Preoperative Prognostic Nutritional Index as Independent Predictor of Overall Survival on Hepatocellular Carcinoma after Liver Transplantation

170 Background: The Milan criteria are utilized to predict outcomes in patients with hepatocellular carcinoma (HCC) who undergo liver transplantation (LT). Though the survival of these patients has significantly improved since the adoption of these criteria, the risk of recurrence after LT is as high as 20 percent. One limitation of the Milan criteria is the lack of any estimation of tumor biology. The neutrophil-lymphocyte ratio (NLR) has been proposed as a peripheral surrogate for tumor biology. The predictive power of the NLR has been demonstrated for several solid tumors, and early evidence points to a role in HCC. We hypothesize that the NLR is predictive of overall survival and recurrence-free survival in patients with HCC who undergo LT. Methods: This is a retrospective analysis of adult patients undergoing LT for HCC between 2000 and 2008 at our institution. We defined an elevated NLR as a ratio of five or greater. Results: We identified 160 patients who underwent LT for HCC, 28 of whom had an elevated NLR. Seventeen subjects experienced recurrent HCC during the study period. The cumulative survival for subjects with an elevated NLR (1-year cumulative survival 70% ± 0.08, 3-year cumulative survival 48% ± 0.09, 5-year cumulative survival 38% ± 0.11) was significantly lower than for subjects with a normal NLR (1-year survival 80% ± 0.04, 3-year survival 75% ± 0.04, 5-year survival 68% ± 0.06). On univariate analysis, seven factors (including an elevated NLR) predicted decreased overall and recurrence-free survival. However, after multivariate analysis, only three factors (including elevated NLR) remained significant as predictors of overall survival. Additionally, multivariate analysis revealed that an elevated NLR was the only significant independent predictor of recurrence-free survival. Conclusions: Preoperative NLR is a powerful independent predictor of overall survival and recurrence-free survival in patients undergoing LT for HCC. Measurement of NLR could serve as a useful and easily obtained adjunct to the MELD score and Milan criteria when evaluating this patient population and determining which patients will gain the most survival benefit from transplant. No significant financial relationships to disclose.

Download Full-text

The importance of the glucose-to-lymphocyte ratio in patients with hepatocellular carcinoma treated with sorafenib

Future Oncology ◽

10.2217/fon-2021-0457 ◽

2021 ◽

Author(s):

Ali Yılmaz ◽

Melih Şimşek ◽

Zekeriya Hannarici ◽

Mehmet E Büyükbayram ◽

Mehmet Bilici ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Prognostic Nutritional Index ◽

Neutrophil To Lymphocyte Ratio ◽

Advanced Hcc ◽

Lymphocyte Ratio ◽

Lymphocyte To Monocyte Ratio ◽

Nutritional Index ◽

Before And After ◽

Immune Inflammation

Aim: To show the prognostic significance of the glucose-to-lymphocyte ratio (GLR) in hepatocellular carcinoma (HCC). Patients & methods: A total of 150 patients with advanced HCC who were treated with sorafenib in our center between January 2011 and December 2019 were included in the study retrospectively. Neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, prognostic nutritional index and GLR were analyzed to assess their prognostic value using Kaplan–Meier and Cox regression analysis before and after propensity score matching (PSM). Results: In univariate analysis before and after PSM, albumin–bilirubin grade, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, lymphocyte-to-monocyte ratio, prognostic nutritional index, AFP level and GLR were found to be significantly associated with both progression-free and overall survival. In multivariate analysis before and after PSM, GLR, albumin–bilirubin grade and AFP were determined to be independent prognostic factors for progression-free and overall survival. Conclusion: The GLR prior to sorafenib treatment is a new prognostic biomarker that may predict survival in advanced HCC.

Download Full-text

The Association between the Preoperative Prognostic Nutritional Index and the Controlling Nutritional Status Score on Tumor Stage, Chemotherapeutic Response and Overall Survival in Ovarian Cancer

Nutrition and Cancer ◽

10.1080/01635581.2021.2022170 ◽

2022 ◽

pp. 1-10

Author(s):

Sema Karakaş ◽

Gökhan Demirayak ◽

Ayşe Büşra Önder ◽

İsa Aykut Özdemir ◽

Cihan Comba ◽

...

