title: Prognostic Nutritional Index (PNI) Predicts Tumor Recurrence of Very Early/Early Stage Hepatocellular Carcinoma After Surgical Resection.
abstract: BACKGROUND
  Approximately one-quarter of patients with Barcelona Clinic Liver Cancer (BCLC) stage 0/A hepatocellular carcinoma (HCC) suffer from tumor relapse within the first year after surgical resection. Little data is available for inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI), in predicting the clinical outcome of patients with very early/early stage HCC who underwent curative surgery.
  
  
  METHODS
  A retrospective cohort study of 324 patients with BCLC stage 0/A primary HCC undergoing surgical resection was conducted to investigate the prognostic impacts of NLR, PLR, and PNI.
  
  
  RESULTS
  The low-PNI group (<45) had an adverse overall survival (1-year survival rate of 92 vs. 97 %; 5-year survival rate of 57 vs. 82 %; p < 0.001) and disease-free survival (1-year survival rate of 69 vs. 85 %; 5-year survival rate of 39 vs. 63 %; p < 0.001). It was an independent predictor for disease-specific death, and early and late tumor relapses, with hazard ratios of 2.78 (p < 0.001), 1.82 (p = 0.011), and 2.55 (p = 0.013), respectively. Neither NLR nor PLR had any prognostic significance.
  
  
  CONCLUSIONS
  The PNI is a significant prognostic factor for OS and DFS of patients with very early/early stage HCC receiving curative surgery.
authors: Department of Anatomical and Cellular Pathology, State Key Laboratory in Oncology in South China, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
authors: Anthony W H
authors: AW
authors: Chan
authors: Institute of Digestive Disease, Partner State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.|Department of Clinical Oncology, State Key Laboratory in Oncology in South China, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors: Stephen L
authors: SL
authors: Chan
authors: Institute of Digestive Disease, Partner State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.|Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors: Grace L H
authors: GL
authors: Wong
authors: Institute of Digestive Disease, Partner State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.|Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors: Vincent W S
authors: VW
authors: Wong
authors: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors: Charing C N
authors: CC
authors: Chong
authors: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors: Paul B S
authors: PB
authors: Lai
authors: Institute of Digestive Disease, Partner State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.|Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors: Henry L Y
authors: HL
authors: Chan
authors: Department of Anatomical and Cellular Pathology, State Key Laboratory in Oncology in South China, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong. kfto@cuhk.edu.hk.|Institute of Digestive Disease, Partner State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong. kfto@cuhk.edu.hk.|Li Ka Shing Institute of Health Science, Sir Y.K. Pao Cancer Centre, The Chinese University of Hong Kong, Shatin, Hong Kong. kfto@cuhk.edu.hk.
authors: Ka-Fai
authors: KF
authors: To
mesh_terms: D001792:Blood Platelets / Q000473:pathology*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D015596:Nutrition Assessment; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate