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Prognostic Nutritional Index (PNI) Predicts Tumor Recurrence of Very Early/Early Stage Hepatocellular Carcinoma After Surgical Resection

  • Hepatobiliary Tumors
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Abstract

Background

Approximately one-quarter of patients with Barcelona Clinic Liver Cancer (BCLC) stage 0/A hepatocellular carcinoma (HCC) suffer from tumor relapse within the first year after surgical resection. Little data is available for inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI), in predicting the clinical outcome of patients with very early/early stage HCC who underwent curative surgery.

Methods

A retrospective cohort study of 324 patients with BCLC stage 0/A primary HCC undergoing surgical resection was conducted to investigate the prognostic impacts of NLR, PLR, and PNI.

Results

The low-PNI group (<45) had an adverse overall survival (1-year survival rate of 92 vs. 97 %; 5-year survival rate of 57 vs. 82 %; p < 0.001) and disease-free survival (1-year survival rate of 69 vs. 85 %; 5-year survival rate of 39 vs. 63 %; p < 0.001). It was an independent predictor for disease-specific death, and early and late tumor relapses, with hazard ratios of 2.78 (p < 0.001), 1.82 (p = 0.011), and 2.55 (p = 0.013), respectively. Neither NLR nor PLR had any prognostic significance.

Conclusions

The PNI is a significant prognostic factor for OS and DFS of patients with very early/early stage HCC receiving curative surgery.

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Disclosure

Grace L.H. Wong has served as an advisory committee member for Otsuka and Gilead, and has also served as a speaker for Bristol-Myers Squibb, Echosens, Furui and Otsuka. Vincent W.S. Wong has served as an advisory committee member for Roche, Novartis, Gilead, and Otsuka, and has also served as a speaker for Bristol-Myers Squibb, Roche, Novartis, Abbott Diagnostics, and Echosens. Henry L.Y. Chan is an advisor for Abbvie, Abivax, Bristol-Myers Squibb, Gilead, Merck, Novartis, and Roche, and has received honorarium for lectures from Abbvie, Bristol-Myers Squibb, Echosens, Gilead, GlaxoSmithKline, Merck, Novartis, and Roche. He has also received an unrestricted grant from Roche for hepatitis B research. Anthony W.H. Chan, Stephen L. Chan, Charing C.N. Chong, Paul B.S. Lai and Ka-Fai To have no conflicts of interest to declare that are directly relevant to the content of this study.

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Correspondence to Ka-Fai To FRCPA.

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Chan, A.W.H., Chan, S.L., Wong, G.L.H. et al. Prognostic Nutritional Index (PNI) Predicts Tumor Recurrence of Very Early/Early Stage Hepatocellular Carcinoma After Surgical Resection. Ann Surg Oncol 22, 4138–4148 (2015). https://doi.org/10.1245/s10434-015-4516-1

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  • DOI: https://doi.org/10.1245/s10434-015-4516-1

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