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- Title
Comprehensive nutritional index for predicting overall survival in hepatocellular carcinoma patients after multiple transarterial chemoembolization.
- Authors
Deng, Jun; He, Jing-Jing; Xie, Lu-Ping; Zheng, Qi-Wen; Wu, Shui-Li; Shao, Hong-Yan
- Abstract
<bold>Background and Objectives: </bold>Little is known about nutritional status in patients with hepatocellular carcinoma (HCC) after multiple rounds of transarterial chemoembolization (TACE). We established a comprehensive nutritional index (CNI) and evaluated its prognostic value for overall survival (OS) and time to progression (TTP).<bold>Methods and Study Design: </bold>HCC patients (N=282) who underwent multiple TACE treatments were enrolled. CNI was established by principal component analysis based on body mass index, usual body weight percentage, hemoglobin, total lymphocyte count, and albumin; the cutoff value was determined by receiver operating characteristic curve and Youden index analysis. The correlation between CNI and treatment-related complications was analyzed with Spearman's method. The Kaplan-Meier method with log-rank test and Cox proportional hazards model were used to compare the prognostic values of CNI, prognostic nutritional index (PNI), and nutrition risk index (NRI) for OS and TTP.<bold>Results: </bold>Nutritional status declined after repeated TACE (p<0.001). CNI (cutoff= 0.251) varied according to albumin-bilirubin grade, tumor size, and number of TACE treatments (p<0.001 or 0.025) and was negatively correlated with rate of serious complications (r=-0.185, p=0.002). Patients with low CNI had shorter OS (p=0.014) and TTP (p=0.007); high CNI predicted longer OS (hazard ratio [HR], 0.72; 95% confidence interval [CI]: 0.52-1.00, p=0.048) and TTP (HR, 0.69; 95% CI: 0.50-0.94, p=0.019). Post-treatment PNI and NRI were unrelated to prognosis (p>0.05).<bold>Conclusions: </bold>HCC patients have poor nutritional status after multiple TACE treatments, which predicts shorter OS and TTP. The prognostic performance of CNI is superior to those of PNI and NRI.
- Subjects
LIVER tumors; NUTRITIONAL assessment; CHEMOEMBOLIZATION; RETROSPECTIVE studies; PROGNOSIS; TREATMENT effectiveness; HEPATOCELLULAR carcinoma
- Publication
Asia Pacific Journal of Clinical Nutrition, 2021, Vol 30, Issue 1, p7
- ISSN
0964-7058
- Publication type
journal article
- DOI
10.6133/apjcn.202103_30(1).0002