Title: The Predictive Value of PIV, PLR, LMR, NPR, and NLR for the Prognosis of
Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma Combined with
Liver Cirrhosis
Version: 1 Date: 27 Feb 2025
Reviewer's report:
This study tried to find in 216 patients with hepatocellular carcinoma and cirrhosis underwent
TACE a prognostic laboratory marker able to predict the post-TACE outcome
They considered the following systemic inflammatory markers such as the pan-Immunological
Value, Platelet-Lymphocyte Ratio, Lymphocyte-Monocyte Ratio, Neutrophil-Platelet Ratio,
and Neutrophil-Lymphocyte ratio. They stratified patients into good (n=92) and poor prognosis
groups (n = 124) based on one-year post-operative outcomes using the RECIST criteria. The
results demonstrated that in the poor prognosis patient  group there were significantly higher
PIV, PLR, NLR, and NPR, and lower LMR. Multivariate analysis identified PIV and NPR as
the strongest independent predictors of poor prognosis and ROC analysis demonstrated that PIV
had the greatest predictive accuracy (AUC = 0.803).  Thus PIV, PLR, LMR, NPR, and NLR
demonstrated significant prognostic value for cirrhotic HCC patients treated with TACE.
The study explores whether laboratory markers may assist the management and treatment of
HCC receiving TACE and has therefore clinical interest. However, since in cirrhotic patients
there are several potential variables affecting the clinical and laboratory features, the authors
should add the following data:
1) previous HCC treatment such as surgical resection, percutaneous ablation, as any previous
treatment might affect laboratory value and the optimal liver function to perform TACE
in more fragile patients in cirrhotic patients, as recently recommended (DOI: 10.1016/
j.jhep.2021.11.013);
2) TACE technique: selective? superselective?; how many nodules for each TACE session could
be treated?
3) Portal hypertension status: this condition may be associated with higher intestinal
permeability and higher risk of bacterial translocation that, in turn, might impact inflammatory
laboratory variables. Was some portal hypertension sign (varices, liver/spleen stiffness,
ultrasound) assessed before performing TACE?.
4) discussing previous literature data, many other laboratory value and scores have been
proposed as prognostic markers for clinical practice, and very simple laboratory assessment such
as the transient post-TACE serum transaminase elevation. Can the authors discuss and compare
their results with the other?
Title: The Predictive Value of PIV, PLR, LMR, NPR, and NLR for the Prognosis of
Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma Combined with
Liver Cirrhosis
Version: 1 Date: 27 Feb 2025
Reviewer's report:
This study tried to find in 216 patients with hepatocellular carcinoma and cirrhosis underwent
TACE a prognostic laboratory marker able to predict the post-TACE outcome
They considered the following systemic inflammatory markers such as the pan-Immunological
Value, Platelet-Lymphocyte Ratio, Lymphocyte-Monocyte Ratio, Neutrophil-Platelet Ratio,
and Neutrophil-Lymphocyte ratio. They stratified patients into good (n=92) and poor prognosis
groups (n = 124) based on one-year post-operative outcomes using the RECIST criteria. The
results demonstrated that in the poor prognosis patient  group there were significantly higher
PIV, PLR, NLR, and NPR, and lower LMR. Multivariate analysis identified PIV and NPR as
the strongest independent predictors of poor prognosis and ROC analysis demonstrated that PIV
had the greatest predictive accuracy (AUC = 0.803).  Thus PIV, PLR, LMR, NPR, and NLR
demonstrated significant prognostic value for cirrhotic HCC patients treated with TACE.
The study explores whether laboratory markers may assist the management and treatment of
HCC receiving TACE and has therefore clinical interest. However, since in cirrhotic patients
there are several potential variables affecting the clinical and laboratory features, the authors
should add the following data:
1) previous HCC treatment such as surgical resection, percutaneous ablation, as any previous
treatment might affect laboratory value and the optimal liver function to perform TACE
in more fragile patients in cirrhotic patients, as recently recommended (DOI: 10.1016/
j.jhep.2021.11.013);
2) TACE technique: selective? superselective?; how many nodules for each TACE session could
be treated?
3) Portal hypertension status: this condition may be associated with higher intestinal
permeability and higher risk of bacterial translocation that, in turn, might impact inflammatory
laboratory variables. Was some portal hypertension sign (varices, liver/spleen stiffness,
ultrasound) assessed before performing TACE?.
4) discussing previous literature data, many other laboratory value and scores have been
proposed as prognostic markers for clinical practice, and very simple laboratory assessment such
as the transient post-TACE serum transaminase elevation. Can the authors discuss and compare
their results with the other?
Please review this paper.
user
Title: The Predictive Value of PIV, PLR, LMR, NPR, and NLR for the Prognosis of
Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma Combined with
Liver Cirrhosis
Version: 1 Date: 27 Feb 2025
Reviewer's report:
This study tried to find in 216 patients with hepatocellular carcinoma and cirrhosis underwent
TACE a prognostic laboratory marker able to predict the post-TACE outcome
They considered the following systemic inflammatory markers such as the pan-Immunological
Value, Platelet-Lymphocyte Ratio, Lymphocyte-Monocyte Ratio, Neutrophil-Platelet Ratio,
and Neutrophil-Lymphocyte ratio. They stratified patients into good (n=92) and poor prognosis
groups (n = 124) based on one-year post-operative outcomes using the RECIST criteria. The
results demonstrated that in the poor prognosis patient  group there were significantly higher
PIV, PLR, NLR, and NPR, and lower LMR. Multivariate analysis identified PIV and NPR as
the strongest independent predictors of poor prognosis and ROC analysis demonstrated that PIV
had the greatest predictive accuracy (AUC = 0.803).  Thus PIV, PLR, LMR, NPR, and NLR
demonstrated significant prognostic value for cirrhotic HCC patients treated with TACE.
The study explores whether laboratory markers may assist the management and treatment of
HCC receiving TACE and has therefore clinical interest. However, since in cirrhotic patients
there are several potential variables affecting the clinical and laboratory features, the authors
should add the following data:
1) previous HCC treatment such as surgical resection, percutaneous ablation, as any previous
treatment might affect laboratory value and the optimal liver function to perform TACE
in more fragile patients in cirrhotic patients, as recently recommended (DOI: 10.1016/
j.jhep.2021.11.013);
2) TACE technique: selective? superselective?; how many nodules for each TACE session could
be treated?
3) Portal hypertension status: this condition may be associated with higher intestinal
permeability and higher risk of bacterial translocation that, in turn, might impact inflammatory
laboratory variables. Was some portal hypertension sign (varices, liver/spleen stiffness,
ultrasound) assessed before performing TACE?.
4) discussing previous literature data, many other laboratory value and scores have been
proposed as prognostic markers for clinical practice, and very simple laboratory assessment such
as the transient post-TACE serum transaminase elevation. Can the authors discuss and compare
their results with the other?
assistant