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

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. PubMed, EMBASE, Web...

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Bibliographic Details
Published in:PloS one 2018-10, Vol.13 (10), p.e0202987-e0202987
Main Authors: Wang, Zhiling, Wang, Jie, Wang, Peijun
Format: Article
Language:English
Subjects:
Analysis
Biology and Life Sciences
Cancer patients
Carcinoma, Hepatocellular - diagnosis
Carcinoma, Hepatocellular - physiopathology
Children & youth
Cirrhosis
Confidence intervals
Disease-Free Survival
Female
Fibrosis - diagnosis
Fibrosis - physiopathology
Food and nutrition
Health aspects
Hepatectomy
Hepatitis
Hepatocellular carcinoma
Hepatology
Hospitals
Humans
Inflammation
Liver cancer
Liver cirrhosis
Liver Neoplasms - diagnosis
Liver Neoplasms - physiopathology
Lymphocytes
Male
Medical ethics
Medical prognosis
Medicine and Health Sciences
Meta-analysis
Metastasis
Neoplasm Metastasis
Neoplasm Staging
Nutrition
Nutrition Assessment
Nutritional requirements
Observational studies
Patients
Physical Sciences
Prognosis
Research and Analysis Methods
Science Policy
Studies
Surgery
Survival
Tumors
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Summary: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. 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. 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. PNI is an independent predictive indicator of survival and associated with serum AFP, tumor recurrence, tumor size and TNM stages in HCC patients.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0202987