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PNI-Based Nomograms to Predict Tumor Progression and Survival for Patients with Unresectable Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization
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 hepatocellu...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9867481/ https://www.ncbi.nlm.nih.gov/pubmed/36675418 http://dx.doi.org/10.3390/jcm12020486 |
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author | Lei, Kai Deng, Zhuo-Fan Wang, Jia-Guo You, Ke Xu, Jie Liu, Zuo-Jin |
author_facet | Lei, Kai Deng, Zhuo-Fan Wang, Jia-Guo You, Ke Xu, Jie Liu, Zuo-Jin |
author_sort | Lei, Kai |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9867481 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98674812023-01-22 PNI-Based Nomograms to Predict Tumor Progression and Survival for Patients with Unresectable Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization Lei, Kai Deng, Zhuo-Fan Wang, Jia-Guo You, Ke Xu, Jie Liu, Zuo-Jin J Clin Med Article 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. MDPI 2023-01-06 /pmc/articles/PMC9867481/ /pubmed/36675418 http://dx.doi.org/10.3390/jcm12020486 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/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/). |
spellingShingle | Article Lei, Kai Deng, Zhuo-Fan Wang, Jia-Guo You, Ke Xu, Jie Liu, Zuo-Jin PNI-Based Nomograms to Predict Tumor Progression and Survival for Patients with Unresectable Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization |
title | PNI-Based Nomograms to Predict Tumor Progression and Survival for Patients with Unresectable Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization |
title_full | PNI-Based Nomograms to Predict Tumor Progression and Survival for Patients with Unresectable Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization |
title_fullStr | PNI-Based Nomograms to Predict Tumor Progression and Survival for Patients with Unresectable Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization |
title_full_unstemmed | PNI-Based Nomograms to Predict Tumor Progression and Survival for Patients with Unresectable Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization |
title_short | PNI-Based Nomograms to Predict Tumor Progression and Survival for Patients with Unresectable Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization |
title_sort | pni-based nomograms to predict tumor progression and survival for patients with unresectable hepatocellular carcinoma undergoing transcatheter arterial chemoembolization |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9867481/ https://www.ncbi.nlm.nih.gov/pubmed/36675418 http://dx.doi.org/10.3390/jcm12020486 |
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