The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib
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. This multicentric study included a training cohort of 194 HCC patients and three external validation cohorts of 129, 7...
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| Veröffentlicht in: | PloS one 2020-05, Vol.15 (5), p.e0232449-e0232449 |
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| creator | Caputo, Francesco Dadduzio, Vincenzo Tovoli, Francesco Bertolini, Giulia Cabibbo, Giuseppe Cerma, Krisida Vivaldi, Caterina Faloppi, Luca Rizzato, Mario Domenico Piscaglia, Fabio Celsa, Ciro Fornaro, Lorenzo Marisi, Giorgia Conti, Fabio Silvestris, Nicola Silletta, Marianna Lonardi, Sara Granito, Alessandro Stornello, Caterina Massa, Valentina Astara, Giorgio Delcuratolo, Sabina Cascinu, Stefano Scartozzi, Mario Casadei-Gardini, Andrea |
| description | 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.
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).
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 (p< 0.0038) were independent prognostic factors for OS. By performing the same multivariate analysis of the training cohort, the PNI 31.3 was found to be an independent prognostic factor for predicting OS in all the three validation cohorts.
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. |
| doi_str_mv | 10.1371/journal.pone.0232449 |
| format | Article |
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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).
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.
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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0232449</identifier><identifier>PMID: 32379785</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Albumin ; Antineoplastic agents ; Aspartate aminotransferase ; Biology and life sciences ; Biomarkers ; Body mass index ; Cancer ; Carcinoma ; Cell number ; Clinical medicine ; Dehydrogenases ; Drug therapy ; Gastroenterology ; Hematology ; Hepatitis ; Hepatocellular carcinoma ; Hepatology ; Hospitals ; Inhibitor drugs ; Liver cancer ; Lymphocytes ; Medical prognosis ; Medicine and Health Sciences ; Methods ; Multivariate analysis ; Neutrophils ; Nutritional assessment ; Oncology ; Patient outcomes ; Physical Sciences ; Prognosis ; Research and Analysis Methods ; Serum albumin ; Sorafenib ; Studies ; Survival ; Targeted cancer therapy ; Training</subject><ispartof>PloS one, 2020-05, Vol.15 (5), p.e0232449-e0232449</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Caputo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Caputo et al 2020 Caputo et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c653t-4fb06a211b4c35e853ee68f97fb2dc0053a5770a3091cd8f8b1dc1f8550ee3e83</citedby><cites>FETCH-LOGICAL-c653t-4fb06a211b4c35e853ee68f97fb2dc0053a5770a3091cd8f8b1dc1f8550ee3e83</cites><orcidid>0000-0002-0637-739X ; 0000-0001-6289-7202</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205300/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205300/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32379785$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Caputo, Francesco</creatorcontrib><creatorcontrib>Dadduzio, Vincenzo</creatorcontrib><creatorcontrib>Tovoli, Francesco</creatorcontrib><creatorcontrib>Bertolini, Giulia</creatorcontrib><creatorcontrib>Cabibbo, Giuseppe</creatorcontrib><creatorcontrib>Cerma, Krisida</creatorcontrib><creatorcontrib>Vivaldi, Caterina</creatorcontrib><creatorcontrib>Faloppi, Luca</creatorcontrib><creatorcontrib>Rizzato, Mario Domenico</creatorcontrib><creatorcontrib>Piscaglia, Fabio</creatorcontrib><creatorcontrib>Celsa, Ciro</creatorcontrib><creatorcontrib>Fornaro, Lorenzo</creatorcontrib><creatorcontrib>Marisi, Giorgia</creatorcontrib><creatorcontrib>Conti, Fabio</creatorcontrib><creatorcontrib>Silvestris, Nicola</creatorcontrib><creatorcontrib>Silletta, Marianna</creatorcontrib><creatorcontrib>Lonardi, Sara</creatorcontrib><creatorcontrib>Granito, Alessandro</creatorcontrib><creatorcontrib>Stornello, Caterina</creatorcontrib><creatorcontrib>Massa, Valentina</creatorcontrib><creatorcontrib>Astara, Giorgio</creatorcontrib><creatorcontrib>Delcuratolo, Sabina</creatorcontrib><creatorcontrib>Cascinu, Stefano</creatorcontrib><creatorcontrib>Scartozzi, Mario</creatorcontrib><creatorcontrib>Casadei-Gardini, Andrea</creatorcontrib><title>The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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).
