Table 4.

Prognostic Factors Associated with Mortality Among Patients with Advanced HCC in Palliative Treatment: A Multivariate Cox Regression Analysis with Adjusted Hazard Ratio in Two Separate Models with Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio

Initial Model			Final Model with Sequentially Added Predictors
			CTP Score Added		MELD Score Added		BCLC Score Added
Model with NLR	HR (95%CI)	p-value	HR (95%CI)	p-value	HR (95%CI)	p-value	HR (95%CI)	p-value
Age	0.98 (0.95–1.01)	0.2	–		–
Gender (M vs F)	0.80 (0.32–1.80)	0.5	–	–	–
Hemoglobin level	1.21 (0.98–1.50)	0.07	1.28 (1.04–1.60)	0.02	1.36 (1.06–1.74)	0.02	1.28 (1.04–1.58)	0.02
ALT	1.0 (1.000–1.002)	0.2	-
NLR	1.11 (1.02–1.21)	0.01	1.12 (1.03–1.21)	0.01	1.11 (1.01–1.23)	0.03	1.12 (1.03–1.21)	0.01
Added predictors
CTP score	Not added		NS	–
MELD score	Not added				1.10 (1.03–1.20)	0.01
BCLC score	Not added						NS
Model with PLR
Age	0.98 (0.95–1.01)	0.2
Gender (M vs F)	0.69 (0.30–1.60)	0.4
Hemoglobin level	1.16 (0.94–1.44)	0.2			1.40 (1.12–1.74)	0.003
ALT	1.00 (1.00–1.002)	0.2	1.001 (1.001–1.002)	0.003	–	0.004	1.001 (1.000–1.002)
PLR	1.00 (1.00–1.002)	0.04	1.004 (1.002–1.007)	0.002	–	0.002	1.004 (1.002 −1.007)
Added predictors
CTP score	Not added		NS	–
MELD score	Not added				1.09 (1.03–1.60)	0.01
BCLC score	Not added						NS

Notes: Predictors (CTP, MELD, BCLC scores) were sequentially added and withdrew to the initial model that encompasses NLR or PLR to find out the stability of the prognostic effect of NLR and PLR in two separate models. The NLR and hemoglobin level was stable whatever the added predictors compared to PLR. MELD score was stable in the two models.

Abbreviations: HR, hazard ratio; CI, confidence interval; M, male; F, female; ALT, alanine aminotransferase; CTP, Child–Turcotte–Pugh; MELD, model for end-stage liver disease; BCLC, Barcelona clinic liver cancer; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; NS, not significant.