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Role of the prognostic nutritional index in predicting survival in advanced hepatocellular carcinoma treated with regorafenib
Author(s) -
Rimini Margherita,
Yoo Changoon,
Lonardi Sara,
Masi Gianluca,
Piscaglia Fabio,
Kim HyungDon,
Rizzato Mario D.,
Salani Francesca,
Ielasi Luca,
Forgione Antonella,
Bang Yeonghak,
Soldà Caterina,
Catanese Silvia,
Sansone Vito,
Ryu MinHee,
Ryoo BaekYeol,
Burgio Valentina,
Cucchetti Alessandro,
Cascinu Stefano,
CasadeiGardini Andrea
Publication year - 2021
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13669
Subject(s) - regorafenib , medicine , hepatocellular carcinoma , hazard ratio , multivariate analysis , univariate analysis , oncology , confidence interval , gastroenterology , receiver operating characteristic , cohort , cancer , colorectal cancer
Abstract Aim A link has been established between malnutrition, immunological status, and hepatocellular carcinoma (HCC). The prognostic nutritional index (PNI) has been recognized as a prognostic indicator in early‐stage HCC and in patients treated with first‐line therapy. However, to date, the role of the PNI in HCC patients treated with regorafenib has not been reported. Methods We undertook a multicentric analysis on a cohort of 284 patients affected by advanced HCC treated with regorafenib. The PNI was calculated as follows: 10 × serum albumin concentration (g/dl) + 0.005 × peripheral lymphocyte count (number/mm 3 ). Univariate and multivariate analyses were used to investigate the association between PNI and survival outcomes. Results A PNI cut‐off value of 44.45 was calculated by a receiver operating characteristic analysis. The median overall survival was 12.8 and 7.8 months for patients with high (>44.45) and low (≤44.45) PNI, respectively (hazard ratio, 0.58; 95% confidence interval, 0.43–0.77; p = 0.0002). In the univariate and multivariate analyses, low PNI value and increased serum bilirubin level emerged as independent prognostic factors for overall survival. No differences were found between high and low PNI in terms of progression‐free survival ( p = 0.14). Conclusion If validated, the PNI could represent an easy‐to‐use prognostic tool able to guide the clinical decision‐making process in HCC patients treated with regorafenib.