Geriatric nutritional risk index and newly developed scoring system as prognosis prediction for unresectable hepatocellular carcinoma patients treated with lenvatinib
Abstract In the current era of immune therapy, lenvatinib (LEN) continues to be vital for treating unresectable hepatocellular carcinoma (uHCC) patients. This study investigates the importance of nutritional status in the prognosis of uHCC patients receiving LEN and evaluates a new prognostic scorin...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-01-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-024-78539-4 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841559779743367168 |
|---|---|
| author | Hideko Ohama Atsushi Hiraoka Toshifumi Tada Masashi Hirooka Kazuya Kariyama Joji Tani Masanori Atsukawa Koichi Takaguchi Ei Itobayashi Shinya Fukunishi Kunihiko Tsuji Toru Ishikawa Kazuto Tajiri Hironori Ochi Satoshi Yasuda Hidenori Toyoda Chikara Ogawa Takashi Nishimura Takeshi Hatanaka Satoru Kakizaki Noritomo Shimada Kazuhito Kawata Atsushi Naganuma Hisashi Kosaka Tomomitsu Matono Hidekatsu Kuroda Yutaka Yata Hironori Tanaka Hiroki Nishikawa Hiroshi Shibata Fujimasa Tada Kazuhiro Nouso Asahiro Morishita Akemi Tsutsui Takuya Nagano Norio Itokawa Tomomi Okubo Taeang Arai Michitaka Imai Yohei Koizumi Shinichiro Nakamura Hiroko Iijima Masaki Kaibori Yoichi Hiasa Takashi Kumada |
| author_facet | Hideko Ohama Atsushi Hiraoka Toshifumi Tada Masashi Hirooka Kazuya Kariyama Joji Tani Masanori Atsukawa Koichi Takaguchi Ei Itobayashi Shinya Fukunishi Kunihiko Tsuji Toru Ishikawa Kazuto Tajiri Hironori Ochi Satoshi Yasuda Hidenori Toyoda Chikara Ogawa Takashi Nishimura Takeshi Hatanaka Satoru Kakizaki Noritomo Shimada Kazuhito Kawata Atsushi Naganuma Hisashi Kosaka Tomomitsu Matono Hidekatsu Kuroda Yutaka Yata Hironori Tanaka Hiroki Nishikawa Hiroshi Shibata Fujimasa Tada Kazuhiro Nouso Asahiro Morishita Akemi Tsutsui Takuya Nagano Norio Itokawa Tomomi Okubo Taeang Arai Michitaka Imai Yohei Koizumi Shinichiro Nakamura Hiroko Iijima Masaki Kaibori Yoichi Hiasa Takashi Kumada |
| author_sort | Hideko Ohama |
| collection | DOAJ |
| description | Abstract In the current era of immune therapy, lenvatinib (LEN) continues to be vital for treating unresectable hepatocellular carcinoma (uHCC) patients. This study investigates the importance of nutritional status in the prognosis of uHCC patients receiving LEN and evaluates a new prognostic scoring system that combines the geriatric nutritional risk index (GNRI) and systemic inflammatory response. From 2018 to 2022, 484 uHCC patients treated with LEN (384 males, median age 73). Prognostic value was compared between GNRI and C-reactive protein (CRP) scoring (GNRI-C score), GNRI, and neo-Glasgow prognostic score (neo-GPS). Evaluation was based on the Akaike information criterion (AIC) and concordance index(c-index). Median progression-free survival (mPFS) was 9.3/6.8/4.6 months for GNRI no-risk/low-risk/moderate-to-major risk (p < 0.01, AIC 4742.4/c-index 0.585). Median overall survival (mOS) was 27.8/15.2/9.5 months (p < 0.01, AIC 3433.34/c-index 0.639). For GNRI-C score, mPFS was 10.8/7.1/5.6/4.0 months (score 0/1/2/3) (p < 0.01, AIC 4732.82/c-index 0.6), while neo-GPS showed mPFS of 8.5/5.1/5.2 months (p < 0.01, AIC 4745.89/c-index 0.562). For mOS, GNRI-C score demonstrated 28.6/20.0/10.1/8.4 months (score 0/1/2/3) (p < 0.01, AIC 3420.27/c-index 0.652), while neo-GPS indicated 21.0/12.4/4.5 months (p < 0.01, AIC 3468.84/c-index 0.564). The newly devised GNRI-C score, incorporating nutritional and inflammatory markers, could offer improved prognostic predictions for uHCC patients treated with LEN. |
