Platelet-to-Lymphocyte Ratio and Large Tumor Size Predict Microvascular Invasion after Resection for Hepatocellular Carcinoma

Abstract

Background: Recurrence after curative resection of hepatocellular carcinoma (HCC) is associated with early death<br />and poor prognosis. Microvascular invasion (mVI) is strongly associated with disease recurrence. Although many studies<br />have examined the relationship between various serum inflammatory indices and post-treatment prognosis, little is<br />known about preoperative predictors of microvascular invasion in HCC. Methods: Patients who underwent curative<br />hepatic resection for HCC at our institute from January 2006 to December 2016 were retrospectively reviewed. The<br />associations between mVI and various potential risk factors, including tumor size, hepatitis B and C virus infection,<br />Child–Pugh scores, platelet-to-lymphocyte ratio, and neutrophil-to-lymphocyte ratio, were analyzed. Optimal cut-off<br />values were determined using receiver operating characteristic curves. Results: A total of 330 HCC patients were<br />enrolled in this study, of whom 74 (22.4%) had tumors with mVI. After univariate analysis, two parameters were<br />significantly associated with mVI after hepatic resection: platelet-to-lymphocyte ratio ≥102 (odds ratio [OR] 2.385,<br />p = 0.001) and tumor size ≥5 cm (OR 4.29, p < 0.001). Both variables remained significant risk factors for mVI after<br />multivariate analysis: platelet-to-lymphocyte ratio ≥102 (OR 1.831, p = 0.034) and tumor size ≥5 cm (OR 3.791,<br />p < 0.001). Conclusions: Large tumor size (≥5 cm) and high platelet-to-lymphocyte ratio (≥102) are independent<br />predictive factors for mVI in HCC.