title: Postoperative prognostic nutritional index change is an independent predictor of survival in patients with small hepatocellular carcinoma.
abstract: BACKGROUND
  There is limited information concerning the postoperative prognostic nutritional index change (ΔPNI) in hepatocellular carcinoma (HCC). This study was designed to evaluate the prognostic value of ΔPNI in patients with small HCC who underwent liver resection.
  
  
  METHODS
  A retrospective cohort study was performed to analyze 243 patients with small HCC who underwent liver resection. Patients were divided into prognostic nutritional index (PNI)-increased group (n = 161) and PNI-decreased group (n = 82) according to postoperative PNI change. Clinical data, overall survival (OS), and recurrence-free survival (RFS) were statistically compared between the 2 groups, and a multivariate analysis was used to identify prognostic factors.
  
  
  RESULTS
  Multivariable analysis revealed that ΔPNI as independent predictors of OS and RFS in patients with small HCC after liver resection (P < .01 for both).
  
  
  CONCLUSIONS
  Decreased PNI, but not low preoperative PNI was an independent risk factor for OS and RFS in patients with small HCC who underwent liver resection.
authors.affiliation: Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Peng
authors.affiliation: Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China.
authors.forename: Chuan
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China. Electronic address: ccwentianfu@163.com.
authors.forename: Tian-Fu
authors.initials: TF
authors.lastname: Wen
authors.affiliation: Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China.
authors.forename: Lv-Nan
authors.initials: LN
authors.lastname: Yan
authors.affiliation: Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China.
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China.
authors.forename: Wen-Tao
authors.initials: WT
authors.lastname: Wang
authors.affiliation: Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China.
authors.forename: Jia-Yin
authors.initials: JY
authors.lastname: Yang
authors.affiliation: Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China.
authors.forename: Ming-Qing
authors.initials: MQ
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D002681:China; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Hepatocellular carcinoma; Liver resection; Milan criteria; Prognostic factor; Prognostic nutritional index