TY - JOUR
T1 - Neutrophil-to-lymphocyte ratio predicts prognosis after neoadjuvant chemotherapy and resection of intrahepatic cholangiocarcinoma
AU - Omichi, Kiyohiko
AU - Cloyd, Jordan M.
AU - Yamashita, Suguru
AU - Tzeng, Ching Wei D.
AU - Conrad, Claudius
AU - Chun, Yun Shin
AU - Aloia, Thomas A.
AU - Vauthey, Jean Nicolas
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/10
Y1 - 2017/10
N2 - Background Previous studies have demonstrated a strong association between the preoperative neutrophil-to-lymphocyte ratio and the outcomes of patients with resected hepatocellular carcinoma and colorectal liver metastases. However, the predictive ability of neutrophil-to-lymphocyte ratio in patients with intrahepatic cholangiocarcinoma, especially those treated with preoperative chemotherapy, has been less well described. Methods The clinicopathological characteristics, overall survival, and recurrence free survival of all patients with intrahepatic cholangiocarcinoma resected between 2000–2015, were compared between those with elevated (≥3.0) and normal (<3.0) neutrophil-to-lymphocyte ratio. Results Among 119 patients who met the inclusion criteria, 64 (53.8%) had neutrophil-to-lymphocyte ratio <3.0 and 55 (46.2%) had neutrophil-to-lymphocyte ratio ≥3.0. Patients with neutrophil-to-lymphocyte ratio ≥3.0 were more likely to be female and have lymph node metastasis (P <.05). Cumulative 5-year overall survival and recurrence free survival rates were 87% and 60%, respectively in patients with neutrophil-to-lymphocyte ratio <3.0, compared with 64% and 39%, respectively in patients with neutrophil-to-lymphocyte ratio ≥3.0 (P =.049 and.038). Among 43 patients treated with preoperative chemotherapy and resection, 21 (48.8%) had neutrophil-to-lymphocyte ratio <3.0 and 22 (51.2%) had neutrophil-to-lymphocyte ratio ≥3.0. In this subgroup, cumulative 5-year overall survival and recurrence free survival rates were 95% and 70%, respectively in the patients with neutrophil-to-lymphocyte ratio <3.0 compared with 50% and 26%, respectively in the patients with neutrophil-to-lymphocyte ratio ≥3.0 (P =.002 and P =.004). On multivariate analysis, a neutrophil-to-lymphocyte ratio ≥3.0 was associated significantly with worse overall survival among all patients as well as overall survival and recurrence free survival among the subgroup who received preoperative chemotherapy. Conclusion Neutrophil-to-lymphocyte ratio is associated independently with worse survival in patients with intrahepatic cholangiocarcinoma undergoing resection or neoadjuvant chemotherapy prior to resection.
AB - Background Previous studies have demonstrated a strong association between the preoperative neutrophil-to-lymphocyte ratio and the outcomes of patients with resected hepatocellular carcinoma and colorectal liver metastases. However, the predictive ability of neutrophil-to-lymphocyte ratio in patients with intrahepatic cholangiocarcinoma, especially those treated with preoperative chemotherapy, has been less well described. Methods The clinicopathological characteristics, overall survival, and recurrence free survival of all patients with intrahepatic cholangiocarcinoma resected between 2000–2015, were compared between those with elevated (≥3.0) and normal (<3.0) neutrophil-to-lymphocyte ratio. Results Among 119 patients who met the inclusion criteria, 64 (53.8%) had neutrophil-to-lymphocyte ratio <3.0 and 55 (46.2%) had neutrophil-to-lymphocyte ratio ≥3.0. Patients with neutrophil-to-lymphocyte ratio ≥3.0 were more likely to be female and have lymph node metastasis (P <.05). Cumulative 5-year overall survival and recurrence free survival rates were 87% and 60%, respectively in patients with neutrophil-to-lymphocyte ratio <3.0, compared with 64% and 39%, respectively in patients with neutrophil-to-lymphocyte ratio ≥3.0 (P =.049 and.038). Among 43 patients treated with preoperative chemotherapy and resection, 21 (48.8%) had neutrophil-to-lymphocyte ratio <3.0 and 22 (51.2%) had neutrophil-to-lymphocyte ratio ≥3.0. In this subgroup, cumulative 5-year overall survival and recurrence free survival rates were 95% and 70%, respectively in the patients with neutrophil-to-lymphocyte ratio <3.0 compared with 50% and 26%, respectively in the patients with neutrophil-to-lymphocyte ratio ≥3.0 (P =.002 and P =.004). On multivariate analysis, a neutrophil-to-lymphocyte ratio ≥3.0 was associated significantly with worse overall survival among all patients as well as overall survival and recurrence free survival among the subgroup who received preoperative chemotherapy. Conclusion Neutrophil-to-lymphocyte ratio is associated independently with worse survival in patients with intrahepatic cholangiocarcinoma undergoing resection or neoadjuvant chemotherapy prior to resection.
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U2 - 10.1016/j.surg.2017.05.015
DO - 10.1016/j.surg.2017.05.015
M3 - Article
C2 - 28688518
AN - SCOPUS:85021782634
SN - 0039-6060
VL - 162
SP - 752
EP - 765
JO - Surgery (United States)
JF - Surgery (United States)
IS - 4
ER -