Publicação
Lymphocyte-C-Reactive Protein Ratio: Impact on Prognosis of Patients Following Resection of Primary Liver Cancer.
| Resumo: | Objective: We sought to characterize the prognostic value of lymphocyte-C-reactive protein ratio (LCR) among patients undergoing liver resection (LR) for hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). Methods: Patients who underwent curative-intent LR for HCC and ICC between 2000 and 2023 were identified from a multiinstitutional database. The prognostic value of nine different inflammatory markers were evaluated relative to short- (i.e., postoperative morbidity) and long-term (recurrence-free survival [RFS] and overall survival [OS]) outcomes. Results: Among 715 patients, 499 (69.8%) and 216 (30.2%) individuals were included in the derivation and validation cohorts, respectively. Patients with advanced disease and poor tumor biology had lower median levels of LCR. An optimal LCR cutoff threshold of 6100 was identified in the derivation cohort. LCR demonstrated the highest accuracy to predict RFS and OS, with areas under the ROC curve of 0.724 and 0.716, respectively. After adjusting for relevant clinicodemographic factors, lower LCR remained associated with higher odds of postoperative complications (OR: 1.98 [95% CI: 1.27-3.10] and p = 0.003) and particularly, infectious complications (OR: 2.80 [95% CI: 1.57-5.01] and p < 0.001). A lower LCR was independently associated with worse RFS (HR: 2.43 [95% CI: 1.41-3.83] and p = 0.002) and OS (HR: 2.95 [95% CI: 2.10-4.16] and p < 0.001). The prognostic ability of LCR for short- and long-term outcomes performed well in an independent validation cohort. Conclusion: LCR was strongly associated with risk of postoperative morbidity as well as worse RFS and OS among patients undergoing LR for HCC and ICC. Preoperative LCR assessment can aid surgeons in the preoperative risk-stratification of patients undergoing surgery for primary liver cancer. |
|---|---|
| Autores principais: | Altaf, Abdullah |
| Outros Autores: | Baldo, Andrea; Khalil, Mujtaba; Rashid, Zayed; Akabane, Miho; Zindani, Shahzaib; Sarfraz, Azza; Ruzzenente, Andrea; Aldrighetti, Luca; Bauer, Todd W; Pinto Marques, Hugo; Martel, Guillaume; Popescu, Irinel; Weiss, Mathew J; Kitago, Minoru; Poultsides, George; Maithel, Shishir K; Lam, Vincent; Hugh, Tom; Gleisner, Ana; Shen, Feng; Cauchy, François; Koerkamp, Bas G; Endo, Itaru; Pawlik, Timothy M |
| Assunto: | HCC CIR Aged Middle Aged Female Male Humans Bile Duct Neoplasms* / blood Bile Duct Neoplasms* / mortality Bile Duct Neoplasms* / surgery Biomarkers Tumor / blood C-Reactive Protein* / analysis C-Reactive Protein* / metabolism Carcinoma Hepatocellular* / blood Hepatocellular* / mortality Hepatocellular* / surgery Cholangiocarcinoma* / blood Cholangiocarcinoma* / mortality Cholangiocarcinoma* / surgery Hepatectomy* Liver Neoplasms* / blood Liver Neoplasms* / mortality Liver Neoplasms* / surgery Lymphocytes* Postoperative Complications / epidemiology Prognosis Retrospective Studies |
| Ano: | 2025 |
| País: | Portugal |
| Tipo de documento: | texto |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Centro Hospitalar de Lisboa Central, EPE (CHLC) |
| Idioma: | inglês |
| Origem: | Repositório do Centro Hospitalar de Lisboa Central, EPE |
| _version_ | 1868412232814034944 |
|---|---|
| author | Altaf, Abdullah |
| author2 | Baldo, Andrea Khalil, Mujtaba Rashid, Zayed Akabane, Miho Zindani, Shahzaib Sarfraz, Azza Ruzzenente, Andrea Aldrighetti, Luca Bauer, Todd W Pinto Marques, Hugo Martel, Guillaume Popescu, Irinel Weiss, Mathew J Kitago, Minoru Poultsides, George Maithel, Shishir K Lam, Vincent Hugh, Tom Gleisner, Ana Shen, Feng Cauchy, François Koerkamp, Bas G Endo, Itaru Pawlik, Timothy M |
