The preoperative nutritional and inflammatory indexs as prognostic factors in patients with early-stage resectable extrahepatic bile duct cancer

Abstract

Background Cancer - associated malnutrition and systemic inflammation have been shown to be strongly linked with poor prognosis in various cancers. The aim of this study was to investigate the prognostic values of the prognostic nutritional index (PNI), nutritional risk index (NRI), advanced lung cancer inflammation index (ALI), and systemic immune-inflammation index (SII) in patients with early-stage resectable extrahepatic bile duct cancer (BDC). Methods A total of 155 early-stage resectable extrahepatic BDC were recruited for this retrospective study. Kaplan-Meier and Cox regression analyses were used to evaluate the prognostic power of preoperative PNI, NRI, ALI, and SII in patients with early-stage extrahepatic BDC. Nomogram was developed based on the results of multivariate Cox analyses and were then validated and calibrated. Results Receiver operating characteristic curve (ROC) analysis identified the optimal cut-off points for PNI, NRI, ALI, and SII were 48.7, 100.5, 49.9, and 659.8. Low PNI, NRI, ALI, and high SII were related to TNM stage (P < 0.05). Kaplan-Meier analysis showed that low PNI, NRI, ALI, and high SII were related to poor overall survival (OS) and recurrence-free survival (RFS) of patients. Multivariate analyses indicated that lymph nodes metastasis, PNI, NRI, ALI, and SII were significant independent factors for OS and RFS. Nomograms were developed to predict OS and RFS for patients with early-stage resectable extrahepatic BDC. Conclusion Preoperative PNI, NRI, ALI, and SII could be used as prospective noninvasive prognostic biomarkers for patients with early-stage resectable extrahepatic BDC.