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The Impact of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Among Patients with Intrahepatic Cholangiocarcinoma

2018Journal article Open access
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dc.contributor.authorBuettner, S
dc.contributor.authorSpolverato, G
dc.contributor.authorKimbrough, CW
dc.contributor.authorAlexandrescu, S
dc.contributor.authorPinto Marques, H
dc.contributor.authorLamelas, J
dc.contributor.authorAldrighetti, L
dc.contributor.authorGamblin, T
dc.contributor.authorMaithel, SK
dc.contributor.authorPulitano, C
dc.contributor.authorWeiss, M
dc.contributor.authorBauer, TW
dc.contributor.authorShen, F
dc.contributor.authorPoultsides, GA
dc.contributor.authorMarsh, JW
dc.contributor.authorIJzermans, JN
dc.contributor.authorKoerkamp, BG
dc.contributor.authorPawlik, TM
dc.date.accessioned2019-12-10T16:13:32Z
dc.date.available2019-12-10T16:13:32Z
dc.date.issued2018
dc.description.abstractBACKGROUND: Neutrophil-to-lymphocyte ratio and platelets-to-lymphocyte ratio may be host factors associated with prognosis. We sought to determine whether neutrophil-to-lymphocyte and platelets-to-lymphocyte ratio were associated with overall survival among patients undergoing surgery for intrahepatic cholangiocarcinoma. METHODS: Patients who underwent resection for intrahepatic cholangiocarcinoma between 1990 and 2015 were identified from 12 major centers. Clinicopathologic factors and overall survival were compared among patients stratified by neutrophil-to-lymphocyte ratio and platelets-to-lymphocyte ratio. Risk factors identified on multivariable analysis were included in a prognostic model and the discrimination was assessed using Harrell's concordance index (C index). RESULTS: A total of 991 patients were identified. Median neutrophil-to-lymphocyte ratio and platelets-to-lymphocyte ratio were 2.7 (interquartile range [IQR]: 2.0-4.0) and 109.6 (IQR: 72.4-158.8), respectively. Preoperative neutrophil-to-lymphocyte ratio was elevated (≥5) in 100 patients (10.0%) and preoperative platelets-to-lymphocyte ratio (≥190) in 94 patients (15.2%). Patients with low and high neutrophil-to-lymphocyte ratio and platelets-to-lymphocyte ratio generally had similar baseline characteristics with regard to tumor characteristics. Overall survival was 37.7 months (95% confidence interval [CI]: 32.7-42.6); 1-, 3-, and 5-year overall survival was 78.8%, 51.6%, and 39.3%, respectively. Patients with an neutrophil-to-lymphocyte ratio <5 had a median survival of 47.1 months (95% CI: 37.9-53.3) compared with a median survival of 21.9 months (95% CI: 4.8-39.1) among patients with an neutrophil-to-lymphocyte ratio ≥5 (P = .001). In contrast, patients who had a platelets-to-lymphocyte ratio <190 vs platelets-to-lymphocyte ratio ≥190 had comparable long-term survival (P > .05). On multivariable analysis, an elevated neutrophil-to-lymphocyte ratio was independently associated with decreased overall survival (hazard ratio: 1.04, 95% CI: 1.01-1.07; P = .002). Patients could be stratified into low- versus high-risk groups based on standard tumor-specific factors such as lymph node status, tumor size, number, and vascular invasion (C index 0.62). When neutrophil-to-lymphocyte ratio was added to the prognostic model, the discriminatory ability of the model improved (C index 0.71). CONCLUSION: Elevated neutrophil-to-lymphocyte ratio was independently associated with worse overall survival and improved the prognostic estimation of long-term survival among patients with intrahepatic cholangiocarcinoma undergoing resection.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationSurgery. 2018 Sep;164(3):411-418.pt_PT
dc.identifier.doi10.1016/j.surg.2018.05.002pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3389
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectAgedpt_PT
dc.subjectBile Duct Neoplasmspt_PT
dc.subjectCholangiocarcinomapt_PT
dc.subjectFemalept_PT
dc.subjectHepatectomypt_PT
dc.subjectHumanspt_PT
dc.subjectLength of Staypt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectPredictive Value of Testspt_PT
dc.subjectPrognosispt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectSurvival Ratept_PT
dc.subjectLymphocyte Countpt_PT
dc.subjectNeutrophilspt_PT
dc.subjectPlatelet Countpt_PT
dc.subjectHCC CIRpt_PT
dc.titleThe Impact of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Among Patients with Intrahepatic Cholangiocarcinomapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage418pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage411pt_PT
oaire.citation.titleSurgerypt_PT
oaire.citation.volume164pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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