Keyword(s):

Ovarian Cancer ◽

Overall Survival ◽

Nutritional Status ◽

Prognostic Nutritional Index ◽

Tumor Stage ◽

Nutritional Index ◽

Status Score ◽

Chemotherapeutic Response

Download Full-text

Pretreatment low prognostic nutritional index and low albumin–globulin ratio are predictive for overall survival in nasopharyngeal cancer

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-019-05595-2 ◽

2019 ◽

Vol 276 (11) ◽

pp. 3221-3230 ◽

Cited By ~ 9

Author(s):

Mete Gundog ◽

Hatice Basaran

Keyword(s):

Overall Survival ◽

Nasopharyngeal Cancer ◽

Prognostic Nutritional Index ◽

Nutritional Index

Download Full-text

Onodera’s prognostic nutritional index is a strong prognostic indicator for patients with hepatocellular carcinoma after initial hepatectomy, especially patients with preserved liver function

BMC Surgery ◽

10.1186/s12893-020-00917-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Akihiro Tanemura ◽

Shugo Mizuno ◽

Aoi Hayasaki ◽

Kazuyuki Gyoten ◽

Takehiro Fujii ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Prognostic Factors ◽

Prognostic Factor ◽

Liver Function ◽

Prognostic Nutritional Index ◽

Independent Prognostic Factor ◽

Related Factors ◽

Impaired Liver Function ◽

Nutritional Index ◽

Initial Hepatectomy

Abstract Background Several inflammation-based scores are used to assess the surgical outcomes of hepatocellular carcinoma (HCC). The aim of the present study was to elucidate the prognostic value of the prognostic nutritional index (PNI) in HCC patients who underwent hepatectomy with special attention to preoperative liver functional reserve. Methods Preoperative demographic and tumor-related factors were analyzed in 189 patients with HCC undergoing initial hepatectomy from August 2005 to May 2016 to identify significant prognostic factors. Results Multivariate analysis for overall survival (OS) revealed that female sex (p = 0.005), tumor size (p < 0.001) and PNI (p = 0.001) were independent prognostic factors. Compared to the High PNI group (PNI ≥ 37, n = 172), the Low PNI group (PNI < 37, n = 17) had impaired liver function and significantly poorer OS (13% vs. 67% in 5-year OS, p = 0.001) and recurrence-free survival (RFS) (8 vs. 25 months in median PFS time, p = 0.002). In the subgroup of patients with a preserved liver function of LHL15 ≥ 0.9, PNI was also independent prognostic factor, and OS (21% vs. 70% in 5-year OS, p = 0.008) and RFS (8 vs. 28 months in median PFS time, p = 0.018) were significantly poorer in the Low PNI group than the High PNI group. Conclusions PNI was an independent prognostic factor for HCC patients who underwent hepatectomy. Patients with PNI lower than 37 were at high risk for early recurrence and poor patient survival, especially in the patients with preserved liver function of LHL ≥ 0.9.

Download Full-text

Prognostic value of pretreatment prognostic nutritional index in non-small cell lung cancer: A systematic review and meta-analysis

The International Journal of Biological Markers ◽

10.1177/1724600818799876 ◽

2018 ◽

Vol 33 (4) ◽

pp. 372-378 ◽

Cited By ~ 12

Author(s):

Yuanyuan Hu ◽

Jie Shen ◽

RuiKe Liu ◽

ZhiMei Feng ◽

ChangNing Zhang ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Biomarker ◽

Meta Analysis ◽

Disease Free Survival ◽

Prognostic Nutritional Index ◽

Progression Free Survival ◽

Free Survival ◽

Nutritional Index ◽

Nsclc Patients ◽

Disease Free

Background: The pretreatment prognostic nutritional index has been considered a potential prognostic biomarker in patients with non-small cell lung cancer (NSCLC), but this remains controversial. Therefore, we performed a meta-analysis to systematically assess the prognostic value of the prognostic nutritional index in patients with NSCLC. Methods: We systematically searched PubMed, EMBASE, Web of Science, and CNKI. The hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs) were used to evaluate the link between the prognostic nutritional index and the oncological outcomes of patients with NSCLC, including overall survival, disease-free survival/recurrence-free survival, and progression-free survival. Results: Fifteen studies were included in this meta-analysis. Twelve of these studies explored the association between the prognostic nutritional index and the overall survival of patients with NSCLC. Our pooled analysis indicated that a low prognostic nutritional index was significantly related to adverse overall survival (HR 1.61; 95% CI 1.44, 1.81; P < 0.001). Our results also showed that the prognostic nutritional index was a negative predictor for disease-free survival/recurrence-free survival, and progression-free survival in patients with NSCLC. Conclusion: Our meta-analysis demonstrated that there was a close association between the prognostic nutritional index value and prognosis in NSCLC patients and that the prognostic nutritional index may act as a useful prognostic biomarker in NSCLC patients.

Download Full-text