Prognostic significance of preoperative prognostic nutritional index in hepatocellular carcinoma: a meta-analysis

Man, Zhongran; Pang, Qing; Zhou, Lei; Wang, Yong; Hu, Xiaotao; Song, Yang; Jin, Hao; Liu, Huichun

doi:10.1016/j.hpb.2018.03.019

Cited by 54 publications

(55 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To further investigate the application value of PNI in HCC surgery, we conducted a meta-analysis and try to draw a more comprehensive conclusion. To the best of our knowledge, a meta-analysis including eight studies for surgical resection, has conclude that the preoperative PNI is a prognostic maker in HCC, but the study didn't mainly emphasize HCC patients after curative surgery and was heterogeneous in nature for the surgical resection (I 2 ¼ 89.8% and p < 0.001) [18]. In our meta-analysis including eight studies, we exclusively analyzed HCC patients who received curative hepatectomy, and there is no heterogeneous (I 2 < 50%).…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

The Preoperative Prognostic Nutritional Index in Hepatocellular Carcinoma After Curative Hepatectomy: A Retrospective Cohort Study and Meta-Analysis

Fan

Chen

et al. 2019

Journal of Investigative Surgery

View full text Add to dashboard Cite

Objective: Conflicting results existed about the role of prognostic nutritional index (PNI) for hepatocellular carcinoma (HCC) patients who received curative hepatectomy. The aim of this study is to identify the predictive capacity of PNI for survival after hepatectomy. Methods: Preoperative PNI, neutrophil-to-lymphocyte ratio (NLR), tumor feature and clinical information of 187 patients with HCC from Sir Run Run Shaw hospital were evaluated. We also conducted a meta-analysis of seven cohort studies. Results: Our study showed that HCC patients with a low PNI of <45 had a poor recurrence-free survival (RFS) rate (hazard ratio [HR] 1.762, 95% confidence interval [CI] 1.066-2.911, p ¼ 0.027, respectively). The 5-year OS and RFS rates of the high PNI (!45) vs low PNI (<45) were 76.7% vs 50.1% (p ¼ 0.001) and 47.0% vs 28.9% (p ¼ 0.001), respectively. In HCC TNM I patients (n ¼ 144), a low PNI remained an independent prognostic factor of OS and RFS (HR 2.305, 95% CI 1.008-5.268, p ¼ 0.048; HR 2.122, 95% CI 1.149-3.920, p ¼ 0.016). The 5-year OS and RFS rates of the high PNI vs low PNI were 81.3% vs 62.4% (p ¼ 0.041) and 53.4% vs 45.6% (p ¼ 0.013), respectively. In the pooled analysis, the data showed that a low PNI was significantly associated with poor OS and RFS (HR 2.27, 95% CI 1.03-4.07, p < 0.001 and HR 1.68, 95% CI 1.45-1.94, p < 0.001, respectively). Conclusions: The preoperative PNI was an independent prognostic factor for OS and RFS rates in HCC patients who received hepatectomy.

show abstract

Section: Discussionmentioning

confidence: 97%

“…The median of BMI (23.39 kg/m 2 ) was set as the cutoff value to balance the patients in our study. The cutoff value of PNI and NLR was respectively defined as 45 and 2.8 according to the literature [7,9,16,[18][19][20]. SPSS 21.0 (SPSS, Chicago, IL, USA) was used to perform statistical analysis.…”

Section: Discussionmentioning

confidence: 99%

The Preoperative Prognostic Nutritional Index in Hepatocellular Carcinoma After Curative Hepatectomy: A Retrospective Cohort Study and Meta-Analysis

Fan

Chen

et al. 2019

Journal of Investigative Surgery

View full text Add to dashboard Cite

show abstract

“…In a meta-analysis by Man et al . 38 , preoperative PNI has been shown to be a prognostic predictive factor for OS, disease-free survival and recurrence in patients with HCC. Chan and colleagues 39 confirmed that a low preoperative PNI was a significant prognostic factor for OS and disease-free survival in patients undergoing curative hepatic resection for HCC.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment Inflammation-Based Markers Predict Survival Outcomes in Patients with Early Stage Hepatocellular Carcinoma After Radiofrequency Ablation