| format | Article |
| id | doaj-art-f8113088e2dd4e0f9d096e01939c07d3 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-f8113088e2dd4e0f9d096e01939c07d32025-01-05T12:13:59ZengNature PortfolioScientific Reports2045-23222025-01-0115111110.1038/s41598-024-78539-4Geriatric nutritional risk index and newly developed scoring system as prognosis prediction for unresectable hepatocellular carcinoma patients treated with lenvatinibHideko Ohama0Atsushi Hiraoka1Toshifumi Tada2Masashi Hirooka3Kazuya Kariyama4Joji Tani5Masanori Atsukawa6Koichi Takaguchi7Ei Itobayashi8Shinya Fukunishi9Kunihiko Tsuji10Toru Ishikawa11Kazuto Tajiri12Hironori Ochi13Satoshi Yasuda14Hidenori Toyoda15Chikara Ogawa16Takashi Nishimura17Takeshi Hatanaka18Satoru Kakizaki19Noritomo Shimada20Kazuhito Kawata21Atsushi Naganuma22Hisashi Kosaka23Tomomitsu Matono24Hidekatsu Kuroda25Yutaka Yata26Hironori Tanaka27Hiroki Nishikawa28Hiroshi Shibata29Fujimasa Tada30Kazuhiro Nouso31Asahiro Morishita32Akemi Tsutsui33Takuya Nagano34Norio Itokawa35Tomomi Okubo36Taeang Arai37Michitaka Imai38Yohei Koizumi39Shinichiro Nakamura40Hiroko Iijima41Masaki Kaibori42Yoichi Hiasa43Takashi Kumada44Gastroenterology Center, Ehime Prefectural Central HospitalGastroenterology Center, Ehime Prefectural Central HospitalDepartment of Internal Medicine, Japanese Red Cross Himeji HospitalDepartment of Gastroenterology and Metabology, Ehime University Graduate School of MedicineDepartment of Gastroenterology, Okayama City HospitalDepartment of Gastroenterology and Neurology, Kagawa UniversityDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical SchoolDepartment of Hepatology, Kagawa Prefectural Central HospitalDepartment of Gastroenterology, Asahi General HospitalDepartment of Gastroenterology, Hyogo Medical UniversityCenter for Gastroenterology, Teine Keijinkai HospitalDepartment of Gastroenterology, Saiseikai Niigata HospitalDepartment of Gastroenterology, Toyama University HospitalCenter for Liver- Biliary- Pancreatic Disease, Matsuyama Red Cross HospitalDepartment of Gastroenterology and Hepatology, Ogaki Municipal HospitalDepartment of Gastroenterology and Hepatology, Ogaki Municipal HospitalDepartment of Gastroenterology, Japanese Red Cross Takamatsu HospitalDepartment of Gastroenterology, Hyogo Medical UniversityDepartment of Gastroenterology, Gunma Saiseikai Maebashi HospitalDepartment of Clinical Research, NHO Takasaki General Medical CenterDivision of Gastroenterology and Hepatology, Otakanomori HospitalHepatology Division, Department of Internal Medicine II, Hamamatsu University School of MedicineDepartment of Gastroenterology, NHO Takasaki General Medical CenterDepartment of Hepatobiliary Surgery, Kansai Medical UniversityDepartment of Gastroenterology, Hyogo Prefectural Harima-Himeji General Medical CenterDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University, School of MedicineDepartment of Gastroenterology, Hanwa Memorial HospitalDepartment of Gastroenterology, Takarazuka City HospitalDepartment of Gastroenterology, Osaka Medical