The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib.
BACKGROUND AND AIMS:The present study aims to investigate the role of the prognostic nutritional index (PNI) on survival in patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib. METHODS:This multicentric study included a training cohort of 194 HCC patients and three external...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0232449 |
| _version_ | 1819016984047648768 |
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| author | Francesco Caputo Vincenzo Dadduzio Francesco Tovoli Giulia Bertolini Giuseppe Cabibbo Krisida Cerma Caterina Vivaldi Luca Faloppi Mario Domenico Rizzato Fabio Piscaglia Ciro Celsa Lorenzo Fornaro Giorgia Marisi Fabio Conti Nicola Silvestris Marianna Silletta Sara Lonardi Alessandro Granito Caterina Stornello Valentina Massa Giorgio Astara Sabina Delcuratolo Stefano Cascinu Mario Scartozzi Andrea Casadei-Gardini |
| author_facet | Francesco Caputo Vincenzo Dadduzio Francesco Tovoli Giulia Bertolini Giuseppe Cabibbo Krisida Cerma Caterina Vivaldi Luca Faloppi Mario Domenico Rizzato Fabio Piscaglia Ciro Celsa Lorenzo Fornaro Giorgia Marisi Fabio Conti Nicola Silvestris Marianna Silletta Sara Lonardi Alessandro Granito Caterina Stornello Valentina Massa Giorgio Astara Sabina Delcuratolo Stefano Cascinu Mario Scartozzi Andrea Casadei-Gardini |
| author_sort | Francesco Caputo |
| collection | DOAJ |
| description | BACKGROUND AND AIMS:The present study aims to investigate the role of the prognostic nutritional index (PNI) on survival in patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib. METHODS:This multicentric study included a training cohort of 194 HCC patients and three external validation cohorts of 129, 76 and 265 HCC patients treated with Sorafenib, respectively. The PNI was calculated as follows: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3). Univariate and multivariate analyses were performed to investigate the association between the covariates and the overall survival (OS). RESULTS:A PNI cut-off value of 31.3 was established using the ROC analysis. In the training cohort, the median OS was 14.8 months (95% CI 12-76.3) and 6.8 months (95% CI 2.7-24.6) for patients with a high (>31.3) and low (<31.3) PNI, respectively. At both the univariate and the multivariate analysis, low PNI value (p = 0.0004), a 1-unit increase of aspartate aminotransferase (p = 0.0001), and age > 70 years (p< 0.0038) were independent prognostic factors for OS. By performing the same multivariate analysis of the training cohort, the PNI <31.3 versus >31.3 was found to be an independent prognostic factor for predicting OS in all the three validation cohorts. CONCLUSIONS:PNI represents a prognostic tool in advanced HCC treated with first-line Sorafenib. It is readily available and low-cost, and it could be implemented in clinical practice in patients with HCC. |
| first_indexed | 2024-12-21T02:56:18Z |
| format | Article |
| id | doaj.art-574a3b3c1a624653a2b3f7e78e7be113 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T02:56:18Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-574a3b3c1a624653a2b3f7e78e7be1132022-12-21T19:18:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01155e023244910.1371/journal.pone.0232449The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib.Francesco CaputoVincenzo DadduzioFrancesco TovoliGiulia BertoliniGiuseppe CabibboKrisida CermaCaterina VivaldiLuca FaloppiMario Domenico RizzatoFabio PiscagliaCiro CelsaLorenzo FornaroGiorgia MarisiFabio ContiNicola SilvestrisMarianna SillettaSara LonardiAlessandro GranitoCaterina StornelloValentina MassaGiorgio AstaraSabina DelcuratoloStefano CascinuMario ScartozziAndrea Casadei-GardiniBACKGROUND AND AIMS:The present study aims to investigate the role of the prognostic nutritional index (PNI) on survival in patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib. METHODS:This multicentric study included a training cohort of 194 HCC patients and three external validation cohorts of 129, 76 and 265 HCC patients treated with Sorafenib, respectively. The PNI was calculated as follows: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3). Univariate and multivariate analyses were performed to investigate the association between the covariates and the overall survival (OS). RESULTS:A PNI cut-off value of 31.3 was established using the ROC analysis. In the training cohort, the median OS was 14.8 months (95% CI 12-76.3) and 6.8 months (95% CI 2.7-24.6) for patients with a high (>31.3) and low (<31.3) PNI, respectively. At both the univariate and the multivariate analysis, low PNI value (p = 0.0004), a 1-unit increase of aspartate aminotransferase (p = 0.0001), and age > 70 years (p< 0.0038) were independent prognostic factors for OS. By performing the same multivariate analysis of the training cohort, the PNI <31.3 versus >31.3 was found to be an independent prognostic factor for predicting OS in all the three validation cohorts. CONCLUSIONS:PNI represents a prognostic tool in advanced HCC treated with first-line Sorafenib. It is readily available and low-cost, and it could be implemented in clinical practice in patients with HCC.https://doi.org/10.1371/journal.pone.0232449 |
| spellingShingle | Francesco Caputo Vincenzo Dadduzio Francesco Tovoli Giulia Bertolini Giuseppe Cabibbo Krisida Cerma Caterina Vivaldi Luca Faloppi Mario Domenico Rizzato Fabio Piscaglia Ciro Celsa Lorenzo Fornaro Giorgia Marisi Fabio Conti Nicola Silvestris Marianna Silletta Sara Lonardi Alessandro Granito Caterina Stornello Valentina Massa Giorgio Astara Sabina Delcuratolo Stefano Cascinu Mario Scartozzi Andrea Casadei-Gardini The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib. PLoS ONE |
| title | The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib. |
| title_full | The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib. |
| title_fullStr | The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib. |
| title_full_unstemmed | The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib. |
| title_short | The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib. |
| title_sort | role of pni to predict survival in advanced hepatocellular carcinoma treated with sorafenib |
| url | https://doi.org/10.1371/journal.pone.0232449 |
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