Postoperative prognostic nutritional index change is an independent predictor of survival in patients with small hepatocellular carcinoma

• We evaluated the ΔPNI in small HCC patients who underwent liver resection.
• In those patients, decreased PNI predicts worse OS and RFS but not pre- or post-PNI.
• We found that post-ΔPNI as independent predictors of OS and RFS in those patients.

BackgroundThere 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.MethodsA 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.ResultsMultivariable analysis revealed that ΔPNI as independent predictors of OS and RFS in patients with small HCC after liver resection (P < .01 for both).ConclusionsDecreased PNI, but not low preoperative PNI was an independent risk factor for OS and RFS in patients with small HCC who underwent liver resection.