Evidence map›Paper›PMID 41665677›Full record

ArticleCardiovascular and interventional radiology2026

The Prognostic Nutritional Index (PNI) as a Biomarker for Predicting Survival in Hepatocellular Carcinoma Patients Treated with Transarterial Chemoembolization and Lenvatinib, With or Without Programmed Death-1(PD-1) Inhibitors.

Wenji Xu, Zhening Yan, Yushan Zhao, Peng Guo, Rong Wang, Rui Zhang, Duiping Feng, Ruiping Zhang, Yi Chen

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Article in Cardiovascular and interventional radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Wenji XuCollege of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi Province, China.
Zhening YanDepartment of Hepatobiliary Surgery, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi Province, China.
Yushan ZhaoShanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, 030001, China.
Peng GuoShanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, 030032, China.
Rong WangDepartment of Oncology and Vascular Intervention, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi Province, China.
Rui ZhangDepartment of Hepatobiliary Surgery, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi Province, China.
Duiping FengDepartment of Oncology and Vascular Intervention, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi Province, China.
Ruiping ZhangThe Radiology Department of Shanxi Provincial People's Hospital, The Fifth Hospital of Shanxi Medical University, Taiyuan, 030001, China. zrp_7142@sxmu.edu.cn.
Yi ChenShanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, 030032, China. chenyi@sxbqeh.com.cn.ORCID http://orcid.org/0000-0002-0352-0664

Funding

Natural Science Foundation of Shanxi Province 20210302123255Natural Science Foundation of Shanxi Province 202303021211201
6 · The paper itself

Abstract

purposeCurrent treatment strategies for hepatocellular carcinoma (HCC) using transarterial chemoembolization (TACE) combined with lenvatinib and immunotherapy remain largely empirical due to the lack of reliable biomarkers. This study aimed to evaluate the prognostic significance of the Prognostic Nutritional Index (PNI) in HCC patients treated with TACE plus lenvatinib, with or without programmed death-1 (PD-1) inhibitors. MATERIALS AND

methodsWe conducted a retrospective analysis of 237 patients with HCC who received TACE and lenvatinib-based therapy, with or without PD-1 inhibitors, between March 2021 and September 2023. Patients were randomly allocated into training and validation sets in a 7:3 ratio and stratified into low- and high-PNI groups based on an optimal PNI cut-off value. Overall survival (OS) and progression-free survival (PFS) were compared between the PNI groups using the log-rank test.

resultsIn both the training and validation sets, patients with higher PNI scores demonstrated significantly better OS and PFS than those with lower PNI scores. Multivariate Cox regression identified PNI score, treatment modality (TACE + lenvatinib ± PD-1 inhibitor), tumor diameter, alpha-fetoprotein (AFP), and alanine aminotransferase (ALT) as independent prognostic factors for OS. For PFS, independent predictors included PNI score, treatment modality, tumor diameter, Child-Pugh class, and AFP level. Subgroup analyses consistently showed superior OS in the high-PNI group across most strata, including those defined by treatment type, presence of portal vein tumor thrombosis (PVTT) or extrahepatic metastasis (EHM), AFP level (≤ 400 or > 400 ng/mL), and Barcelona Clinic Liver Cancer (BCLC) stage C.

conclusionThe PNI score is a promising biomarker for predicting survival in HCC patients receiving TACE combined with lenvatinib, with or without PD-1 inhibitors. Low PNI is associated with poor survival outcomes, highlighting its potential utility in risk stratification and treatment planning.

Indexed as

Carcinoma, HepatocellularChemoembolization, TherapeuticImmune Checkpoint InhibitorsLiver NeoplasmsNutrition AssessmentPhenylurea CompoundsQuinolinesAgedFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesImmune Checkpoint InhibitorslenvatinibPhenylurea CompoundsQuinolinesHepatocellular carcinomaLenvatinibPD-1 inhibitorPrognostic nutritional indexSurvival

Identifiers

PMID41665677

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.