Abstract: Objective The aim of this study was to investigate the predicting value for survival by preoperative neutrophil-to-lymphocyte ratio (NLR) of patients with massive hepatocellular carcinoma (HCC) treated with TACE combined with microwave ablation (MWA). Methods 87 patients with massive HCC were recruited and treated with TACE combined with MWA in our hospital between January 2007 and October 2013, and they were divided into high (NLR≥2.37, n=47) and low NLR group (NLR<2.37, n=40 patients) pre-operationally. Results The males proportion was 78.7%, ≥55 years old was 29.8%, tumor diameter were (7.1±1.2) cm, Child-Pugh grade A proportion was 61.7%, the proportion of serum albumin ≥35 g/L was 34.0%, the proportion of serum ALT>40U/L was 76.7%, AST>40U/L was 53.2% and AFP ≥200 μg/L was 59.6% in patients with high NLR, not significantly different as compared to 80.0%, 27.5%,(6.9±1.1)cm, 62.5%, 30.0%, 75.0%, 57.5% and 57.5% in patients with low NLR(P>0.05); the survival rates at 1a , 2 a and 3 a in patients with low NLR after treatment were 92.5%(37/40),62.5%(25/40) and 20.0%(8/40), significantly higher than 55.3%(26/47),31.9%(15/47) and 8.5%(4/47) in patients with high NLR(P <0.05); the median survival time of patients with high and low NLR were 13(11-17)months and 28(23-33)months (P<0.05). Conclusion The NLR might predict the short-term and long-term survival in patients with massive hepatocellular carcinoma treated with TACE combined with MWA, and the higher blood neutrophil counts might impact the clinical prognosis.

Key words: Hepatoma, TACE, Microwave ablation, Neutrophil-to-lymphocyte ratio, Prognosis