Page 336 - ebook HCC

GENEVA, SWITZERLANDA, SWITZERLAND
EASL
PROGRAMME
335
334
334 PROGRAMME AND ABSTRACTSAND ABSTRACTS GENEV EASL HCC SUMMITHCC SUMMIT 335
FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
FEBRUAR
Poster Board Number C92
NEUTROPHIL-TO-LYMPHOCYTE RATIO:
A GOOD PREDICTOR OF DROP OUT IN
HEPATOCELLULAR CANCER PATIENTS WAITING
FOR LIVER TRANSPLANTATION

Quirino Lai, Edward Castro Santa, Juan M. Rico Juri, Rafael S. Pinheiro, Jan Lerut Conclusion: NLR is a good predictor of drop-out risk but not of post-LT recurrence. AFP
slope is superior to NLR in relation to selecting both waiting list and transplanted patients.
Corresponding author’s e-mail: lai.quirino@libero.it Larger studies looking at the role of NLR as a selection tool of LT recipients are warranted.

Introduction: During the last years there has been increasing evidence that systemic
inflammation in patients with hepatocellular cancer (HCC) is related to poorer survival.
Elevated neutrophil-to-lymphocyte ratio (NLR) has been shown to have a high efficacy in
predicting outcome of these patients.

Aims: The aim of this study is to evaluate the role of NLR as a selection tool in HCC
patients waiting for liver transplantation (LT) and to look at its potential to predict drop-out
on the waiting list and post-LT recurrence.

Methodology: During the period January 1995–March 2012, 181 patients with a pre-
operatively proven diagnosis of HCC entered the waiting list for LT. Thirty-five (19.3%)
patients dropped out from the list during and 146 (80.7%) patients were transplanted. As
of October 31, 2012, the median follow-up from moment of WL registration for the entire
population was 4.2 years (interquartile ranges [IQR]: 1.8-8.3).
CLINICAL POSTER ABSTRACTS out with an AUROC curve of 67.2 (p-value: 0.05). Alpha-foeto-protein (AFP) slope was CLINICAL POSTER ABSTRACTS
Results: At c-statistics, the last NLR determination was the best prognostic test of drop-
the best prognostic test of post-LT recurrence (AUROC: 67.1; p-value: 0.05). The last
NLR had a poor ability to predict post-LT recurrence. At multivariable Cox regression
analysis, AFP slope > 15 ng/mL/month (HR 2.4; p-value: 0.003) and last NLR > 5.4 (HR:
1.8; p-value: 0.03) were the unique risk factors for drop-out. NLR was not a predictor of
post-LT recurrence.
The last NLR > 5.4 allowed to stratify well the patients in relation to intention-to-treat (ITT)
survival analysis. Patients exceeding the mentioned cut-off value had a 5-year survival
of 48.2% vs. 64.5% in patients not meeting this threshold limit (p 0.02). NLR had a poor
ability in stratifying the patients in relation to tumor-free survival (TFS) (p 0.4). AFP slope
allowed to stratify the population both in ITT and TFS analyses (Fig. 1).