Francesco Caputo1, Vincenzo Dadduzio2, Francesco Tovoli3, Giulia Bertolini4, Giuseppe Cabibbo5, Krisida Cerma1, Caterina Vivaldi6, Luca Faloppi7, Mario Domenico Rizzato2,8, Fabio Piscaglia3, Ciro Celsa5, Lorenzo Fornaro6, Giorgia Marisi4, Fabio Conti9, Nicola Silvestris10, Marianna Silletta11, Sara Lonardi2, Alessandro Granito3, Caterina Stornello12, Valentina Massa6, Giorgio Astara13, Sabina Delcuratolo10, Stefano Cascinu14, Mario Scartozzi13, Andrea Casadei-Gardini1. 1. Division of Oncology, Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena, Italy. 2. Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy. 3. Azienda Ospedaliera Universitaria S.Orsola-Malpighi Bologna, Bologna, Italy. 4. Medical Oncology Unit IRCSS-IRST Meldola, Meldola, Italy. 5. Section of Gastroenterology & Hepatology, PROMISE, University of Palermo, Palermo, Italy. 6. Department of Oncology, University of Pisa, Pisa, Italy. 7. Medical Oncology Unit, Macerata General Hospital, Macerata, Italy. 8. Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy. 9. Department of Internal Medicine, Degli Infermi Hospital, Faenza, Italy. 10. Medical Oncology Unit, IRCCS Giovanni Paolo II Cancer Center, Bari, Italy. 11. Medical Oncology Department, Campus Biomedico, University of Rome, Rome, Italy. 12. Digestive and Liver Disease Unit, S. Andrea Hospital, Rome, Italy. 13. Department of Medical Oncology, University of Cagliari, Cagliari, Italy. 14. Department of Medical Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Abstract
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 (<31.3) PNI, respectively. At both the univariate and the multivariate analysis, low PNI value (p = 0.0004), a 1-unit increase of aspartate aminotransferase (p = 0.0001), and age > 70 years (p< 0.0038) were independent prognostic factors for OS. By performing the same multivariate analysis of the training cohort, the PNI <31.3 versus >31.3 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.
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 HCCpatients and three external validation cohorts of 129, 76 and 265 HCCpatients 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 (<31.3) PNI, respectively. At both the univariate and the multivariate analysis, low PNI value (p = 0.0004), a 1-unit increase of aspartate aminotransferase (p = 0.0001), and age > 70 years (p< 0.0038) were independent prognostic factors for OS. By performing the same multivariate analysis of the training cohort, the PNI <31.3 versus >31.3 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.
Authors: Clelia Donisi; Marco Puzzoni; Pina Ziranu; Eleonora Lai; Stefano Mariani; Giorgio Saba; Valentino Impera; Marco Dubois; Mara Persano; Marco Migliari; Andrea Pretta; Nicole Liscia; Giorgio Astara; Mario Scartozzi Journal: Front Oncol Date: 2021-01-07 Impact factor: 6.244
Authors: Lukas Müller; Felix Hahn; Aline Mähringer-Kunz; Fabian Stoehr; Simon J Gairing; Friedrich Foerster; Arndt Weinmann; Peter R Galle; Jens Mittler; Daniel Pinto Dos Santos; Michael B Pitton; Christoph Düber; Roman Kloeckner Journal: Front Oncol Date: 2021-06-10 Impact factor: 6.244
Authors: I G Rapposelli; S Shimose; T Kumada; S Okamura; A Hiraoka; G G Di Costanzo; F Marra; E Tamburini; A Forgione; F G Foschi; M Silletta; S Lonardi; G Masi; M Scartozzi; M Nakano; H Shibata; K Kawata; A Pellino; C Vivaldi; E Lai; A Takata; K Tajiri; H Toyoda; R Tortora; C Campani; M G Viola; F Piscaglia; F Conti; C A M Fulgenzi; G L Frassineti; M D Rizzato; F Salani; G Astara; T Torimura; M Atsukawa; T Tada; V Burgio; M Rimini; S Cascinu; A Casadei-Gardini Journal: ESMO Open Date: 2021-06-15