The predictive value of integrated inflammation scores in the survival of patients with resected hepatocellular carcinoma: A Retrospective Cohort Study

Background: Evidence supports the predictive potential of inflammatory marker-derived scores (inflammation scores) and hepatitis B virus (HBV) infection on prognosis of patients with hepatocellular carcinoma (HCC). However, no study has longitudinally assessed the predictive values of inflammation scores combined with hepatitis B virus status on survival of these patients. Therefore, a study was designed to evaluate the prognostic capacity of preoperative, dynamic changes in integrated scores, through a combination of general inflammation scores and HBV infection status, on HCC patients undergoing tumor resection. Methods: The clinicopathological data of 247 patients with primary HCC who underwent liver resection were collected. Inflammation-related laboratory examinations were performed 1 week before operation, and 1 week, 1 month, 3months, and 6months after operation. The prognostic values of preoperative and dynamic changes in integrated inflammation scores were studied using the Cox regression models. Results: Elevated preoperative integrated inflammation scores, including co-Glasgow prognostic score (coGPS), co-modified Glasgow prognostic score (comGPS), co-C reactive protein to albumin ratio (coCRP/ALB), co-prognostic index (coPI), co-neutrophil to lymphocyte ratio (coNLR), co-lymphocyte to monocyte ratio (coLMR), coNLR-PLR and coCRP/ALB-PLR, were associated with decreased overall survival (OS). Dynamic changes in coGPS, comGPS, coCRP/ALB, coPI, coPLR, coNLR, coSII, coNLR-PLR, and coCRP/ALBPLR were independent prognostic factors of OS. coCRP/ALB-PLR was significantly associated with disease free survival. Conclusions: Preoperative and dynamic changes in integrated inflammation scores, particularly for coCRP/ALB-PLR were important and stable prognostic markers in HCC. (C) 2017 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.