Evidence map›Paper›PMID 31372942›Full record

ArticleHepatology international2019

Association between neutrophil-lymphocyte ratio, socioeconomic status, and ethnic minority with treatment outcome in hepatocellular carcinoma.

Yifei Zhang, N Patrik Brodin, Nitin Ohri, Santiago Thibaud, Andreas Kaubisch, Milan Kinkhabwala, Madhur Garg, Chandan Guha, Rafi Kabarriti

Abstract read
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In one paragraph

Article in Hepatology international, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

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

  1. Racial and Ethnic Disparities in Survival Among Patients With Hepatocellular Carcinoma in the United States: A Systematic Review and Meta-Analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022
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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

9 authors.

Yifei ZhangDepartment of Medicine (Oncology), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
N Patrik BrodinDepartment of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 210th Street, Bronx, NY, 10467, USA.
Nitin OhriDepartment of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 210th Street, Bronx, NY, 10467, USA.
Santiago ThibaudDepartment of Medicine (Oncology), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Andreas KaubischDepartment of Medicine (Oncology), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Milan KinkhabwalaDepartment of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Madhur GargDepartment of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 210th Street, Bronx, NY, 10467, USA.
Chandan GuhaDepartment of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 210th Street, Bronx, NY, 10467, USA.
Rafi KabarritiDepartment of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 210th Street, Bronx, NY, 10467, USA. rkabarri@montefiore.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with lower socioeconomic status (SES), ethnic minorities and elevated neutrophil-lymphocyte ratio (NLR) have been suggested to have worse outcomes in hepatocellular carcinoma (HCC). However, how changes in NLR after intervention relate to survival has not been elucidated.

objectivesWe evaluated the association of NLR with overall survival (OS) and progression-free survival (PFS) in a large institutional cohort of HCC.

methodsWe reviewed all patients diagnosed with HCC between 2005-2016. The association between elevated NLR (> 4) and survival was examined with univariable and multivariable Cox regression.

resultsWe identified 991 patients diagnosed with HCC. Lower SES and Hispanic and non-Hispanic Black ethnicity were significantly associated with lower NLR (p = 0.015 and 0.019, respectively). Elevated NLR, but not SES or ethnicity, was an independent predictor of worse OS (HR = 1.66, p < 0.001) and PFS (HR = 1.25, p = 0.032). The median OS in patients with elevated NLR was 8 months, compared to 42 months in patients with normal NLR. Patients with elevated NLR unresponsive to treatment and those with NLR that became elevated after treatment had significantly worse 3-year OS (47% and 44%, respectively), compared to patients whose NLR remained normal or normalized after treatment (72% and 80%, respectively; p < 0.01).

conclusionsOur study showed that elevated NLR, but not SES or ethnicity, is an independent prognostic marker for OS and PFS in patients with HCC. NLR trends following intervention were highly predictive of outcome. NLR is easy to obtain and would provide valuable information to clinicians in evaluating prognosis and monitoring response after procedures.

Indexed as

Lymphocyte CountNeutrophilsAsianBiomarkersBlack or African AmericanCarcinoma, HepatocellularFemaleHealthcare DisparitiesHispanic or LatinoHumansLiver NeoplasmsMaleMiddle AgedMinority GroupsProportional Hazards ModelsSocial ClassBiomarkersEthnicityHepatocellular carcinomaNeutrophil-to-lymphocyte ratioPrognosisSocioeconomic status

Identifiers

PMID31372942

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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.