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 < 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; = 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.