PLR low, PLR low + liver cirrhosis, PLR high, and PLR high + liver cirrhosis. When compared with the OS and RFS rates in 4 groups, there were no significant difference between PLR low + liver cirrhosis and PLR high + liver cirrhosis groups, as shown in the Figures 1 and 2. We found that the 1-, 3-, and 5-year OS rates were 82.5%, 55.6%, and 46.2%, respectively, in the low PLR group, which were significantly higher compared with the high PLR group (70.0%, 42.7%, and 30.3%, respectively, P = 0.0058, Figure 3). In addition, elevated PLR values significantly correlated with ICC recurrence following hepatic resection. High preoperative PLR was also associated with worse RFS (PLR < 123 vs. PLR ≥ 123, median RFS 24.0 ± 5.6 vs. 12.3 ± 2.2 months). The 1-, 3-, and 5-year RFS rates were significantly lower in the high PLR group (50.9%, 32.6%, and 28.9%, respectively) compared with the low PLR group (66.1%, 49.4%, and 39.4%, respectively, P = 0.0153, Figure 4). These data suggest that high PLR may be a marker of early ICC recurrence after hepatic resection.

Bottom Line: Our results showed that PLR represents an independent adverse prognostic factor for OS and RFS in ICC patients using univariate and multivariate analyses.The optimal PLR cutoff value was 123 using receiver operating curve analyses.In addition, high PLR values were associated with tumor size (P = 0.020).

View Article: PubMed Central - PubMed

Affiliation: From the Liver Cancer Institute (QC, ZD, DY, LY, ZW, YX, JF, JZ), Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education; and Institute of Biomedical Sciences (DY, JF, JZ), Fudan University, Shanghai, People's Republic of China.

ABSTRACT
The elevated platelet-to-lymphocyte ratio (PLR), determined using an easy blood test based on platelet and lymphocyte counts, is reported to be a predictor of poor survival in patients with several cancers. The prognostic role of preoperative PLR in patients with intrahepatic cholangiocarcinoma (ICC) has, until now, been rarely investigated. The purpose of our study was to evaluate the prognostic significance of PLR in a large cohort of ICC patients after hepatic resection. We obtained data from 322 consecutive nonmetastatic ICC patients who underwent hepatectomy without preoperative therapy between 2005 and 2011. Clinicopathological parameters, including PLR, were evaluated. Overall survival (OS) and recurrence-free survival (RFS) were assessed using the Kaplan-Meier method. Using multivariate Cox regression models, the independent prognostic value of preoperative PLR was determined. Our results showed that PLR represents an independent adverse prognostic factor for OS and RFS in ICC patients using univariate and multivariate analyses. The optimal PLR cutoff value was 123 using receiver operating curve analyses. The 5-year OS and RFS rates after hepatectomy were 30.3% and 28.9% for the group with PLR 123 greater, compared with 46.2% and 39.4% for the group with PLR less than 123 (P = 0.0058 and 0.0153, respectively). In addition, high PLR values were associated with tumor size (P = 0.020). Our results suggest that preoperative PLR might represent a novel independent prognostic factor for OS and RFS in ICC patients with hepatic resection.

Show MeSH
Related in: MedlinePlus