Early Increases in Platelet and Leukocyte Counts for Predicting Prognosis in Transarterial Chemoembolization and Sorafenib Patients with Hepatocellular Carcinoma

Abstract

Objective: To examine the relationship between the early increase in platelet and leukocyte counts and the prognosis in patients with hepatocellular carcinoma (HCC) receiving transarterial chemoembolization (TACE) combined with sorafenib. Methods: In this retrospective cohort study, a rise in both the platelet and leukocyte counts seven days after receiving TACE combined with sorafenib compared with three days before treatment was considered the early increase (positive group). If none or only one of the platelet or leukocyte counts increased, this was considered the rest situation (negative group). Blood samples were collected in Vacutainer tubes and immediately tested for leukocyte and platelet counts. In the study, overall survival (OS) was the primary outcome. Time to progression (TTP) serves as another secondary endpoint. Risk factors were analyzed using the logistic model. Results: 75 HCC patients received TACE combined with sorafenib were enrolled in this study. There were 61 patients in the positive group and 14 patients in the negative group. Compared with the negative group, patients in the positive group had a shorter median OS (14.8 vs 31.9 months; Hazard ratio (HR): 2.7; 95% confidence interval (CI): 1.3–5.4) and median TTP (3.0 vs 9.0 months; HR: 2.6; 95% CI: 1.2–5.4) in univariate analysis. Multivariate analysis indicated that the early increase in platelet and leukocyte counts was an independent indicator of a poorer OS (HR: 2.4; 95% CI: 1.1–5.2) and TTP (HR: 2.7; 95% CI: 1.3–6.0). Conclusions: The early increase in leukocyte and platelet counts might be a convenient and effective predictive factor in HCC patients received TACE combined with sorafenib, but larger prospective studies are needed for further confirmation.