Comparison of the Value of Multiple Preoperative Objective Nutritional Indices for the Evaluation of Prognosis after Hepatectomy for Hepatocellular Carcinoma

Abstract

Objective:

To investigate the impact of preoperative objective nutritional indices on the prognosis of patients with hepatocellular carcinoma (HCC) who underwent radical hepatectomy and to compare their predictive value for prognosis.

Methods:

The clinical data of 661 patients were retrospectively reviewed to analyze the risk factors associated with prognosis; explore the role of the prognostic nutritional index (PNI), nutritional risk index (NRI), and control nutritional status (CONUT) in HCC prognosis; and compare their predictive value.

Results:

Several independent risk factors for overall survival (OS) were identified, including neutrophil count, prealbumin level, microvascular invasion (MVI), Barcelona Clinic Liver Cancer (BCLC) stage, and PNI. The following factors were confirmed to be associated with recurrence-free survival (RFS): alpha-fetoprotein (AFP) level, prothrombin time (PT), tumor size, tumor capsule, MVI, BCLC stage, and PNI. Compared with the corresponding subgroups, patients in the high PNI (>45) group and the high NRI (>100) group had better RFS and OS (P < 0.05). However, patients in the low CONUT score (≤3) group had a similar prognosis to patients in the high CONUT (>3) group (P = 0.050). Receiver operating characteristic (ROC) curve results showed that the area under the curve (AUC) of the PNI was significantly higher than that of the CONUT for RFS or OS but similar to that of the NRI.

Conclusions:

The predictive ability of the PNI for HCC prognosis was significantly better than that of the CONUT but similar to that of the NRI.

Disclosure Statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

Guangxi Medical University Young Science Foundation (GXMUYSF 202117); Guangxi Natural Science Foundation (2018JJA140312); Guangxi Medical and Health Appropriate Technology Development and Promotion Application Project (S201302-1)