The prognostic value of prognostic nutritional index in hepatocellular carcinoma patients: A meta-analysis of observational studies.

PLoS One

General Surgery, Affiliated Tumor Hospital of Zhengzhou University, Henan Provincial Cancer Hospital, Zhengzhou, Henan Province, China.

Published: March 2019

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Article Abstract

Background And Aims: The clinical value of the prognostic nutritional index (PNI) in hepatocellular carcinoma (HCC) has been investigated in previous studies, but the results remain controversial. Here we present a meta-analysis to systematically review the association between PNI and HCC prognosis.

Method: PubMed, EMBASE, Web of Science databases were systematically searched to identify relevant studies. Data were abstracted independently by two reviewers. A meta-analysis was performed to determine the prognostic and clinic-pathological values of PNI in HCC patients. Odds ratios (ORs) and 95% confidence intervals (CIs) were extracted to estimate the association of PNI with survival and clinic-pathological characteristics, respectively.

Results: A total of eleven studies involving 3165 patients were analyzed. The pooled results indicated that low PNI is a significant predictor of poor 1-year, 3-year, 5-year OS (OR, 2.91, 4.05, 3.65; 95%CI, 2.30 to 3.70, 3.27 to 5.03,2.96-4.50; P = 0.14,0.22,0.11 respectively) and disease-free survival (DFS) (OR,2.35, 2.57, 2.75; 95%CI, 1.71 to 3.23, 1.89 to 3.49,2.01 to 3.75; P = 0.39,0.04,0.11, respectively). Moreover, PNI is significantly associated with serum AFP, tumor recurrence, tumor size and TNM stages in HCC patients. However, PNI is not significantly associated with tumor number and the incidence of cirrhosis in HCC patients.

Conclusions: PNI is an independent predictive indicator of survival and associated with serum AFP, tumor recurrence, tumor size and TNM stages in HCC patients.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6185720PMC
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202987PLOS

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