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Postoperative Prognostic Nutritional Index Predicts Survival of Patients with Hepatocellular Carcinoma within Milan Criteria and Hypersplenism

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

To investigate the predictable value of postprognostic nutritional index (PNI) for patients who are suffering hepatocellular carcinoma (HCC) within Milan criteria and hypersplenism with well-preserved liver function after curative resection.

Methods

Patients were divided into two groups: group A (postoperative PNI < 53.05, n = 280) and group B (postoperative PNI ≥ 53.05, n = 109), according to cutoff value of receiver-operating characteristic curve. Clinical data, overall survival (OS), and disease-free survival (DFS) were statistically compared between the two groups, and a multivariate analysis was used to identify prognostic factors.

Results

The 1-, 3-, 5-, 7-, and 9-year OS of patients in group A were 93.3, 74.2, 53.6, 39.6, and 33.0%, respectively, and 98.9, 89.5, 79.7, 63.9, and 63.9%, respectively, for patients in group B (P = 0.001). The corresponding 1-, 3-, 5-, 7-, and 9-year DFS was 74.1, 51.1, 41.5, 30.1, 24.0, and 83.8, 64.6, 79.7, 54.0, and 49.9% for patients in the two groups, respectively (P = 0.009). Multivariable analysis revealed postoperative PNI as independent predictors of OS (P = 0.004) and DFS (P = 0.007) in patients with HCC within Milan criteria and hypersplenism after liver resection.

Conclusions

Postoperative PNI, not preoperative PNI, could predict survival of patients with HCC within Milan criteria and hypersplenism after surgical resection.

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Authors and Affiliations

  1. Department of Liver Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, Guoxuexiang 37, Chengdu, Sichuan Province, 610041, China

    Xiaoyun Zhang, Chuan Li, Tianfu Wen, Wei Peng, Lunan Yan & Jiayin Yang

Authors
  1. Xiaoyun Zhang
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  2. Chuan Li
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  3. Tianfu Wen
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  4. Wei Peng
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  5. Lunan Yan
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  6. Jiayin Yang
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Contributions

Conception: Zhang XY and Wen TF. Acquisition of data: Zhang XY, Li C, and Pen W. Analysis of data: all authors. Writing: Zhang XY. Critical revision: all authors. Final approval: all authors.

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Correspondence to Tianfu Wen.

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The authors declare that they have no conflict of interest.

Financial Support

This work was in part supported by grant from the Scientific and Technological Support Project of Sichuan Province 2016SZ0025 and 2015SZ0049.

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Zhang, X., Li, C., Wen, T. et al. Postoperative Prognostic Nutritional Index Predicts Survival of Patients with Hepatocellular Carcinoma within Milan Criteria and Hypersplenism. J Gastrointest Surg 21, 1626–1634 (2017). https://doi.org/10.1007/s11605-017-3414-1

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  • DOI: https://doi.org/10.1007/s11605-017-3414-1

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