PLoS ONE (Jan 2020)

The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib.

  • 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

DOI
https://doi.org/10.1371/journal.pone.0232449
Journal volume & issue
Vol. 15, no. 5
p. e0232449

Abstract

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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 ( 70 years (p31.3 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.