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GIUSEPPE CABIBBO

Utility of neutrophil-to-lymphocyte ratio to identify long-term survivors among HCC patients treated with sorafenib

  • Autori: Casadei-Gardini A.; Dadduzio V.; Rovesti G.; Cabibbo G.; Vukotic R.; Rizzato M.D.; Orsi G.; Rossi M.; Guarneri V.; Lonardi S.; D'agostino D.; Celsa C.; Andreone P.; Zagonel V.; Scartozzi M.; Cascinu S.; Cucchetti A.
  • Anno di pubblicazione: 2020
  • Tipologia: Articolo in rivista
  • OA Link: http://hdl.handle.net/10447/533869

Abstract

Sorafenib is the first multikinase inhibitor demonstrating a survival benefit for patients suffering from advanced hepatocellular carcinoma (HCC). However, 1 issue remains open: what is the factor able to predict which patients will be long survivors?In the present study, we harnessed the potential of conditional survival, aiming at estimating the probability that a patient receiving sorafenib survives for more than 3 years.The present multicentric study was conducted on a cohort of 438 HCC patients. The primary end point was conditional overall survival. Kaplan-Meier survival analysis was used to calculate conditional overall survival probabilities at 3 years.The 3-year conditional survival of patients without disease progression highlights that NLR and ECOG are the factors that most accurately predict the probability of long survival. The 3-year conditional survival of patients with disease progression showed a medium effect size for HCV status, alpha-fetoprotein and NLR at all time-points. Macro-vascular portal vein invasion, extra hepatic disease, and BCLC we have a large effect size at 6 months and a medium effect size at 12 and 24 months.Our findings support the use of baseline NLR for the identification of patients with a higher probability of long-survival. NLR should be used as a stratification factor in the forthcoming clinical trials on the drugs for the advanced HCC now in pipeline.