{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:23:58Z","timestamp":1791390238659,"version":"4.3.3"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Systemic inflammation plays a critical role in hepatocellular carcinoma (HCC) progression and postoperative outcomes. This study assessed the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for overall (OS) and recurrence-free survival (RFS) in patients undergoing curative hepatectomy or orthotopic liver transplantation (OLT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicenter retrospective cohort of 74 HCC patients (86.5% male; median age 68.0 years), NLR and PLR were evaluated preoperatively and at 1-, 3-, 6-, and 12-months post-surgery. Associations with OS and RFS were evaluated using univariate, multivariable, and Cox proportional hazards models with time-varying covariates, while model discrimination was assessed using Harrell\u2019s concordance index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Elevated preoperative PLR predicted major postoperative complications (AUROC\u00a0=\u00a00.667, p = 0.030). The 3-month NLR demonstrated strong discriminative performance for OS (C-index 0.79). In time-varying Cox models, postoperative NLR emerged as a robust, time-independent predictor of OS (HR 1.35; p = 0.033), independent of the surgical procedure and Barcelona Clinic Liver Cancer stage. Multivariable analyses demonstrated that elevated NLR at 3-, 6-, and 12-months and PLR at 12 months independently predicted reduced OS. Hepatectomy was the dominant determinant of reduced RFS compared with OLT (p &amp;lt; 0.001), while an NLR threshold &amp;gt;2.5 identified a subgroup at markedly increased mortality risk, particularly following hepatectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Postoperative NLR is a powerful, time-independent prognostic biomarker for OS in surgically treated HCC, especially after liver resection, while PLR provides complementary prognostic information. These findings support the clinical integration of inflammation-based biomarkers into postoperative risk stratification and surveillance strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1801659","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T05:35:59Z","timestamp":1777354559000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Prognostic significance of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in hepatocellular carcinoma: a retrospective multicenter study on overall and recurrence-free survival following liver resection or liver transplantation"],"prefix":"10.3389","volume":"17","author":[{"given":"Konstantinos","family":"Arvanitakis","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, First Department of Internal Medicine, AHEPA University Hospital, Aristotle University of 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