Prognostic nutritional index predicts short-term outcomes after liver resection for hepatocellular carcinoma within the Milan criteria.
BACKGROUND
The prognostic nutritional index (PNI) is calculated based on the serum albumin concentration and the total lymphocyte count. The aim of this study was to investigate the prognostic ability of the PNI for postoperative complications after liver resection to treat hepatocellular carcinoma (HCC) within the Milan criteria.


RESULTS
Postoperative complications were observed in 166 (44.6%) patients. The optimal cutoff value of the PNI was set at 45.6 for postoperative complications. Patients in the PNI-low (PNI < 45.6) group were more likely to have postoperative complications, more blood loss, a longer surgery time and a longer hospital stay than patients in the PNI-high group (PNI > 45.6). Our regression analysis demonstrated that the preoperative PNI and albumin-bilirubin (ALBI) score were significantly associated with postoperative complications (Pearson correlation coefficient, -0.865, p < 0.001). The multivariate analysis revealed that the PNI was an independent predictor of postoperative complications.


METHODS
Three-hundred and seventy-two patients who underwent partial hepatectomy for HCC from 2003 to 2014 were identified. The cutoff value of the PNI was determined by a receiver operating characteristic (ROC) curve analysis. Univariate and multivariate analyses were performed to identify clinicopathological features associated with postoperative complications.


CONCLUSIONS
The PNI may be a significant prognostic factor for evaluating short-term outcomes of patients with HCC after partial hepatectomy.
Research Institute of Advanced Surgical Techniques and Engineering, Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Mengyun
M
Ke
Department of Hepatobiliary Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
Tao
T
Xu
Department of Laboratory Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Na
N
Li
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Yifan
Y
Ren
Research Institute of Advanced Surgical Techniques and Engineering, Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Aihua
A
Shi
Research Institute of Advanced Surgical Techniques and Engineering, Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.|Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Yi
Y
Lv
Research Institute of Advanced Surgical Techniques and Engineering, Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.|Department of thoracic surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Haiqi
H
He
D000328:Adult; D019540:Area Under Curve; D001663:Bilirubin / Q000097:blood; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016009:Chi-Square Distribution; D003661:Decision Support Techniques; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009752:Nutritional Status; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D000075462:Serum Albumin, Human / Q000032:analysis; D013997:Time Factors; D016896:Treatment Outcome
C422455:ALB protein, human; D001663:Bilirubin; D000075462:Serum Albumin, Human
hepatectomy; hepatocellular carcinoma; postoperative complications; prognostic nutritional index