Evidence map›Paper›PMID 31001964›Full record

ArticleClinical and molecular hepatology2019

Underlying liver disease and advanced stage liver cancer are associated with elevated neutrophil-lymphocyte ratio.

Linda Wong, Kliment Bozhilov, Brenda Hernandez, Sandi Kwee, Owen Chan, Luke Ellis, Loic LeMarchand

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PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical and molecular hepatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  20. Cellular based immunotherapy for primary liver cancer.Journal of experimental & clinical cancer research : CR · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Linda WongDepartment of Surgery, University of Hawaii, Honolulu, HI, USA.
Kliment BozhilovDepartment of Surgery, University of Hawaii, Honolulu, HI, USA.
Brenda HernandezCancer Center, University of Hawaii, Honolulu, HI, USA.
Sandi KweePositron Emission Tomography Research Center, The Queens Medical Center, Honolulu, HI, USA.
Owen ChanCancer Center, University of Hawaii, Honolulu, HI, USA.
Luke EllisDepartment of Surgery, University of Hawaii, Honolulu, HI, USA.
Loic LeMarchandCancer Center, University of Hawaii, Honolulu, HI, USA.

Funding

University of Hawaii Cancer Center CCSGP30CA071789 · NCI · UNIVERSITY OF HAWAII AT MANOA · PI Pallav Pokhrel · 1996 to 2026
$56.2M
RESEARCH DESIGN AND BIOSTATISTICS COREU54MD007584 · NIMHD · UNIVERSITY OF HAWAII AT MANOA · PI MOKUAU, NOREEN, SHIRAMIZU, BRUCE T · 2012 to 2018
$21.1M
Pathway Specific Functional Biomarkers for the Early Detection of Liver CancerU01CA230690 · NCI · GEORGE WASHINGTON UNIVERSITY · PI MISHRA, LOPA, SHETTY, KIRTI · 2018 to 2022
$3.4M
NCI NIH HHS P30 CA071789NCI NIH HHS U01 CA230690NIMHD NIH HHS U54 MD007584
6 · The paper itself

Abstract

BACKGROUND/

aimsInflammation-based scores, such as the neutrophil-to-lymphocyte ratio (NLR), have been associated with prognosis in hepatocellular carcinoma (HCC); but variable cut-off values and potential lack of specificity have limited the utility of NLR. This study evaluates NLR in a large cohort of HCC patients.

methodsWe retrospectively reviewed 789 HCC cases (1993-2017) for demographics, tumor characteristics, treatment, and survival. NLR was stratified into NLR ≥1.5 and NLR ≥3 and analyzed for correlation with American Joint Committee on Cancer (AJCC) and Barcelona Clinic Liver Cancer (BCLC) stages. In 235 patients who underwent liver resection, survival and recurrence were evaluated by NLR.

resultsIn 789 HCC cases, mean NLR was increased with advanced AJCC and BCLC stages. Hepatitis C patients were less likely to have NLR ≥1.5 and ≥3. Non-alcoholic steatohepatitis patients were more likely to have NLR ≥3. Patients with tumor size >5 cm, rupture, or macrovascular invasion were more likely to have NLR ≥3. In patients treated with resection, NLR ≥3 predicted early recurrence (odds ratio [OR] 4.14, P<0.01) and overall recurrence (OR 4.05, P<0.01). Mean NLR was 4.30 in those with recurrence and 2.75 in those without recurrence. Patients with NLR ≥3 showed significantly worse survival compared to those with NLR <3 (P<0.01 by log-rank test).

conclusionElevated NLR is associated with advanced cancer stage and aggressive tumor characteristics, such as large size, rupture, and invasion. NLR ≥3 was associated with early and overall recurrence after resection but varied with etiology. NLR may be a useful biomarker in predicting recurrence for HCC patients undergoing curative resection, but further studies are required to elucidate the effect of disease etiology.

Indexed as

AgedCarcinoma, HepatocellularFemaleHumansKaplan-Meier EstimateLiver NeoplasmsLymphocytesMaleMiddle AgedMultivariate AnalysisNeoplasm Recurrence, LocalNeoplasm StagingNeutrophilsNon-alcoholic Fatty Liver DiseaseOdds RatioRetrospective StudiesHepatocellular carcinomaLiver cancer

Identifiers

PMID31001964
PMCPMC6759430

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.