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

Yusuke Iizawa¹  Hiroyuki Kato¹  Kazuyuki Gyoten¹  Hiroyuki Sakurai¹  Takehiro Fujii¹  Yasuhiro Murata¹  Akihiro Tanemura¹  Aoi Hayasaki¹  Naohisa Kuriyama¹  Shugo Mizuno¹  Masashi Kishiwada¹  Shuji Isaji² 

[1] Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, 514-0001, Tsu, Mie, Japan;Mie University Hospital, 2-174 Edobashi, 514-0001, Tsu, Mie, Japan;

关键词: Hepatocellular carcinoma;    PNI;    Hepatectomy;    Liver functional reserve;    Technetium-99 m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin (99mTc-GSA) liver scintigraphy;    LHL15;    NLR;    PLR;    ALBI grade;    GPS;   

DOI  :  10.1186/s12893-020-00917-2

来源: Springer

【 摘 要 】

BackgroundSeveral 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.MethodsPreoperative 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.ResultsMultivariate 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.ConclusionsPNI 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.

【 授权许可】

CC BY