Prognostic nutritional index serves as a predicative marker of survival and associates with systemic inflammatory response in metastatic intrahepatic cholangiocarcinoma

Abstract Background Intrahepatic cholangiocarcinoma (ICC) is a malignant neoplasm with a poor prognosis. Prediction of prognosis is critical for the individualized clinical management of patients with ICC. The purpose of this study is to establish a nomogram based on the psoas muscle index (PMI) and prognostic nutritional index (PNI) to identify the high risk-patient with ICC after curative resection. Methods ICC Patients after hepatectomy in multi-hospital from August 2012 to October 2019 were enrolled. The overall survival (OS) and recurrence-free survival (RFS) rates were analyzed by Kaplan-Meier. The independent factors were identified by univariate and multivariate Cox regression analyses. A nomogram based on independent factors was established to predict ICC patient prognosis. Results 178 ICC patients were included. The OS was worst in the patients with a combination of low PMI combined low PNI (p < 0.01). PMI, PNI, lymph node metastasis and tumor differentiation were the independent prognostic risk factors; these factors were used to establish the nomogram was established by it. The calibration curve revealed that the nomogram survival probability prediction model was in good agreement with the actual observation results. The nomogram has good reliability in predicting ICC patient prognosis (OS C-index = 0.692). The area under the receiver operating characteristic curve (AUC) for the nomogram's 3-year predicted survival was 0.752. Based on the stratified by nomogram, the median survival for low-risk patients was 59.8 months, compared with 16.2 months for high-risk patients (p༜0.001). Conclusion The nomogram based on the PMI and PNI can identify patients with the highest risk of poor prognosis after curative hepatectomy. It is a good decision-making tool for individualized treatment.

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The Relationship Between 18F-FDG Uptake on PET/CT and Markers of Systemic Inflammatory Response in Patients Undergoing Surgery for Intrahepatic Cholangiocarcinoma

Anticancer Research ◽

10.21873/anticanres.13117 ◽

2018 ◽

Vol 39 (1) ◽

pp. 341-346 ◽

Cited By ~ 2

Author(s):

SATORU SEO ◽

TOMOAKI YOH ◽

KOSHIRO MORINO ◽

HIROAKI FUJI ◽

KOJIRO TAURA ◽

...

Keyword(s):

Inflammatory Response ◽

Intrahepatic Cholangiocarcinoma ◽

Systemic Inflammatory Response ◽

Fdg Uptake ◽

Pet Ct ◽

18F Fdg ◽

The Relationship

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Sa1571 THE RELATIONSHIP BETWEEN FDG UPTAKE, MARKERS OF SYSTEMIC INFLAMMATORY RESPONSE AND OUTCOME IN INTRAHEPATIC CHOLANGIOCARCINOMA

Gastroenterology ◽

10.1016/s0016-5085(20)33996-2 ◽

2020 ◽

Vol 158 (6) ◽

pp. S-1330-S-1331

Author(s):

Satoru Seo ◽

Koshiro Morino ◽

Tomoaki Yoh ◽

Ken Fukumitsu ◽

Takamichi Ishii ◽

...

Keyword(s):

Inflammatory Response ◽

Intrahepatic Cholangiocarcinoma ◽

Systemic Inflammatory Response ◽

Fdg Uptake ◽

The Relationship

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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

Frontiers in Oncology ◽

10.3389/fonc.2021.769696 ◽

2021 ◽

Vol 11 ◽

Author(s):

Qi Li ◽

Chen Chen ◽

Jian Zhang ◽

Hong Wu ◽

Yinghe Qiu ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Intrahepatic Cholangiocarcinoma ◽