| author2_role | author author author author author author author author author author author author author author author author author author author author author author author author |
| author_facet | Altaf, Abdullah Baldo, Andrea Khalil, Mujtaba Rashid, Zayed Akabane, Miho Zindani, Shahzaib Sarfraz, Azza Ruzzenente, Andrea Aldrighetti, Luca Bauer, Todd W Pinto Marques, Hugo Martel, Guillaume Popescu, Irinel Weiss, Mathew J Kitago, Minoru Poultsides, George Maithel, Shishir K Lam, Vincent Hugh, Tom Gleisner, Ana Shen, Feng Cauchy, François Koerkamp, Bas G Endo, Itaru Pawlik, Timothy M |
| author_role | author |
| contributor_name_str_mv | Repositório da Unidade Local de Saúde São José |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Altaf, Abdullah\"},{\"Person.name\":\"Baldo, Andrea\"},{\"Person.name\":\"Khalil, Mujtaba\"},{\"Person.name\":\"Rashid, Zayed\"},{\"Person.name\":\"Akabane, Miho\"},{\"Person.name\":\"Zindani, Shahzaib\"},{\"Person.name\":\"Sarfraz, Azza\"},{\"Person.name\":\"Ruzzenente, Andrea\"},{\"Person.name\":\"Aldrighetti, Luca\"},{\"Person.name\":\"Bauer, Todd W\"},{\"Person.name\":\"Pinto Marques, Hugo\"},{\"Person.name\":\"Martel, Guillaume\"},{\"Person.name\":\"Popescu, Irinel\"},{\"Person.name\":\"Weiss, Mathew J\"},{\"Person.name\":\"Kitago, Minoru\"},{\"Person.name\":\"Poultsides, George\"},{\"Person.name\":\"Maithel, Shishir K\"},{\"Person.name\":\"Lam, Vincent\"},{\"Person.name\":\"Hugh, Tom\"},{\"Person.name\":\"Gleisner, Ana\"},{\"Person.name\":\"Shen, Feng\"},{\"Person.name\":\"Cauchy, François\"},{\"Person.name\":\"Koerkamp, Bas G\"},{\"Person.name\":\"Endo, Itaru\"},{\"Person.name\":\"Pawlik, Timothy M\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Repositório da Unidade Local de Saúde São José |
| datacite.creators.creator.creatorName.fl_str_mv | Altaf, Abdullah Baldo, Andrea Khalil, Mujtaba Rashid, Zayed Akabane, Miho Zindani, Shahzaib Sarfraz, Azza Ruzzenente, Andrea Aldrighetti, Luca Bauer, Todd W Pinto Marques, Hugo Martel, Guillaume Popescu, Irinel Weiss, Mathew J Kitago, Minoru Poultsides, George Maithel, Shishir K Lam, Vincent Hugh, Tom Gleisner, Ana Shen, Feng Cauchy, François Koerkamp, Bas G Endo, Itaru Pawlik, Timothy M |
| datacite.date.Accepted.fl_str_mv | 2025-08-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2025-11-27T16:24:26Z |
| datacite.date.embargoed.fl_str_mv | 2025-11-27T16:24:26Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | HCC CIR Aged Middle Aged Female Male Humans Bile Duct Neoplasms* / blood Bile Duct Neoplasms* / mortality Bile Duct Neoplasms* / surgery Biomarkers Tumor / blood C-Reactive Protein* / analysis C-Reactive Protein* / metabolism Carcinoma Hepatocellular* / blood Hepatocellular* / mortality Hepatocellular* / surgery Cholangiocarcinoma* / blood Cholangiocarcinoma* / mortality Cholangiocarcinoma* / surgery Hepatectomy* Liver Neoplasms* / blood Liver Neoplasms* / mortality Liver Neoplasms* / surgery Lymphocytes* Postoperative Complications / epidemiology Prognosis Retrospective Studies |
| datacite.titles.title.fl_str_mv | Lymphocyte-C-Reactive Protein Ratio: Impact on Prognosis of Patients Following Resection of Primary Liver Cancer. |
| dc.contributor.none.fl_str_mv | Repositório da Unidade Local de Saúde São José |
| dc.creator.none.fl_str_mv | Altaf, Abdullah Baldo, Andrea Khalil, Mujtaba Rashid, Zayed Akabane, Miho Zindani, Shahzaib Sarfraz, Azza Ruzzenente, Andrea Aldrighetti, Luca Bauer, Todd W Pinto Marques, Hugo Martel, Guillaume Popescu, Irinel Weiss, Mathew J Kitago, Minoru Poultsides, George Maithel, Shishir K Lam, Vincent Hugh, Tom Gleisner, Ana Shen, Feng Cauchy, François Koerkamp, Bas G Endo, Itaru Pawlik, Timothy M |