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.
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.</description><subject>Albumin</subject><subject>Antineoplastic agents</subject><subject>Aspartate aminotransferase</subject><subject>Biology and life sciences</subject><subject>Biomarkers</subject><subject>Body mass index</subject><subject>Cancer</subject><subject>Carcinoma</subject><subject>Cell number</subject><subject>Clinical medicine</subject><subject>Dehydrogenases</subject><subject>Drug therapy</subject><subject>Gastroenterology</subject><subject>Hematology</subject><subject>Hepatitis</subject><subject>Hepatocellular carcinoma</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Inhibitor drugs</subject><subject>Liver cancer</subject><subject>Lymphocytes</subject><subject>Medical prognosis</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Multivariate 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role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib</title><author>Caputo, Francesco ; Dadduzio, Vincenzo ; Tovoli, Francesco ; Bertolini, Giulia ; Cabibbo, Giuseppe ; Cerma, Krisida ; Vivaldi, Caterina ; Faloppi, Luca ; Rizzato, Mario Domenico ; Piscaglia, Fabio ; Celsa, Ciro ; Fornaro, Lorenzo ; Marisi, Giorgia ; Conti, Fabio ; Silvestris, Nicola ; Silletta, Marianna ; Lonardi, Sara ; Granito, Alessandro ; Stornello, Caterina ; Massa, Valentina ; Astara, Giorgio ; Delcuratolo, Sabina ; Cascinu, Stefano ; Scartozzi, Mario ; Casadei-Gardini, Andrea</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c653t-4fb06a211b4c35e853ee68f97fb2dc0053a5770a3091cd8f8b1dc1f8550ee3e83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Albumin</topic><topic>Antineoplastic agents</topic><topic>Aspartate aminotransferase</topic><topic>Biology and life 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Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Caputo, Francesco</au><au>Dadduzio, Vincenzo</au><au>Tovoli, Francesco</au><au>Bertolini, Giulia</au><au>Cabibbo, Giuseppe</au><au>Cerma, Krisida</au><au>Vivaldi, Caterina</au><au>Faloppi, Luca</au><au>Rizzato, Mario Domenico</au><au>Piscaglia, Fabio</au><au>Celsa, Ciro</au><au>Fornaro, Lorenzo</au><au>Marisi, Giorgia</au><au>Conti, Fabio</au><au>Silvestris, Nicola</au><au>Silletta, Marianna</au><au>Lonardi, Sara</au><au>Granito, Alessandro</au><au>Stornello, Caterina</au><au>Massa, Valentina</au><au>Astara, Giorgio</au><au>Delcuratolo, Sabina</au><au>Cascinu, Stefano</au><au>Scartozzi, Mario</au><au>Casadei-Gardini, Andrea</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2020-05-07</date><risdate>2020</risdate><volume>15</volume><issue>5</issue><spage>e0232449</spage><epage>e0232449</epage><pages>e0232449-e0232449</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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).
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.
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32379785</pmid><doi>10.1371/journal.pone.0232449</doi><tpages>e0232449</tpages><orcidid>https://orcid.org/0000-0002-0637-739X</orcidid><orcidid>https://orcid.org/0000-0001-6289-7202</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2020-05, Vol.15 (5), p.e0232449-e0232449 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2399838008 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Albumin Antineoplastic agents Aspartate aminotransferase Biology and life sciences Biomarkers Body mass index Cancer Carcinoma Cell number Clinical medicine Dehydrogenases Drug therapy Gastroenterology Hematology Hepatitis Hepatocellular carcinoma Hepatology Hospitals Inhibitor drugs Liver cancer Lymphocytes Medical prognosis Medicine and Health Sciences Methods Multivariate analysis Neutrophils Nutritional assessment Oncology Patient outcomes Physical Sciences Prognosis Research and Analysis Methods Serum albumin Sorafenib Studies Survival Targeted cancer therapy Training |
| title | The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib |
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