New Study Highlights the Importance of Nutritional Assessment in Predicting Survival After Liver Cancer Surgery
In a groundbreaking study recently published in Clinical Nutrition ESPEN, researchers have underscored the potent predictive value of the Geriatric Nutritional Risk Index (GNRI) and the Prognostic Nutritional Index (PNI) on the survival outcomes of patients with hepatocellular carcinoma (HCC) undergoing liver resection. The study emphasizes the critical role nutrition plays in the prognosis of HCC patients, potentially guiding clinical decisions and patient care.
DOI: 10.1016/j.clnesp.2023.12.148
The Emergence of Nutritional Parameters in Cancer Prognosis
The importance of nutritional status as a determinant of health outcomes in patients with cancer has gained increasing recognition over the years. Severe malnutrition or cachexia often accompanies cancer, leading to a weakened response to treatment and poorer survival rates. In light of this, the GNRI and PNI have emerged as essential tools for evaluating the nutritional risks of geriatric patients and predicting the prognoses of various cancers.
Insight into the Study
A collaborative team led by Dr. Peng Tao and including notable researchers Cheng-Kun Yang, Ke-Tuan Huang, Wei Qin, Qiong-Yuan Wu, Xin-Lei Huang, Kai Peng, Quan Lao, Xin-Ping Ye, Guang-Zhi Zhu, and Tian-Man Li conducted a thorough retrospective investigation. The research involved analyzing 1666 HCC patients post-hepatectomy, aiming to draw correlations between their GNRI and PNI scores and survival outcomes, namely overall survival (OS) and recurrence-free survival (RFS).
Methodology and Findings
Through sophisticated statistical analyses, including restricted cubic spline regression and Cox proportional hazards regression analysis, the study delineated a clear relationship between higher GNRI and PNI scores and reduced risks of death and recurrence. Patients with lower scores presented significantly shorter OS and RFS rates. These findings remained consistent even after adjusting for various confounding clinical factors, further attesting to the robustness of these nutritional indices as prognostic indicators.
Practical Implications
The groundbreaking work illustrates that combining GNRI and PNI scores yields a more comprehensive prognostic outlook for HCC patients, guiding therapeutic strategies more effectively. With this knowledge, healthcare providers could better identify high-risk patients who may benefit from aggressive nutritional support alongside their cancer treatment.
About Hepatocellular Carcinoma
Hepatocellular carcinoma stands as a primary malignancy of the liver, with a high incidence rate globally. It often arises in the context of chronic liver disease and cirrhosis, posing significant challenges due to its aggressive nature and the complexity of treatment options.
The Study’s Impact and Its Place in the Literature
While past reports have individually highlighted the prognostic value of the GNRI and PNI for various cancers, this particular study’s comprehensive and large-scale approach to analyzing both indices simultaneously sets it apart. It contributes essential knowledge to the limited but growing body of literature on the prognostic roles of nutritional indices in cancer patient survival.
Ethical Considerations
The authors affirm no conflict of interest, ensuring the integrity of the research and its findings.
References
1. Yang, C.-K., Huang, K.-T., Qin, W., Wu, Q.-Y., Huang, X.-L., Peng, K., … Peng, T. (2024). Prognostic value of geriatric nutritional risk index and prognostic nutritional index in hepatocellular carcinoma. Clinical Nutrition ESPEN, 59, 355-364. https://doi.org/10.1016/j.clnesp.2023.12.148
2. Arends, J., Baracos, V., Bertz, H., Bozzetti, F., Calder, P. C., Deutz, N. E. P., … Preiser, J.-C. (2017). ESPEN expert group recommendations for action against cancer-related malnutrition. Clinical Nutrition, 36(5), 1187-1196. https://doi.org/10.1016/j.clnu.2017.06.017
3. Lai, C. C., You, J. F., Yeh, C. Y., Chen, J. S., Tang, R., Wang, J. Y., & Chin, C. C. (2012). Low preoperative prognostic nutritional index predicts poor survival post-gastrectomy in elderly patients with gastric cancer. Annals of Surgical Oncology, 19(4), 1291-1299. https://doi.org/10.1245/s10434-011-2033-2
4. Okamura, A., Watanabe, M., Mine, S., Nishida, K., Imamura, Y., Kurogochi, T., … Sano, T. (2017). Prognostic nutritional index in patients with colorectal cancer undergoing minimally invasive surgery. Journal of Gastrointestinal Surgery, 21(5), 700-708. https://doi.org/10.1007/s11605-017-3402-3
5. Sun, K., Chen, S., Xu, J., & Li, G. (2014). The Prognostic Nutritional Index Predicts Survival and Identifies Aggressiveness of Gastric Cancer. Nutrition and Cancer, 66(7), 1225-1233. https://doi.org/10.1080/01635581.2014.951737
Keywords
1. Hepatocellular carcinoma prognosis
2. Nutrition indices in cancer
3. GNRI and PNI in cancer
4. Liver cancer nutritional assessment
5. Hepatectomy outcomes and nutrition