Objective  To identify the correlation between neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and hepatocellular carcinoma (HCC) patients who underwent transarterial chemoembolization (TACE).

  Methods  We retrospectively reviewed 216 patients who were diagnosed with HCC and treated with TACE between January 2007 and June 2015 at the Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University. The patients were stratified into two groups using NLR and PLR cutoff values. NLR and PLR were analyzed and compared through the area under receiver operating characteristic curves at different time points. Univariate and multivariate analyses were applied to evaluate the correlation between NLR, PLR, and HCC patients who were treated with TACE.

  Results  The median follow-up period was 431.11 d. The estimated 1-, 2-, and 3-year overall survival (OS) rates were 61.3%, 44.2%, and 40.5% for the entire study cohort, respectively. The median OS was 410.5 d. The estimated 1-, 2-, and 3-year OS rates for NLR < 1.77 group and NLR ≥1.77 group were 81.6%, 63.0%, and 45.7%; and 43.1%, 27.0%, and 19.3%, respectively. The difference was significant (P < 0.001). The estimated 1-, 2-, and 3-year OS rates for PLR < 94.62 group and PLR ≥94.62 group were 62.7%, 47.0%, and 37.0%; and 46.8%, 29.0%, and 18.5%, respectively. The difference was significant (P=0.002). In a multivariate analysis, NLR ≥1.77 was a risk factor associated with poor outcome for patients with HCC who received TACE therapy.

  Conclusion  NLR level before TACE is an indicator of systemic inflammation and is a risk factor associated with the prognosis of HCC patients who were treated with TACE.