Non-secretion of AFP and neutrophil lymphocyte ratio as predictors for survival in hepatocellular carcinoma patients treated with sorafenib: a large UK cohort.

BACKGROUND

Sorafenib is the current standard of care for patients with advanced or metastatic hepatocellular carcinoma. Currently no universally agreed model exists correlating the Neutrophil Lymphocyte ratio (NLR) and non-secretion of AFP with the survival of HCC patients treated with sorafenib.

PATIENTS AND METHODS

We retrospectively analysed patient records with a confirmed diagnosis of HCC treated with sorafenib between April 2009 and March 2014. Survival analysis was performed using the Kaplan-Meier method and Cox regression.

RESULTS

Patients separated into groups based on NLR (≤3 or >3), or AFP secretion profile (<7 ng/ml or ≥7 ng/ml) derived diverging Kaplan-Meier curves for overall survival (OS). The median OS in those with NLR ≤3.0 was 9.0 months (95% CI: 7.7-11.1 months) and in those with NLR >3.0 it was 6.0 months (95% CI: 4.9-8.2 months) [HR 1.32 (95% CI: 0.96-1.80)]. The median overall survival post sorafenib was higher in the "non-secretor" AFP group. OS for AFP <7 ng/ml was 10.0 months (95% CI: 7.7-19.3 months) compared to AFP ≥7ng/ml: 6.6 months (95% CI: 5.3-8.4 months) [HR 1.64 (95% CI: 1.15-2.33)].

CONCLUSION

NLR and AFP non - secretion at diagnosis are potential significant prognosticators for overall survival from initiation of sorafenib.