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Prognostic Value of Preoperative Prognostic Nutritional Index and Body Mass Index Combination in Patients with Unresectable Hepatocellular Carcinoma After Transarterial Chemoembolization

Authors Li S, Guo JH, Lu J, Wang C, Wang H

Received 7 November 2020

Accepted for publication 26 January 2021

Published 17 February 2021 Volume 2021:13 Pages 1637—1650

DOI https://doi.org/10.2147/CMAR.S290983

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Sanjeev Srivastava


Shengwei Li, Jin-He Guo, Jian Lu, Chao Wang, Hao Wang

Department of Interventional Radiology, Zhongda Hospital, Southeast University, Nanjing, 210009, People’s Republic of China

Correspondence: Jin-He Guo
Department of Interventional Radiology, Zhongda Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, People’s Republic of China
Tel +86 18551850103
Email jinheguo@sina.com

Background: The aim of our study was to validate the value of combined preoperative prognostic nutritional index and body mass index in predicting overall survival (OS) and progression-free survival (PFS) in patients who underwent treatment of transarterial chemoembolization.
Methods: A single-centered retrospective study of 285 unresectable HCC patients who received treatment of transarterial chemoembolization from January 2013 to June 2015 was conducted. In our retrospective analysis, preoperative PNI and BMI data of patients were calculated and analyzed. The data of patient demographic, clinical, pathological and hematological characteristics were also systematically acquired and analyzed.
Results: Low PNI was correlated with cirrhosis, AFP ≥ 200 mg/L, Child-Pugh class B, ALT and AST ≥ 40 IU/L, TBIL≥ 21μmol/L, vascular invasion, tumor size ≥ 5 cm BCLC A/B and TNM III–IV stages (all p < 0.05). Likewise, low BMI was related to AFP ≥ 200 mg/L, Child-Pugh class B, AST ≥ 40IU/L, tumor size ≥ 5 cm, vascular invasion, BCLC C and TNM III–IV stages (all p < 0.05). In our multivariate analysis, AFP levels, tumor size, PNI and BMI were identified as independent predictive factors for OS and PFS of patients (all p < 0.05). Prominently, low PNI combined with low BMI adversely affected the overall survival and disease-free survival and the combination of PNI-BMI scores was proved to be the superior distinguished capacity compared with PNI or BMI alone because of higher area under the curve.
Conclusion: Preoperative PNI and BMI are independent predictors for prognosis in intermediate or advanced hepatocellular carcinoma patients after transarterial chemoembolization treatment. The PNI and BMI combination can promote the accuracy of prognostic prediction for patients with HCC compared with single score.

Keywords: prognostic nutritional index, body mass index, hepatocellular carcinoma, transarterial chemoembolization, prognosis

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