| dc.date.Accepted.fl_str_mv | 2025-08-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2025-11-27T16:24:26Z |
| dc.date.embargoed.fl_str_mv | 2025-11-27T16:24:26Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10400.17/5232 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Wiley |
| dc.rights.cclincense.fl_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | HCC CIR Aged Middle Aged Female Male Humans Bile Duct Neoplasms* / blood Bile Duct Neoplasms* / mortality Bile Duct Neoplasms* / surgery Biomarkers Tumor / blood C-Reactive Protein* / analysis C-Reactive Protein* / metabolism Carcinoma Hepatocellular* / blood Hepatocellular* / mortality Hepatocellular* / surgery Cholangiocarcinoma* / blood Cholangiocarcinoma* / mortality Cholangiocarcinoma* / surgery Hepatectomy* Liver Neoplasms* / blood Liver Neoplasms* / mortality Liver Neoplasms* / surgery Lymphocytes* Postoperative Complications / epidemiology Prognosis Retrospective Studies |
| dc.title.fl_str_mv | Lymphocyte-C-Reactive Protein Ratio: Impact on Prognosis of Patients Following Resection of Primary Liver Cancer. |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_18cf |
| description | Objective: We sought to characterize the prognostic value of lymphocyte-C-reactive protein ratio (LCR) among patients undergoing liver resection (LR) for hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). Methods: Patients who underwent curative-intent LR for HCC and ICC between 2000 and 2023 were identified from a multiinstitutional database. The prognostic value of nine different inflammatory markers were evaluated relative to short- (i.e., postoperative morbidity) and long-term (recurrence-free survival [RFS] and overall survival [OS]) outcomes. Results: Among 715 patients, 499 (69.8%) and 216 (30.2%) individuals were included in the derivation and validation cohorts, respectively. Patients with advanced disease and poor tumor biology had lower median levels of LCR. An optimal LCR cutoff threshold of 6100 was identified in the derivation cohort. LCR demonstrated the highest accuracy to predict RFS and OS, with areas under the ROC curve of 0.724 and 0.716, respectively. After adjusting for relevant clinicodemographic factors, lower LCR remained associated with higher odds of postoperative complications (OR: 1.98 [95% CI: 1.27-3.10] and p = 0.003) and particularly, infectious complications (OR: 2.80 [95% CI: 1.57-5.01] and p < 0.001). A lower LCR was independently associated with worse RFS (HR: 2.43 [95% CI: 1.41-3.83] and p = 0.002) and OS (HR: 2.95 [95% CI: 2.10-4.16] and p < 0.001). The prognostic ability of LCR for short- and long-term outcomes performed well in an independent validation cohort. Conclusion: LCR was strongly associated with risk of postoperative morbidity as well as worse RFS and OS among patients undergoing LR for HCC and ICC. Preoperative LCR assessment can aid surgeons in the preoperative risk-stratification of patients undergoing surgery for primary liver cancer. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | text |
| fulltext.url.fl_str_mv | https://repositorio.chlc.pt/bitstreams/3ed3998b-6b8e-45e8-9c80-ee38a734f2b1/download |
| id | rchlc_1dbffd5c4e21bae80d95d40279ebb671 |
| identifier.url.fl_str_mv | http://hdl.handle.net/10400.17/5232 |
| instacron_str | chlc |
| institution | Centro Hospitalar de Lisboa Central, EPE (CHLC) |
| instname_str | Centro Hospitalar de Lisboa Central, EPE (CHLC) |
| language | eng |
| network_acronym_str | rchlc |
| network_name_str | Repositório do Centro Hospitalar de Lisboa Central, EPE |
| oai_identifier_str | oai:repositorio.chlc.pt:10400.17/5232 |
| organization_str_mv | urn:organizationAcronym:chlc |