Predictive Ability ◽

Prognostic Nutritional Index ◽

Radical Resection ◽

Time Dependent ◽

Cancer Antigen ◽

Nutritional Index ◽

Tertiary Hospitals

BackgroundThe preoperative nutritional status and the immunological status have been reported to be independent prognostic factors of patients with intrahepatic cholangiocarcinoma (ICC). This study aimed to investigate whether prognostic nutritional index (PNI) + albumin–bilirubin (ALBI) could be a better predictor than PNI and ALBI alone in patients with ICC after radical resection.MethodsThe prognostic prediction evaluation of the PNI, ALBI, and the PNI+ALBI grade was performed in 373 patients with ICC who underwent radical resection between 2010 and 2018 at six Chinese tertiary hospitals, and external validation was conducted in 162 patients at four other Chinese tertiary hospitals. Overall survival (OS) and relapse-free survival (RFS) were estimated using the Kaplan–Meier method. Multivariate analysis was conducted to identify independent prognostic factors. A time-dependent receiver operating characteristic (ROC) curve and a nomogram prediction model were further constructed to assess the predictive ability of PNI, ALBI, and the PNI+ALBI grade. The C-index and a calibration plot were used to assess the performance of the nomogram models.ResultsUnivariate analysis showed that PNI, ALBI, and the PNI+ALBI grade were prognostic factors for the OS and RFS of patients with ICC after radical resection in the training and testing sets (p < 0.001). Multivariate analysis showed that the PNI+ALBI grade was an independent risk factor for OS and RFS in the training and testing sets (p < 0.001). Analysis of the relationship between the PNI+ALBI grade and clinicopathological characteristics showed that the PNI+ALBI grade correlated with obstructive jaundice, alpha-fetoprotein (AFP), cancer antigen 19-9 (CA19-9), cancer antigen 125 (CA125), PNI, ALBI, Child–Pugh grade, type of resection, tumor size, major vascular invasion, microvascular invasion, T stage, and N stage (p < 0.05). The time-dependent ROC curves showed that the PNI+ALBI grade had better prognostic predictive ability than the PNI, ALBI, and the Child–Pugh grade in the training and testing sets.ConclusionPreoperative PNI+ALBI grade is an effective and practical predictor for the OS and RFS of patients with ICC after radical resection.

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343 EFFECTS OF PREOPERATIVE PNI (PROGNOSTIC NUTRITIONAL INDEX) AND POSTOPERATIVE INFLAMMATORY RESPONSE ON PROGNOSIS IN PATIENTS WITH ESOPHAGEAL CANCER

Diseases of the Esophagus ◽

10.1093/dote/doab052.343 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Yoshinori Fujiwara ◽

Masaharu Higashida ◽

Hisako Kubota ◽

Yuko Okamoto ◽

Syumei Mineta ◽

...

Keyword(s):

Esophageal Cancer ◽

Blood Loss ◽

Inflammatory Response ◽

Nutritional Status ◽

Cancer Patients ◽

Inflammatory Responses ◽

Cox Model ◽

Prognostic Nutritional Index ◽

Nutritional Index ◽

Group 3

Abstract The effects of preoperative nutritional status and postoperative inflammatory response on esophageal cancer patients on prognosis were unclear. In the present study, we evaluated the preoperative nutritional parameters and postoperative inflammatory responses and analyzed relationship between these parameters and cancer prognosis. Methods One hundred and eleven esophageal squamous cell carcinoma patients were analyzed with pathological TNM StageI-IV. Preoperative nutritional parameters: PNI (Prognostic Nutritional Index) was calculated from following formula:10 x Albumin(g/dl) +0.005 x peripheral lymphocyte counts (/mm3). Preoperative NLR (Neutrophil/Lymphocyte ratio) was defined as absolute neutrophil counts divided by the absolute lymphocyte counts. The highest CRP level was evaluated as postoperative inflammatory responses. Cut-off values of these continuous parameters were calculated by ROC, and univariate and multivariate analysis using Cox model for overall survival (OS) were examined in the parameters. Results Overall three or five years survivals were 60.9%, 56.28%, respectively. Cut-off value of PNI, CRP, NLR, Intraoperative blood loss were 44.8, 21.7 mg/dl,2.27,159 mL, respectively. High PNI group was significantly better survival than low group (3 years OS, 65.94 vs 45.82%, p < 0.05). No association between PNI and prognosis was noted for patients with pStageI, but the low PNI patients of pStageII-IV were extremely poor prognosis (p < 0.01). High CRP group was tendency to be worse survival than low group (3 years OS, 65.97 vs 38.82%, p = 0.062). The patients of low blood loss group was significantly better survival than high group (p < 0.05).NLR was not associated with OS. Cox model showed that pTNM, tumor location, and PNI were independent prognostic factors. Conclusion Preoperative nutritional status affected the prognosis of esophageal cancer patients. But, postoperative inflammatory response was not affected the prognosis of these patients. Preoperative nutritional interventions may improve the prognosis of patients with esophageal cancer.

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