Impact of Immuno-nutritional status (prognostic nutritional index, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio) on response to Transarterial chemoembolization in Patients with Hepatocellular carcinoma

Abstract

: Background: Hepatocellular carcinoma (HCC) ranks as the fifth most common cancer worldwide. For individuals with intermediate-stage HCC, Transarterial chemoembolization (TACE) is a viable therapy option. So it is crucial to select patients to improve clinical outcomes in HCC patients after TACE. For patients with various cancers, immune health, including nutritional status and inflammatory state is essential. The prognostic nutritional index (PNI) is a multiparametric indicator that has been shown to accurately reflect patients' immune-inflammatory and nutritional status. The levels of neutrophil/lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) have been well-documented as systemic inflammation biomarkers that predict the prognosis of multiple neoplasms. Aim: This Study aimed to detect the impact of immuno-nutritional status in HCC patients treated with TACE. Patients and methods: Sixty patients with HCC who underwent TACE were enrolled and followed up in the Tropical Medicine Department, Tanta University. We excluded patients with prior locoregional therapy, systemic therapy and/or surgical intervention. At baseline and at 1& 3months post-procedure, laboratory criteria, tumor criteria were recorded, PNI, NLR PLR were calculated before TACE. Univariate and multivariate analyses were performed to identify factors affecting response to TACE. Results: Univariate analysis showed that high PNI, low NLR and low PLR were associated with a better response after TACE while multivariate analysis showed that only high PNI was an independent predictor of good response. Conclusion: Prognostic nutritional index can be used as baseline predictor of response before TACE.