Preoperative lymphocyte‐to‐monocyte ratio is useful for stratifying the prognosis of hepatocellular carcinoma patients with a low Cancer of the Liver Italian Program score undergoing curative resection

• Main Authors: Takayuki Shimizu, Mitsuru Ishizuka, Kyung Hwa Park, Takayuki Shiraki, Yuhki Sakuraoka, Shozo Mori, Yukihiro Iso, Masato Kato, Taku Aoki, Keiichi Kubota
• Format: Article
• Language: English
• Published: Wiley 2019-05-01
• Series: Annals of Gastroenterological Surgery
• Subjects: CLIP score; curative resection; hepatocellular carcinoma; low CLIP score; lymphocyte‐to‐monocyte ratio
• Online Access: https://doi.org/10.1002/ags3.12251

Abstract Background and Aim Although the Cancer of the Liver Italian Program (CLIP) score is useful for prognostication of patients with hepatocellular carcinoma (HCC), a previous study has reported that the CLIP score was unable to stratify the postoperative outcomes of HCC patients in whom the score was low (0‐1). Recent studies have reported that the preoperative lymphocyte‐to‐monocyte ratio (LMR) is useful for prognostication of patients with various cancer. Methods We reviewed 329 HCC patients with a low CLIP score (0‐1) undergoing curative resection. This study had the approval of the Institutional Review Board (28068). Multivariate analyses were carried out to detect clinical factors correlating with overall survival (OS). Kaplan‐Meier analysis and the log‐rank test were used for comparison of OS. Results Multivariate analysis showed that LMR (<4.35/≥4.35) was significantly associated with OS (hazard ratio [HR], 2.022; 95% CI, 1.141‐3.583; P = 0.016) as well as portal vein invasion (HR, 2.410; 95%CI, 1.258‐4.618; P = 0.008). Kaplan‐Meier analysis and the log‐rank test showed a significant difference in OS and relapse‐free survival between patients with high LMR and those with low LMR. Conclusion Preoperative LMR is useful for stratifying the prognosis of HCC patients with a low CLIP score (0‐1) undergoing curative resection.