| person_str_mv | Altaf, Abdullah Baldo, Andrea Khalil, Mujtaba Rashid, Zayed Akabane, Miho Zindani, Shahzaib Sarfraz, Azza Ruzzenente, Andrea Aldrighetti, Luca Bauer, Todd W Pinto Marques, Hugo Martel, Guillaume Popescu, Irinel Weiss, Mathew J Kitago, Minoru Poultsides, George Maithel, Shishir K Lam, Vincent Hugh, Tom Gleisner, Ana Shen, Feng Cauchy, François Koerkamp, Bas G Endo, Itaru Pawlik, Timothy M |
| publishDate | 2025 |
| publisher.none.fl_str_mv | Wiley |
| reponame_str | Repositório do Centro Hospitalar de Lisboa Central, EPE |
| repository_id_str | urn:repositoryAcronym:rchlc |
| service_str_mv | urn:repositoryAcronym:rchlc |
| spelling | engWileyengObjective: We sought to characterize the prognostic value of lymphocyte-C-reactive protein ratio (LCR) among patients undergoing liver resection (LR) for hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). Methods: Patients who underwent curative-intent LR for HCC and ICC between 2000 and 2023 were identified from a multiinstitutional database. The prognostic value of nine different inflammatory markers were evaluated relative to short- (i.e., postoperative morbidity) and long-term (recurrence-free survival [RFS] and overall survival [OS]) outcomes. Results: Among 715 patients, 499 (69.8%) and 216 (30.2%) individuals were included in the derivation and validation cohorts, respectively. Patients with advanced disease and poor tumor biology had lower median levels of LCR. An optimal LCR cutoff threshold of 6100 was identified in the derivation cohort. LCR demonstrated the highest accuracy to predict RFS and OS, with areas under the ROC curve of 0.724 and 0.716, respectively. After adjusting for relevant clinicodemographic factors, lower LCR remained associated with higher odds of postoperative complications (OR: 1.98 [95% CI: 1.27-3.10] and p = 0.003) and particularly, infectious complications (OR: 2.80 [95% CI: 1.57-5.01] and p < 0.001). A lower LCR was independently associated with worse RFS (HR: 2.43 [95% CI: 1.41-3.83] and p = 0.002) and OS (HR: 2.95 [95% CI: 2.10-4.16] and p < 0.001). The prognostic ability of LCR for short- and long-term outcomes performed well in an independent validation cohort. Conclusion: LCR was strongly associated with risk of postoperative morbidity as well as worse RFS and OS among patients undergoing LR for HCC and ICC. Preoperative LCR assessment can aid surgeons in the preoperative risk-stratification of patients undergoing surgery for primary liver cancer.application/pdfengLymphocyte-C-Reactive Protein Ratio: Impact on Prognosis of Patients Following Resection of Primary Liver Cancer.Altaf, AbdullahBaldo, AndreaKhalil, MujtabaRashid, ZayedAkabane, MihoZindani, ShahzaibSarfraz, AzzaRuzzenente, AndreaAldrighetti, LucaBauer, Todd WPinto Marques, HugoMartel, GuillaumePopescu, IrinelWeiss, Mathew JKitago, MinoruPoultsides, GeorgeMaithel, Shishir KLam, VincentHugh, TomGleisner, AnaShen, FengCauchy, FrançoisKoerkamp, Bas GEndo, ItaruPawlik, Timothy MHostingInstitutionOrganizationalRepositório da Unidade Local de Saúde São Josée-mailmailto:repositorio@ulssjose.min-saude.ptrepositorio@ulssjose.min-saude.ptDOIIsPartOf10.1002/wjs.12675.2025-11-27T16:24:26Z2025-082025-08-01T00:00:00ZHandlehttp://hdl.handle.net/10400.17/5232http://purl.org/coar/access_right/c_abf2open accessHCC CIRAgedMiddle AgedFemaleMaleHumansBile Duct Neoplasms* / bloodBile Duct Neoplasms* / mortalityBile Duct Neoplasms* / surgeryBiomarkersTumor / bloodC-Reactive Protein* / analysisC-Reactive Protein* / metabolismCarcinomaHepatocellular* / bloodHepatocellular* / mortalityHepatocellular* / surgeryCholangiocarcinoma* / bloodCholangiocarcinoma* / mortalityCholangiocarcinoma* / surgeryHepatectomy*Liver Neoplasms* / bloodLiver Neoplasms* / mortalityLiver Neoplasms* / surgeryLymphocytes*Postoperative Complications / epidemiologyPrognosisRetrospective Studies1013065 bytesother research producthttp://purl.org/coar/resource_type/c_18cftext2025-08http://creativecommons.org/licenses/by/4.0/http://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.chlc.pt/bitstreams/3ed3998b-6b8e-45e8-9c80-ee38a734f2b1/downloadWorld Journal of Surgery49821952206 |
