Refining Prognosis in Chemoembolization for Hepatocellular Carcinoma: Immunonutrition and Liver Function
A combination of albumin-bilirubin (ALBI) grading and the Prognostic Nutritional Index (PNI) was identified recently as a highly predictive tool for patients with hepatocellular carcinoma (HCC) undergoing tumor ablation. The present study evaluated this combination in patients undergoing transarteri...
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| Veröffentlicht in: | Cancers 2021-08, Vol.13 (16), p.3961 |
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| creator | Müller, Lukas Hahn, Felix Mähringer-Kunz, Aline Stoehr, Fabian Gairing, Simon Johannes Foerster, Friedrich Weinmann, Arndt Galle, Peter Robert Mittler, Jens Pinto dos Santos, Daniel Pitton, Michael Bernhard Düber, Christoph Kloeckner, Roman |
| description | A combination of albumin-bilirubin (ALBI) grading and the Prognostic Nutritional Index (PNI) was identified recently as a highly predictive tool for patients with hepatocellular carcinoma (HCC) undergoing tumor ablation. The present study evaluated this combination in patients undergoing transarterial chemoembolization (TACE). Between 2010 and 2020, 280 treatment-naïve patients were retrospectively identified. The influence of ALBI grade, PNI and the novel ALBI-PNI on the median overall survival (OS) was assessed. In the next step, the prognostic ability of the combined approach was compared to established scoring systems. Both ALBI grade 2−3 and a low PNI were highly predictive for median OS (ALBI grade 1–3: 39.0 vs. 16.3 vs. 5.4 months, p < 0.001; high vs. low PNI: 21.4 vs. 7.5, p < 0.001). The combination of both resulted in a median OS of 39.0, 20.1, 10.3, and 5.4 months (p < 0.001). With a Concordance Index (C-Index) of 0.69, ALBI-PNI outperformed each individual score (ALBI 0.65, PNI 0.64) and was also better than BCLC, HAP, mHAP-II, and the Six-and-Twelve score (C-Indices 0.66, 0.60, 0.59, and 0.55). Thus, the easy-to-calculate ALBI-PNI may be a promising stratification tool for patients with HCC undergoing TACE, reflecting both immunonutritive status and liver function. |
| doi_str_mv | 10.3390/cancers13163961 |
| format | Article |
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The present study evaluated this combination in patients undergoing transarterial chemoembolization (TACE). Between 2010 and 2020, 280 treatment-naïve patients were retrospectively identified. The influence of ALBI grade, PNI and the novel ALBI-PNI on the median overall survival (OS) was assessed. In the next step, the prognostic ability of the combined approach was compared to established scoring systems. Both ALBI grade 2−3 and a low PNI were highly predictive for median OS (ALBI grade 1–3: 39.0 vs. 16.3 vs. 5.4 months, p < 0.001; high vs. low PNI: 21.4 vs. 7.5, p < 0.001). The combination of both resulted in a median OS of 39.0, 20.1, 10.3, and 5.4 months (p < 0.001). With a Concordance Index (C-Index) of 0.69, ALBI-PNI outperformed each individual score (ALBI 0.65, PNI 0.64) and was also better than BCLC, HAP, mHAP-II, and the Six-and-Twelve score (C-Indices 0.66, 0.60, 0.59, and 0.55). Thus, the easy-to-calculate ALBI-PNI may be a promising stratification tool for patients with HCC undergoing TACE, reflecting both immunonutritive status and liver function.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers13163961</identifier><identifier>PMID: 34439116</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Albumin ; Bilirubin ; Cancer therapies ; Datasets ; Hepatocellular carcinoma ; Interdisciplinary aspects ; Laboratories ; Liver cancer ; Liver cirrhosis ; Medical prognosis ; Patients ; Survival ; Survival analysis</subject><ispartof>Cancers, 2021-08, Vol.13 (16), p.3961</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 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The present study evaluated this combination in patients undergoing transarterial chemoembolization (TACE). Between 2010 and 2020, 280 treatment-naïve patients were retrospectively identified. The influence of ALBI grade, PNI and the novel ALBI-PNI on the median overall survival (OS) was assessed. In the next