Neutrophil to lymphocyte ratio predicts disease progression following intra-arterial therapy of hepatocellular carcinoma

Matthew D. Taussig, Mary Ellen Irene Koran, Samdeep K. Mouli, Asma Ahmad, Sunil Geevarghese, Jennifer C. Baker, Andrew J. Lipnik, Fil Banovac, Daniel B. Brown*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Background Prospectively predicting response to intra-arterial therapy for hepatocellular carcinoma (HCC) is challenging. Neutrophil/lymphocyte ratio (NLR) is a serum biomarker that is associated with survival for multiple malignancies. It was hypothesized that increased NLR would be associated with early disease progression after intra-arterial therapy of HCC. Methods The outcomes of 86 treatment-naïve patients who had chemoembolization or radioembolization of HCC between July 2013–July 2014 were reviewed. Pre-treatment laboratory tests and imaging were used to measure NLR, Child-Pugh (CP) score, tumor number and tumor size. High/low NLR groups were defined as >3 and <3 respectively. Follow-up imaging at two months with assessed response using modified response criteria in solid tumors (mRECIST). Results NLR >3 was seen in 25/86 patients (range 3.0–21.6). NLR >3 patients had a significantly higher baseline CP score. Comorbidities were otherwise similar between groups as was tumor number/size. Disease control was significantly worse (p = 0.014) with NLR >3. Logistic regression for tumor response revealed NLR >3 as the best predictor of early progression (p < 0.0001). Discussion NLR may be a serologic biomarker of early progressive disease after intra-arterial therapy of HCC. Future research should focus on outcomes by treatment type or potentially combining arterial therapies with ablation and/or targeted biologic agents.

Original languageEnglish (US)
Pages (from-to)458-464
Number of pages7
Issue number5
StatePublished - May 2017

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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