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. 2024 Apr 1;15(4):e00678.
doi: 10.14309/ctg.0000000000000678.

Prognostic Nutritional Index as a Prognostic Factor for Very Early-Stage Hepatocellular Carcinoma

Chun-Ting Ho  1   2 , Elise Chia-Hui Tan  3 , Pei-Chang Lee  2   4 , Chi-Jen Chu  2   4 , Yi-Hsiang Huang  2   5   6 , Teh-Ia Huo  7 , Ming-Chih Hou  2   4 , Jaw-Ching Wu  6 , Chien-Wei Su  1   2   4   6
Affiliations

Prognostic Nutritional Index as a Prognostic Factor for Very Early-Stage Hepatocellular Carcinoma

Chun-Ting Ho et al. Clin Transl Gastroenterol. .

Abstract

Introduction: Field factors play more important roles in predicting the outcomes of patients compared with tumor factors in early-stage hepatocellular carcinoma (HCC). However, the prognostic ability of noninvasive serum marker scores for hepatic fibrosis and liver functional reserve on very early-stage HCC is still not yet determined. We aimed to investigate the performance of these serum marker scores in predicting the prognoses of patients with very early-stage HCC.

Methods: A total of 446 patients with very early-stage HCC from 2012 to 2022 were retrospectively enrolled. Serum biomarkers and prognostic scores determining overall survival (OS) were analyzed by Cox proportional hazards model. We compared the Akaike information criterion among the prognostic nutritional index (PNI), aspartate aminotransferase-to-platelet ratio index, albumin-bilirubin (ALBI) score, EZ (easy)-ALBI score, modified ALBI score, fibrosis-4 score, and lymphocyte-to-monocyte ratio to determine the predictability on the OS.

Results: After a median follow-up of 41.0 months (interquartile range 36.9-45.1 months), 81 patients died, with a 5-year OS rate of 71.0%. Among the noninvasive serum marker scores, PNI had the best performance in predicting the OS with the lowest Akaike information criterion (846.407) compared with other scores. Moreover, we stratified the patients into high-risk (PNI <45) and low-risk (PNI ≥45) groups. It showed that the 5-year OS rates were 83.4% and 60.8% in the low-risk and high-risk PNI groups, respectively ( P < 0.001).

Discussion: PNI had the best performance in predicting the OS for patients with very early-stage HCC.

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Conflict of interest statement

Guarantor of the article: Chien-Wei Su, MD, PhD.

Specific author contributions: C.-T.H.: contributed to data collecting and interpreting and manuscript drafting. E.C.-H.T.: contributed to study planning and data interpreting. P.-C.L.: contributed to data collecting. C.-J.C., Y.-H.H., T.-I.H., M.-C.H., and J.-C.W.: contributed to study planning. C.-W.S.: contributed to contributed to study conducting, data interpreting, and manuscript drafting. All authors approved the final version of the article, including the authorship list.

Financial support: This work was supported by grants from the National Science and Technology Council of Taiwan (MOST 111-2314-B-075-056, NSTC 112-2314-B-075-043-MY2) and Taipei Veterans General Hospital (V112C-039, Center of Excellence for Cancer Research MOHW112-TDU-B-221-124007, and Big Data Center), Y.L. Lin Hung Tai Education Foundation, and Yin Shu-Tien Foundation Taipei Veterans General Hospital-National Yang Ming Chiao Tung University Excellent Physician Scientists Cultivation Program (No. 112-V-B-073). The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Potential conflicts of interests: There are no potential conflicts of financial and nonfinancial interests in the study. C.-W.S.: Speakers' bureau: Gilead Sciences, Bristol-Myers Squibb, AbbVie, Bayer, and Roche. Advisory arrangements: Gilead Sciences. Grants: Bristol- Myers Squibb and Eiger.

Previous presentation: A part of this study was presented as a poster exhibition at the annual meeting of the American Association for the Study of the Liver; November 10–14, 2023; Boston, Massachusetts.

Figures

Figure 1.
Figure 1.
Study flowchart. BCLC, Barcelona Clinic Liver Cancer; HCC, hepatocellular carcinoma; PNI, prognostic nutritional index.
Figure 2.
Figure 2.
Comparison of OS between high PNI group and low PNI group. OS, overall survival; PNI, prognostic nutritional index.
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References

    1. Sung H, Ferlay J, Siegel RL, et al. . Global cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71(3):209–49. - PubMed
    1. McGlynn KA, Petrick JL, El-Serag HB. Epidemiology of hepatocellular carcinoma. Hepatology 2021;73(Suppl 1):4–13. - PMC - PubMed
    1. Reig M, Forner A, Rimola J, et al. . BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. J Hepatol 2022;76(3):681–93. - PMC - PubMed
    1. Villanueva A. Hepatocellular carcinoma. N Engl J Med 2019;380(15):1450–62. - PubMed
    1. Chang CY, Wei CY, Chen PH, et al. . The role of albumin-bilirubin grade in determining the outcomes of patients with very early-stage hepatocellular carcinoma. J Chin Med Assoc 2021;84(2):136–43. - PubMed

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