Comparison of the prognostic value of different inflammation-based scores in patients with hepatocellular carcinoma after Lenvatinib therapy.

BACKGROUND

Inflammation is closely related to survival and disease progression in patients with cancer. However, the predictive value of inflammation-based scores for survival in patients with hepatocellular carcinoma (HCC) treated with Lenvatinib has not been fully elucidated.

AIM: To compare different inflammation scores' prognostic values, and establish novel nomogram for predicting overall survival (OS) in HCC patients on Lenvatinib.

METHODS

In total, 144 patients with HCC treated with Lenvatinib were enrolled in this study. The prognostic value of pre-treatment inflammation-based scores was retrospectively analyzed, including the platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, lymphocyte-to-C-reactive protein ratio, lymphocyte-to-monocyte ratio, systemic immune-inflammation index, C-reactive protein-to-albumin ratio, and prognostic nutritional index (PNI). Kaplan-Meier survival curves and time-dependent receiver operating characteristic analysis were used to assess predictive accuracy. Univariate and multivariate Cox regression analyses were conducted to identify prognostic factors predicting OS and construct a prognostic nomogram.

RESULTS

All the inflammation-based scores demonstrated good discrimination in terms of OS (all P < 0.05), and the PNI emerged as an independent predictor of OS in multivariate analysis (hazard ratio = 4.097; 95% confidence interval: 1.405-11.944; P = 0.01). We selected three independent prognostic factors (macrovascular invasion, metastasis, and PNI) to generate a nomogram for OS.

CONCLUSION

The PNI is a prognostic indicator for assessing OS in patients with HCC treated with Lenvatinib and is superior to other inflammation-based scores in predicting OS.