Role of the prognostic nutritional index in predicting survival in advanced hepatocellular carcinoma treated with regorafenib
Margherita Rimini
Division of Oncology, Department of Oncology and Hematology, University Hospital Modena, Modena, Italy
Search for more papers by this authorChangoon Yoo
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorSara Lonardi
Early Phase Clinical Trial Unit, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
Search for more papers by this authorGianluca Masi
Unit of Medical Oncology, Pisa University Hospital, Pisa, Italy
Search for more papers by this authorFabio Piscaglia
Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Search for more papers by this authorHyung-Don Kim
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorMario D. Rizzato
Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
Search for more papers by this authorFrancesca Salani
Unit of Medical Oncology, Pisa University Hospital, Pisa, Italy
Search for more papers by this authorLuca Ielasi
Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorAntonella Forgione
Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorYeonghak Bang
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorCaterina Soldà
Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
Search for more papers by this authorSilvia Catanese
Unit of Medical Oncology, Pisa University Hospital, Pisa, Italy
Search for more papers by this authorVito Sansone
Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Search for more papers by this authorMin-Hee Ryu
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorBaek-Yeol Ryoo
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorValentina Burgio
Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
Search for more papers by this authorAlessandro Cucchetti
Department of Medical and Surgical Sciences-DIMEC, Alma Mater Studiorum – University of Bologna, Bologna, Italy
Department of Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy
Search for more papers by this authorStefano Cascinu
Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
Vita-Salute San Raffaele University, Milan, Italy
Search for more papers by this authorCorresponding Author
Andrea Casadei-Gardini
Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
Vita-Salute San Raffaele University, Milan, Italy
Correspondence
Andrea Casadei-Gardini, Università Vita-Salute; San Raffaele Hospital-IRCCS, via Olgettina 70 20132 Milano, Italy.
Email: [email protected]
Search for more papers by this authorMargherita Rimini
Division of Oncology, Department of Oncology and Hematology, University Hospital Modena, Modena, Italy
Search for more papers by this authorChangoon Yoo
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorSara Lonardi
Early Phase Clinical Trial Unit, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
Search for more papers by this authorGianluca Masi
Unit of Medical Oncology, Pisa University Hospital, Pisa, Italy
Search for more papers by this authorFabio Piscaglia
Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Search for more papers by this authorHyung-Don Kim
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorMario D. Rizzato
Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
Search for more papers by this authorFrancesca Salani
Unit of Medical Oncology, Pisa University Hospital, Pisa, Italy
Search for more papers by this authorLuca Ielasi
Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorAntonella Forgione
Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorYeonghak Bang
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorCaterina Soldà
Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
Search for more papers by this authorSilvia Catanese
Unit of Medical Oncology, Pisa University Hospital, Pisa, Italy
Search for more papers by this authorVito Sansone
Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Search for more papers by this authorMin-Hee Ryu
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorBaek-Yeol Ryoo
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorValentina Burgio
Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
Search for more papers by this authorAlessandro Cucchetti
Department of Medical and Surgical Sciences-DIMEC, Alma Mater Studiorum – University of Bologna, Bologna, Italy
Department of Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy
Search for more papers by this authorStefano Cascinu
Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
Vita-Salute San Raffaele University, Milan, Italy
Search for more papers by this authorCorresponding Author
Andrea Casadei-Gardini
Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
Vita-Salute San Raffaele University, Milan, Italy
Correspondence
Andrea Casadei-Gardini, Università Vita-Salute; San Raffaele Hospital-IRCCS, via Olgettina 70 20132 Milano, Italy.
Email: [email protected]
Search for more papers by this author[Correction added on 05 July 2021, after first online publication: Spelling of the author ‘Casadei-Gardini’ has been corrected.]
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/mm3). 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.
CONFLICT OF INTEREST
The author declares that there is no conflict of interest.
Supporting Information
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Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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