Prediction Of Preoperative Serum Inflammatory Factors On Postoperative Survival Of Patients With Primary Liver Cancer

Background: In recent years,more and more studies have reported that tumor characteristics are not the only determinant of the prognosis of cancer patients.As we all know,inflammation is not only the cause of tumor development and growth,but also the result of tumor growth.As inflammation has become a marker of cancer,inflammatory biomarkers have been shown to be promising prognostic factors to improve the accuracy of cancer research predictions.Previous studies on the effect of preoperative serum inflammatory factors on the prognosis of patients with hepatocellular carcinoma(HCC)have been proved to be effective in predicting prognosis.However,the effects of preoperative neutrophil lymphocyte ratio to albumin ratio(NLRAR)and White blood cell to hemoglobin ratio(WHR)on the prognosis of HCC patients undergoing radical resection are not clear.This study demonstrated the prognostic value of NLRAR and WHR in patients with HCC who underwent radical resection.Methods: A total of 169 patients with HCC who met the enrollment criteria were included in this study.The optimal cutoff values for NLRAR and WHR were selected by X-tile software.The overall survival(OS)was assessed by the Kaplan-Meier analysis with log-rank test and the Cox proportional hazard regression model.The prognostic values of NLRAR and WHR were calculated by the area under the receiver operating characteristic curve(AUC).Decision curve analysis(DCA)was performed for clinical benefits.Results: The high NLRAR group had worsen OS than the low NLRAR group,similar results were found in WHR.The NLRAR and WHR were identified as independent predictors of OS based on the multivariate Cox analyses.The subgroup analyses showed that NLRAR and WHR could predict prognosis in patients with tumor stage I.The NLRAR-WHR scoring system(NWS)could stratify HCC patients into two cohorts with different prognosis,and had better predictive power for OS than NLRAR or WHR alone.Conclusions: The preoperative NLRAR and WHR are effective prognostic indicators for HCC patients after curative hepatectomy.