Liver transplantation for hepatocellular carcinoma: Role of inflammatory and immunological state on recurrence and prognosis

Table 1 Studies reporting the negative impact of increased neutrophil-to-lymphocyte ratio measured at transplant on the outcome of liver transplantation for hepatocellular carcinoma

Ref.	Patients (n)	Type of LT	NLR cut-off level for poor prognosis	Other factors associated with worse outcome	5-yr RFS with high vs low NLR	5-yr OS with high vs low NLR	Parameters positively correlated with increased NLR
Halazun et al[15]	150	NA	5	Tumor sizeAFP	25% vs 75%1	28% vs 64%	None
Bertuzzo et al[16]	219	DDLT	5	Microvascular invasion	6% vs 89%	14% vs 73%	Micro/macro vascular invasionTumor gradingAFPCRPOutside MC
Wang et al[17]	101	DDLT	3	Tumor numberMacrovascular invasion	28% vs 65%1	19% vs 62%	Macrovascular invasionAFPTumor sizeOutside MCOutside UCSF criteriaOutside Hangzhou criteria
Limaye et al[18]	160	NA	5	Microvascular invasion AFP	27% vs 79%	38% vs 68%	None
Motomura et al[19]	158	LDLT	4	Outside MC	30% vs 89%	57% vs 84%	Serum/peritumoral IL-17Density of peritumoral CD163CRPTacrolimus vs cyclosporine
2Yoshizumi et al[20]	104	LDLT	4	Nodule size + number ≥ 8.0	42% vs 86%	Not reported	Microvascular invasionTumor grading

¹In these studies, disease-free survival instead of recurrence-free survival rates were reported (and displayed in the present table);

²This study was performed by the same authors as the previous one[19], and included only patients with surgical and/or locoregional treatment preceding living donor liver transplantation (LDLT). Thus, the patient population is probably at least partly included in the population of the previous study from the same Institution. NLR: Neutrophil-to-lymphocyte ratio; LT: Liver transplantation; HCC: Hepatocellular carcinoma; RFS: Recurrence-free survival; OS: Overall survival; NA: Not assessable; AFP: Alpha-fetoprotein; CRP: C-reactive protein; MC: Milan criteria; DDLT: Deceased donor liver transplantation; UCSF: University of California at San Francisco.