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Inflammation-based scores failed to predict HCC recurrence after liver transplant

Multiple inflammation scores were not associated with an increased risk for hepatocellular carcinoma recurrence after liver transplantation, according to study data.

“Inflammatory-based scores do not predict the recurrence of [HCC] post-liver transplantation in patients with tumors within the Milan criteria,” researcher Emmanuel Tsochatzis MD, MSc, FEBTM, PhD, of the UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, told Healio.com/Hepatology.

Emmanuel Tsochatzis

Tsochatzis and colleagues analyzed the following inflammation-based scores: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and inflammation-based index (IBI) of 150 patients who underwent liver transplantation for HCC at Royal Free Hospital between 1996 and 2010. The goal was to determine whether there were any associations between post-liver transplantation HCC occurrence and the scores. Each of the scores were individually calculated on three separate occasions; once at admission for transplantation, 1 month and 6 months post-transplant.  

NLR was not associated with post-transplant HCC recurrence before transplant (P=.08), 1 month post-transplant (P=.74) or 6 months post-transplant (P=.09). High IBI was not associated with HCC recurrence, as no recurrence was observed in any patients with an IBI score of 2. The PLR was not drastically different in patients who had HCC recurrence vs. those who did not at time of transplant (P=.63), 1 month post-transplant (P=.24) and 6 months post-transplant (P=.15). No score was associated with overall survival.

Univariate analysis showed tumor outside of the Milan criteria (P=.001), the absence of transarterial embolization (P=.009), no response to transarterial embolization (P=.002) among other factors, to be associated with post-transplant HCC recurrence.

“We failed to demonstrate a significant association between the inflammatory scores NLR, PLR and IBI at various time points and HCC recurrence post-LT in patients within the Milan criteria,” the researchers concluded. “Subsequent studies, mostly at the molecular level, could better clarify the immune alterations taking place in HCC pre- and post-transplantation and reveal more specific and accurate serum inflammatory predictors of HCC recurrence.”

Disclosure: The researchers report no relevant financial disclosures.