Prognostic role of inflammatory markers in hepatocellular cancer patients receiving sorafenib therapy

Objective: Systemic inflammatory markers have been shown to have prognostic value in many types of cancers. Although the prognostic role of the systemic immune-inflammation index (SII), derived neutrophil-lymphocyte ratio (dNLR) and platelet lymphocyte ratio (PLR) has been shown in hepatocellular cancer (HCC) patients who underwent transplantation, its prognostic value has not been investigated in HCC patients under sorafenib treatment. We investigated the prognostic value of inflammatory indices in patients with HCC under sorafenib treatment. Materials and Methods: The data of 46 patients with stage III unresectable and stage IV HCC were evaluated retrospectively. SII and dNLR were dichotomized based on receiver operating characteristic (ROC) curve analysis (cut-off values: 355 and 1.8). No cut-off value could be determined for PLR; therefore, the median value was defined as the cut-off for PLR. At the time of diagnosis, values of these three inflammatory markers were analyzed to determine their association with clinicopathologic characteristics and to assess their prognostic values via the Kaplan-Meier method and multivariate Cox regression analysis. Results: Overall survival (OS) was significantly shorter in patients with a high SII, dNLR, or PLR. In univariate analyses, tumor stage, tumor focus count, and presence of extrahepatic lesions seemed to affect survival. Multivariate analysis revealed SII and the presence of extrahepatic lesions as independent risk factors for survival. Conclusion: The findings of the present study suggest that a high SII is an independent risk factor for survival in patients with HCC under sorafenib treatment.