Prognostic value of combined preoperative prognostic nutritional index and body mass index in HCC after hepatectomy

Ji, Fei; Liang, Yao; Fu, Shunjun; Chen, Dubo; Cai, Xiuyu; Li, Shaoqiang; Peng, Baogang; Liu, Liang; Hua, Yunpeng

doi:10.1016/j.hpb.2017.04.008

Cited by 53 publications

(53 citation statements)

References 25 publications

(42 reference statements)

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“…Several studies have reported that a low BMI (underweight) correlates significantly with low albumin levels and sarcopenia, which are clinical manifestations of malnutrition and poor immune function. Ji and co‐workers indicated that a low BMI reflected a poor nutritional status, typically accompanied by a low lymphocyte count suggesting immunological suppression. All of these findings can explain why underweight patients may have a poor postoperative prognosis.…”

Section: Discussionmentioning

confidence: 99%

Multicentre study of the prognostic impact of preoperative bodyweight on long-term prognosis of hepatocellular carcinoma

Shen

Chen

et al. 2019

Journal of British Surgery

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Section: Discussionmentioning

confidence: 99%

Multicentre study of the prognostic impact of preoperative bodyweight on long-term prognosis of hepatocellular carcinoma

Shen

Chen

et al. 2019

Journal of British Surgery

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“…Recently, immuno-nutritional status has been reported to be associated with outcomes in patients with HCC [12][13][14]. The controlling nutritional status (CONUT) score has been developed as an objective assessment tool of nutritional status [15].…”

Section: Introductionmentioning

confidence: 99%

Controlling Nutritional Status (CONUT) Score is Associated with Overall Survival in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib: A Multicenter Cohort Study

et al. 2020

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We aimed to investigate the impact of the controlling nutritional status (CONUT) score, an immuno-nutritional biomarker, on the prognosis of patients with hepatocellular carcinoma (HCC) treated with lenvatinib (LEN). This retrospective study enrolled 164 patients with HCC and treated with LEN (median age 73 years, Barcelona Clinic Liver Cancer (BCLC) stage B/C 93/71). Factors associated with overall survival (OS) were evaluated using multivariate and decision tree analyses. OS was calculated using the Kaplan–Meier method and analyzed using the log–rank test. Independent factors for OS were albumin–bilirubin grade 1, BCLC stage B, and CONUT score <5 (hazard ratio (HR) 2.9, 95% confidence interval (CI) 1.58–5.31, p < 0.001). The CONUT score was the most important variable for OS, with OS rates of 70.0% and 29.0% in the low and high CONUT groups, respectively. Additionally, the median survival time was longer in the low CONUT group than in the high CONUT group (median survival time not reached vs. 11.3 months, p < 0.001). The CONUT score was the most important prognostic variable, rather than albumin–bilirubin grade and BCLC stage, in patients with HCC treated with LEN. Accordingly, immuno-nutritional status may be an important factor in the management of patients with HCC treated with LEN.

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“…However, some previous studies indicated that BMI and GPS could not be appropriate prognostic factors for HCC patients [5,6]. Noteworthily, indictors correlated with malnutrition and inflammation have been proven to be a reliable prognostic factors [7][8][9][10][11][12]. Nutritional status plays an important role on patients recovery from hepatectomy [13].…”

Section: Introductionmentioning

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

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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.

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Prognostic value of combined preoperative prognostic nutritional index and body mass index in HCC after hepatectomy

Abstract: preoperative PNI/BMI is an independent predictor of outcome for HCC patients, especially in patients with early stage HCC. Intriguingly, the PNI + BMI combination can enhance the accuracy of prognosis.

Cited by 53 publications

References 25 publications

Multicentre study of the prognostic impact of preoperative bodyweight on long-term prognosis of hepatocellular carcinoma

Multicentre study of the prognostic impact of preoperative bodyweight on long-term prognosis of hepatocellular carcinoma

Controlling Nutritional Status (CONUT) Score is Associated with Overall Survival in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib: A Multicenter Cohort Study

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

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