Abstract
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.
Acknowledgments
All authors mentioned made a significant contribution to this study, whether that was in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Abbreviation
HCC, hepatocellular carcinoma; PNI, prognostic nutritional index; BMI, body mass index; TACE, transarterial chemoembolization.
Ethics Approval and Data Confidential Statement
Due to the retrospective nature of our study, patient informed consent was waived. This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (IRB) of the Zhong-Da Hospital, Southeast University. All patient data and personal information in our study will be confidential. When the results of our study are published, no information about patients will be disclosed. Our study complied with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Disclosure
The authors state that there is no conflict of interest.