| spellingShingle | Lymphocyte-C-Reactive Protein Ratio: Impact on Prognosis of Patients Following Resection of Primary Liver Cancer. Altaf, Abdullah HCC CIR Aged Middle Aged Female Male Humans Bile Duct Neoplasms* / blood Bile Duct Neoplasms* / mortality Bile Duct Neoplasms* / surgery Biomarkers Tumor / blood C-Reactive Protein* / analysis C-Reactive Protein* / metabolism Carcinoma Hepatocellular* / blood Hepatocellular* / mortality Hepatocellular* / surgery Cholangiocarcinoma* / blood Cholangiocarcinoma* / mortality Cholangiocarcinoma* / surgery Hepatectomy* Liver Neoplasms* / blood Liver Neoplasms* / mortality Liver Neoplasms* / surgery Lymphocytes* Postoperative Complications / epidemiology Prognosis Retrospective Studies |
| status | SINGLETON |
| subject.fl_str_mv | HCC CIR Aged Middle Aged Female Male Humans Bile Duct Neoplasms* / blood Bile Duct Neoplasms* / mortality Bile Duct Neoplasms* / surgery Biomarkers Tumor / blood C-Reactive Protein* / analysis C-Reactive Protein* / metabolism Carcinoma Hepatocellular* / blood Hepatocellular* / mortality Hepatocellular* / surgery Cholangiocarcinoma* / blood Cholangiocarcinoma* / mortality Cholangiocarcinoma* / surgery Hepatectomy* Liver Neoplasms* / blood Liver Neoplasms* / mortality Liver Neoplasms* / surgery Lymphocytes* Postoperative Complications / epidemiology Prognosis Retrospective Studies |
| title | Lymphocyte-C-Reactive Protein Ratio: Impact on Prognosis of Patients Following Resection of Primary Liver Cancer. |
| title_full | Lymphocyte-C-Reactive Protein Ratio: Impact on Prognosis of Patients Following Resection of Primary Liver Cancer. |
| title_fullStr | Lymphocyte-C-Reactive Protein Ratio: Impact on Prognosis of Patients Following Resection of Primary Liver Cancer. |
| title_full_unstemmed | Lymphocyte-C-Reactive Protein Ratio: Impact on Prognosis of Patients Following Resection of Primary Liver Cancer. |
| title_short | Lymphocyte-C-Reactive Protein Ratio: Impact on Prognosis of Patients Following Resection of Primary Liver Cancer. |
| title_sort | Lymphocyte-C-Reactive Protein Ratio: Impact on Prognosis of Patients Following Resection of Primary Liver Cancer. |
| topic | HCC CIR Aged Middle Aged Female Male Humans Bile Duct Neoplasms* / blood Bile Duct Neoplasms* / mortality Bile Duct Neoplasms* / surgery Biomarkers Tumor / blood C-Reactive Protein* / analysis C-Reactive Protein* / metabolism Carcinoma Hepatocellular* / blood Hepatocellular* / mortality Hepatocellular* / surgery Cholangiocarcinoma* / blood Cholangiocarcinoma* / mortality Cholangiocarcinoma* / surgery Hepatectomy* Liver Neoplasms* / blood Liver Neoplasms* / mortality Liver Neoplasms* / surgery Lymphocytes* Postoperative Complications / epidemiology Prognosis Retrospective Studies |
| topic_facet | HCC CIR Aged Middle Aged Female Male Humans Bile Duct Neoplasms* / blood Bile Duct Neoplasms* / mortality Bile Duct Neoplasms* / surgery Biomarkers Tumor / blood C-Reactive Protein* / analysis C-Reactive Protein* / metabolism Carcinoma Hepatocellular* / blood Hepatocellular* / mortality Hepatocellular* / surgery Cholangiocarcinoma* / blood Cholangiocarcinoma* / mortality Cholangiocarcinoma* / surgery Hepatectomy* Liver Neoplasms* / blood Liver Neoplasms* / mortality Liver Neoplasms* / surgery Lymphocytes* Postoperative Complications / epidemiology Prognosis Retrospective Studies |
| url | http://hdl.handle.net/10400.17/5232 |
| visible | 1 |