Preoperative prognostic nutritional index predicts short‑ and long‑term outcomes after liver resection in patients with hepatocellular carcinoma

Abstract

The prognostic nutritional index (PNI) is one of the immune parameters calculated on the basis of the serum albumin and the total lymphocyte count. The aim of the present study was to investigate the prognostic significance of the PNI for short-and long-term outcomes after liver resection for patients with hepatocellular carcinoma (HCC). Data from 162 surgically treated patients with HCC (without any previous treatment) were retrospectively analyzed. The cutoff value of preoperative PNI was 45.0, which was calculated by a receiver operating characteristic curve for predicting the recurrence of HCC after liver resection. Patients were divided into low (n=86) and high (n=76) PNI groups. In short-term outcomes, patients in the low PNI group were more likely to experience postoperative complications compared with those in the high PNI group. The 5-year disease-free survival (DFS) rate in the low PNI group was significantly lower compared with that in the high PNI group (20.5% vs. 48.7%). In the multivariate analysis, a low PNI was an independent prognostic factor for DFS (HR, 1.65; 95% CI, 1.00-2.71). In conclusion, the preoperative PNI may be a prognostic factor for evaluating short-and long-term outcomes after liver resection in patients with HCC.

Preoperative Prognostic Nutritional Index and Neutrophil-to-Lymphocyte Ratio Predict Survival Outcomes of Patients With Hepatocellular Carcinoma After Curative Resection

“…The PNI was initially designed to assess the risk of surgical complications and mortality in patients undergoing gastrointestinal tract surgery (22). Increasing studies suggested that preoperative PNI could predict the overall survival of HCC patients undergoing surgery or targeted therapy (9,10,23). Our study is somewhat different from previous studies.…”

“…Furthermore, it is reported that the presence of an inflammatory response is pathogenic in the development of cancer-associated malnutrition, especially in patients with cirrhosis (5). The prognostic nutritional index (PNI), an overall measure of a patient's immunonutritional condition, has been demonstrated to be an independent prognostic factor in various types of cancer, such as gastric carcinoma (6), colon cancer (7), pancreatic cancer (8), and HCC (9,10). The previous studies have been reported that the PNI was a prognostic factor for evaluating short-and long-term outcomes after liver resection in HCC patients (9) and preoperative PNI predicts prognosis after curative hepatectomy in early Barcelona clinic liver cancer (BCLC) stage HCC (11).…”

“…The prognostic nutritional index (PNI), an overall measure of a patient's immunonutritional condition, has been demonstrated to be an independent prognostic factor in various types of cancer, such as gastric carcinoma (6), colon cancer (7), pancreatic cancer (8), and HCC (9,10). The previous studies have been reported that the PNI was a prognostic factor for evaluating short-and long-term outcomes after liver resection in HCC patients (9) and preoperative PNI predicts prognosis after curative hepatectomy in early Barcelona clinic liver cancer (BCLC) stage HCC (11). However, in the present study, we further explore the correlation between PNI and other series of prognostic indicators and clinical features; in addition, we aimed to combine two or more risk factors to better predict the prognosis of HCC patients after hepatectomy.…”

Preoperative Prognostic Nutritional Index May Be a Strong Predictor of Hepatocellular Carcinoma Recurrence Following Liver Transplantation

“…[10][11][12][13] Recently, there is growing evidence in HCC patients that PNI correlates with prognosis following non-surgical treatment and liver resection. [14][15][16] Its predictive significance in the LT setting remained, however, so far undetermined. Therefore, we conducted a retrospective study to explore the prognostic impact of preoperative PNI in HCC patients following LT.…”

Prediction Efficacy of Prognostic Nutritional Index and Albumin–Bilirubin Grade in Patients With Intrahepatic Cholangiocarcinoma After Radical Resection: A Multi-Institutional Analysis of 535 Patients

“…Albumin-bilirubin (ALBI) was first attempted to assess the liver function reserve of patients diagnosed with hepatocellular carcinoma (HCC) the same as the Child-Pugh grade in 2015, but ALBI had better predictive ability than the Child-Pugh grade for postoperative liver failure and long-term survival of patients undergoing liver resection (7,8). Several recent studies have demonstrated that the PNI and ALBI are closely related to the prognosis of patients with HCC, ICC, and gallbladder cancer (8)(9)(10)(11)(12)(13). Both the preoperative nutritional status and the immunological status have been reported to be independent prognostic factors of patients with ICC (11,(14)(15)(16).…”