Department of Internal medicine, Himeji Red Cross Hospital, Himeji.
Faculty of Nursing, Gifu Kyoritsu University, Ogaki, Gifu.
Eur J Gastroenterol Hepatol. 2021 Feb 1;32(2):261-268. doi: 10.1097/MEG.0000000000001734.
Lenvatinib, a newly developed molecularly targeted agent, has become available as a first-line therapy in patients with unresectable hepatocellular carcinoma (HCC). The platelet-to-lymphocyte ratio (PLR) has been associated with poor outcome in various malignancies, including HCC. In this study, we investigated the ability of PLR to predict outcomes in patients with unresectable HCC who received lenvatinib.
Multivariate survival analysis was performed in 283 patients with unresectable HCC who received lenvatinib. In addition, the utility of PLR for predicting survival was clarified using an inverse probability weighting (IPW) analysis.
Cumulative overall survival at 100, 200, 300, 400, and 500 days was 95.2, 83.8, 68.3, 60.3, and 49.9%, respectively. Multivariate analysis with Cox proportional hazards modeling showed that PLR (≥150) [hazard ratio, 1.588; 95% confidence interval (CI), 1.039-2.428; P = 0.033], α-fetoprotein level, and Barcelona clinic liver cancer stage were independently associated with overall survival. Cumulative overall survival differed significantly between patients with low versus high PLR (P = 0.029). In addition, univariate analysis with Cox proportional hazards modeling adjusted by IPW showed that PLR (≥150) (hazard ratio, 1.396; 95% CI, 1.051-1.855; P = 0.021) was significantly associated with overall survival. Conversely, univariate analysis with Cox proportional hazards modeling adjusted only by IPW showed that PLR (≥150) (hazard ratio, 1.254; 95% CI, 1.016-1.549; P = 0.035) was significantly associated with progression-free survival. PLR values were not independently associated with therapeutic responses before or after IPW-adjusted logistic regression analysis.
PLR predicted overall survival in patients with unresectable HCC who received lenvatinib.
仑伐替尼是一种新开发的分子靶向药物，已成为不可切除肝细胞癌（HCC）患者的一线治疗药物。血小板与淋巴细胞比值（PLR）与包括 HCC 在内的多种恶性肿瘤的不良预后相关。本研究旨在探讨 PLR 预测接受仑伐替尼治疗的不可切除 HCC 患者结局的能力。
对 283 例接受仑伐替尼治疗的不可切除 HCC 患者进行多变量生存分析。此外，还通过逆概率加权（IPW）分析阐明了 PLR 预测生存的效用。
100、200、300、400 和 500 天的累积总生存率分别为 95.2%、83.8%、68.3%、60.3%和 49.9%。Cox 比例风险模型多变量分析显示，PLR（≥150）[风险比，1.588；95%置信区间（CI），1.039-2.428；P=0.033]、甲胎蛋白水平和巴塞罗那临床肝癌分期与总生存率独立相关。低 PLR 与高 PLR 患者的累积总生存率差异有统计学意义（P=0.029）。此外，通过 IPW 调整的 Cox 比例风险模型的单变量分析显示，PLR（≥150）（风险比，1.396；95%CI，1.051-1.855；P=0.021）与总生存率显著相关。相反，仅通过 IPW 调整的 Cox 比例风险模型的单变量分析显示，PLR（≥150）（风险比，1.254；95%CI，1.016-1.549；P=0.035）与无进展生存率显著相关。PLR 值与 IPW 调整后逻辑回归分析前后的治疗反应无关。
PLR 预测接受仑伐替尼治疗的不可切除 HCC 患者的总生存率。