step, the prognostic ability of the combined approach was compared to established scoring systems. Both ALBI grade 2−3 and a low PNI were highly predictive for median OS (ALBI grade 1–3: 39.0 vs. 16.3 vs. 5.4 months, p < 0.001; high vs. low PNI: 21.4 vs. 7.5, p < 0.001). The combination of both resulted in a median OS of 39.0, 20.1, 10.3, and 5.4 months (p < 0.001). With a Concordance Index (C-Index) of 0.69, ALBI-PNI outperformed each individual score (ALBI 0.65, PNI 0.64) and was also better than BCLC, HAP, mHAP-II, and the Six-and-Twelve score (C-Indices 0.66, 0.60, 0.59, and 0.55). Thus, the easy-to-calculate ALBI-PNI may be a promising stratification tool for patients with HCC undergoing TACE, reflecting both immunonutritive status and liver function.</description><subject>Albumin</subject><subject>Bilirubin</subject><subject>Cancer therapies</subject><subject>Datasets</subject><subject>Hepatocellular carcinoma</subject><subject>Interdisciplinary aspects</subject><subject>Laboratories</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Medical prognosis</subject><subject>Patients</subject><subject>Survival</subject><subject>Survival analysis</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpdkUFLxDAQhYMoKurZa8CLl9WmkyaNB0EWdYUFRfQcpmm6G2mTNWkF_fV2dRF1LjPMfDzm8Qg5ZtkZgMrODXpjY2LABCjBtsh-nsl8IoTi27_mPXKU0ks2FgCTQu6SPeAcFGNinywfbeO88wv6EMPCh-QSdZ5Ol7YLtqtC6z6wd8HTJkQ6syvsg7FtO7QY6RSjcT50eEHvum7wwQ99dF80-prO3ZuN9GbwZr06JDsNtskebfoBeb65fprOJvP727vp1XxiQJX9pEJbskJhUdYs4woq5DVIUxgmsMCSGWUFz5DlRjXG5qIumgYlVDCaK9AgHJDLb93VUHW2Ntb3EVu9iq7D-K4DOv334t1SL8KbLkHlJYdR4HQjEMPrYFOvO5fWntHbMCSdF0JkIIAXI3ryD30JQ_SjvTXFpZQ5yJE6_6ZMDClF2_w8wzK9DlL_CxI-ATDUk5M</recordid><startdate>20210805</startdate><enddate>20210805</enddate><creator>Müller, Lukas</creator><creator>Hahn, Felix</creator><creator>Mähringer-Kunz, Aline</creator><creator>Stoehr, Fabian</creator><creator>Gairing, Simon Johannes</creator><creator>Foerster, Friedrich</creator><creator>Weinmann, Arndt</creator><creator>Galle, Peter Robert</creator><creator>Mittler, Jens</creator><creator>Pinto dos Santos, Daniel</creator><creator>Pitton, Michael Bernhard</creator><creator>Düber, Christoph</creator><creator>Kloeckner, Roman</creator><general>MDPI AG</general><general>MDPI</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5572-7763</orcidid><orcidid>https://orcid.org/0000-0003-3240-5152</orcidid><orcidid>https://orcid.org/0000-0002-3234-8891</orcidid><orcidid>https://orcid.org/0000-0002-8626-4044</orcidid><orcidid>https://orcid.org/0000-0002-2469-6036</orcidid><orcidid>https://orcid.org/0000-0001-5492-4792</orcidid></search><sort><creationdate>20210805</creationdate><title>Refining Prognosis in Chemoembolization for Hepatocellular Carcinoma: Immunonutrition and Liver Function</title><author>Müller, Lukas ; 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The present study evaluated this combination in patients undergoing transarterial chemoembolization (TACE). Between 2010 and 2020, 280 treatment-naïve patients were retrospectively identified. The influence of ALBI grade, PNI and the novel ALBI-PNI on the median overall survival (OS) was assessed. In the next step, the prognostic ability of the combined approach was compared to established scoring systems. Both ALBI grade 2−3 and a low PNI were highly predictive for median OS (ALBI grade 1–3: 39.0 vs. 16.3 vs. 5.4 months, p < 0.001; high vs. low PNI: 21.4 vs. 7.5, p < 0.001). The combination of both resulted in a median OS of 39.0, 20.1, 10.3, and 5.4 months (p < 0.001). With a Concordance Index (C-Index) of 0.69, ALBI-PNI outperformed each individual score (ALBI 0.65, PNI 0.64) and was also better than BCLC, HAP, mHAP-II, and the Six-and-Twelve score (C-Indices 0.66, 0.60, 0.59, and 0.55). 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| subjects | Albumin Bilirubin Cancer therapies Datasets Hepatocellular carcinoma Interdisciplinary aspects Laboratories Liver cancer Liver cirrhosis Medical prognosis Patients Survival Survival analysis |
| title | Refining Prognosis in Chemoembolization for Hepatocellular Carcinoma: Immunonutrition and Liver Function |
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