Chu

Shen

Chang

et al. 2018

Sci Rep

View full text Add to dashboard Cite

The prognostic significance of various systemic inflammation‐based markers has been explored in different cancers after surgery. This study aimed to investigate whether these markers could predict outcomes in patients with early-stage hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA). One hundred eighteen patients with newly diagnosed HCC within the Milan criteria receiving RFA as initial therapy were retrospectively enrolled. Pretreatment inflammation-based markers including the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and prognostic nutritional index (PNI), together with other clinicopathologic parameters were collected. Cumulative overall survival (OS) and recurrence-free survival (RFS) were estimated by the Kaplan-Meier method and by multivariate analysis using Cox proportional hazard model. The 1-, 3-, and 5-year OS rates of patients were 90%, 67%, and 52%, respectively. Kaplan-Meier curves showed that baseline high NLR ≥ 2.5 (p = 0.006), low PNI < 40 (p = 0.005), history of end-stage renal disease (ESRD) (p = 0.005), non-Child-Pugh class A (p = 0.001) and elevated alpha-fetoprotein (AFP) ≥ 200 ng/mL (p = 0.005) significantly associated with the poor OS, whereas high PLR ≥ 100 did not. By multivariate analysis, high NLR ≥ 2.5 (hazard ratio (HR) 1.94; 95% confidence interval (CI), 1.05–3.59; p = 0.034), low PNI < 40 (HR 0.38; 95% CI, 0.20–0.72; p = 0.003), ESRD history (HR 3.60; 95% CI, 1.48–8.76; p = 0.005) and elevated AFP ≥ 200 ng/mL (HR 4.61; 95% CI, 1.75–12.13; p = 0.002) were independent factors. An elevated AFP level of ≥200 ng/mL was the significant factor associated with intrahepatic new RFS by univariate and multivariate analyses. In conclusion, pretreatment NLR and PNI are simple and useful predictors for OS in patients with early-stage HCC after RFA.

show abstract

“…Prognostic value of pretreatment PNI has been confirmed in several human cancers, [ 9 , 10 , 21 , 22 ] however, the agreement on the prognostic significance of preoperative PNI in OC has not been reached for contradictory results and small sample size of existing evidence. [ 12 – 17 ] Komura et al [ 14 ] study analyzed 164 patients with early-stage OC, and authors failed to observe the statistical association of preoperative PNI with PFS ( P = .58) and OS ( P = .99).…”

Section: Discussionmentioning

confidence: 99%

“…[ 6 , 7 ] Prognostic nutritional index (PNI), calculated using the following method: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm 3 ) in peripheral blood, can both reflect the nutrition and immunologic status of patients with cancers. [ 8 ] The prognostic value of pretreatment PNI has been verified in several tumors, such as pancreatic cancer, [ 9 ] liver cancer, [ 10 ] and colorectal cancer. [ 11 ] Recently increasing evidence showed that preoperative PNI might predict the prognosis of ovarian cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of preoperative prognostic nutritional index in ovarian cancer

Dai¹,

Liu²,

Li³

et al. 2020

Medicine

View full text Add to dashboard Cite

Background: The prognostic significance of preoperative prognostic nutritional index (PNI) in ovarian cancer (OC) is uncertain, and this study is aimed to clarify the prognostic significance. Methods: We used 4 common databases for conducting a systematic review and meta-analysis, and eligible studies were included in the analysis. The association of preoperative PNI with overall survival (OS), progression-free survival (PFS), and clinicopathological parameters was analyzed. Results: A total of 2050 patients with OC receiving the surgical treatment were analyzed in this study. Patients with low PNI tended to have a shorter OS (hazard ratio [HR] = 1.82, 95% CI = 1.30–2.55, P < .01) and PFS (HR = 1.91, 95% CI = 1.53–2.39, P < .01) compared with those with high PNI. Besides, low PNI was significantly associated with more advanced International Federation of Gynecology and Obstetrics stage ( P < .01), the occurrence of ascites ( P < .01), larger residual tumor ( P < .01), insensitive to chemotherapy ( P < .01), and higher CA125 ( P < .01) compared with high PNI in OC. Conclusion: Low preoperative PNI is associated with shorter OS, shorter PFS, and worse clinicopathological parameters in OC. Low preoperative PNI is an unfavorable prognostic indicator of patients with OC.

show abstract

Prognostic significance of preoperative prognostic nutritional index in hepatocellular carcinoma: a meta-analysis

Abstract: The current meta-analysis demonstrates that preoperative PNI is a prognostic marker in HCC.

Cited by 54 publications

References 48 publications

The Preoperative Prognostic Nutritional Index in Hepatocellular Carcinoma After Curative Hepatectomy: A Retrospective Cohort Study and Meta-Analysis

The Preoperative Prognostic Nutritional Index in Hepatocellular Carcinoma After Curative Hepatectomy: A Retrospective Cohort Study and Meta-Analysis

Pretreatment Inflammation-Based Markers Predict Survival Outcomes in Patients with Early Stage Hepatocellular Carcinoma After Radiofrequency Ablation

Prognostic significance of preoperative prognostic nutritional index in ovarian cancer

Contact Info

Product

Resources

About