Abstract
BACKGROUND: Clinical tools for predicting prognosis are limited for patients with hepatocellular carcinoma (HCC) undergoing hepatic arterial infusion chemotherapy (HAIC)-based hepatectomy. This study evaluated the prognostic significance of neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) in patients with HCC who received HAIC-based hepatectomy. METHODS: This dual-center retrospective study included 390 patients who received HAIC-based conversion resection to investigate the relationship of NLR and LMR with survival outcomes, adverse events, and risk factors. RESULTS: A total of 390 patients with HCC who received HAIC-based conversion liver resection were included. Patients with NLR ≥ 5 exhibited a significantly shorter overall survival (OS) and recurrence-free survival (RFS) compared to those with NLR < 5 (P = 0.0181 and P = 0.0164, respectively). Patients with LMR ≥ 3 exhibited favorable OS and RFS rates compared to those with LMR < 3 (P = 0.0195 and P = 0.0225, respectively). Similar results were observed in patients who achieved an objective response. NLR ≥ 5 and LMR < 3 were significantly associated with decreased OS and RFS compared to NLR < 5 and LMR ≥ 3 (P = 0.0131, P = 0.0104, P = 0.0055, and P = 0.0329, respectively). CONCLUSION: NLR and LMR have an effective predictive capability in prognosis for patients with HCC who received HAIC-based conversion surgery. These findings may help surgeons and patients make decisions regarding HAIC-based conversion hepatectomy.