PNI-Based Nomograms to Predict Tumor Progression and Survival for Patients with Unresectable Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization

作者全名："Lei, Kai; Deng, Zhuo-Fan; Wang, Jia-Guo; You, Ke; Xu, Jie; Liu, Zuo-Jin"

作者地址："[Lei, Kai; Deng, Zhuo-Fan; Wang, Jia-Guo; You, Ke; Xu, Jie; Liu, Zuo-Jin] Chongqing Med Univ, Affiliated Hosp 2, Dept Hepatobiliary Surg, Chongqing 404606, Peoples R China"

通信作者："Liu, ZJ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Hepatobiliary Surg, Chongqing 404606, Peoples R China."

来源：JOURNAL OF CLINICAL MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000915213400001

JCR分区：Q1

影响因子：3

年份：2023

卷号：12

期号：2

开始页：　

结束页：　

文献类型：Article

关键词：hepatocellular carcinoma (HCC); nomogram; prognostic nutritional index (PNI); survival; transcatheter arterial chemoembolization (TACE); tumor progression

摘要："Background: The relationship between the prognostic nutritional index (PNI) and the prognosis of malignancy has been increasingly mentioned in recent research. This study aimed to construct nomograms based on the PNI to predict tumor progression and survival in patients with unresectable hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolization (TACE). Materials and Methods: The development set included 785 patients who underwent their first TACE between 2012 and 2016, and the validation set included 336 patients who underwent their first TACE between 2017 and 2018. The clinical outcomes included the time to progression (TTP) and overall survival (OS). Cox regression was applied to screen for independent risk factors of TTP and OS in the development set, and PNI-based nomograms were constructed for TTP and OS. The predictive performance of nomograms was conducted through the C-index, calibration curves, and decision analysis curves in the development set and validation set. Results: After multivariate analysis, the prognostic predictors of both TTP and OS included portal vessel invasion, extrahepatic metastasis, tumor number, alpha-fetoprotein (AFP) level, longest tumor diameter, and PNI. Furthermore, the Child-Pugh classification and platelets (PLTs) were independent risk factors for OS only. Nomograms for predicting TTP and OS were constructed using TTP and OS prognostic factors. In the development set and the validation set, the C-index of the TTP nomograms was 0.699 (95% confidence interval (CI): 0.680-0.718) and 0.670 (95%CI: 0.638-0.702), and the C-index of the OS nomograms was 0.730 (95%CI: 0.712-0.748) and 0.700 (95%CI: 0.665-0.723), respectively. Conclusion: Nomograms based on the PNI can effectively predict tumor progression and survival in patients with unresectable HCC undergoing TACE."

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