and Pharmaceutical UniversityDepartment of Gastroenterology, Tokushima Prefectural Central HospitalGastroenterology Center, Ehime Prefectural Central HospitalDepartment of Gastroenterology, Okayama City HospitalDepartment of Gastroenterology and Neurology, Kagawa UniversityDepartment of Hepatology, Kagawa Prefectural Central HospitalDepartment of Hepatology, Kagawa Prefectural Central HospitalDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical SchoolDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical SchoolDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical SchoolDepartment of Gastroenterology, Saiseikai Niigata HospitalDepartment of Gastroenterology and Metabology, Ehime University Graduate School of MedicineDepartment of Internal Medicine, Japanese Red Cross Himeji HospitalDepartment of Gastroenterology, Hyogo Medical UniversityDepartment of Hepatobiliary Surgery, Kansai Medical UniversityDepartment of Gastroenterology and Metabology, Ehime University Graduate School of MedicineDepartment of Nursing, Gifu Kyoritsu UniversityAbstract In the current era of immune therapy, lenvatinib (LEN) continues to be vital for treating unresectable hepatocellular carcinoma (uHCC) patients. This study investigates the importance of nutritional status in the prognosis of uHCC patients receiving LEN and evaluates a new prognostic scoring system that combines the geriatric nutritional risk index (GNRI) and systemic inflammatory response. From 2018 to 2022, 484 uHCC patients treated with LEN (384 males, median age 73). Prognostic value was compared between GNRI and C-reactive protein (CRP) scoring (GNRI-C score), GNRI, and neo-Glasgow prognostic score (neo-GPS). Evaluation was based on the Akaike information criterion (AIC) and concordance index(c-index). Median progression-free survival (mPFS) was 9.3/6.8/4.6 months for GNRI no-risk/low-risk/moderate-to-major risk (p < 0.01, AIC 4742.4/c-index 0.585). Median overall survival (mOS) was 27.8/15.2/9.5 months (p < 0.01, AIC 3433.34/c-index 0.639). For GNRI-C score, mPFS was 10.8/7.1/5.6/4.0 months (score 0/1/2/3) (p < 0.01, AIC 4732.82/c-index 0.6), while neo-GPS showed mPFS of 8.5/5.1/5.2 months (p < 0.01, AIC 4745.89/c-index 0.562). For mOS, GNRI-C score demonstrated 28.6/20.0/10.1/8.4 months (score 0/1/2/3) (p < 0.01, AIC 3420.27/c-index 0.652), while neo-GPS indicated 21.0/12.4/4.5 months (p < 0.01, AIC 3468.84/c-index 0.564). The newly devised GNRI-C score, incorporating nutritional and inflammatory markers, could offer improved prognostic predictions for uHCC patients treated with LEN.https://doi.org/10.1038/s41598-024-78539-4Hepatocellular carcinomaLenvatinibGNRICRPGNRI-C |
| spellingShingle | Hideko Ohama Atsushi Hiraoka Toshifumi Tada Masashi Hirooka Kazuya Kariyama Joji Tani Masanori Atsukawa Koichi Takaguchi Ei Itobayashi Shinya Fukunishi Kunihiko Tsuji Toru Ishikawa Kazuto Tajiri Hironori Ochi Satoshi Yasuda Hidenori Toyoda Chikara Ogawa Takashi Nishimura Takeshi Hatanaka Satoru Kakizaki Noritomo Shimada Kazuhito Kawata Atsushi Naganuma Hisashi Kosaka Tomomitsu Matono Hidekatsu Kuroda Yutaka Yata Hironori Tanaka Hiroki Nishikawa Hiroshi Shibata Fujimasa Tada Kazuhiro Nouso Asahiro Morishita Akemi Tsutsui Takuya Nagano Norio Itokawa Tomomi Okubo Taeang Arai Michitaka Imai Yohei Koizumi Shinichiro Nakamura Hiroko Iijima Masaki Kaibori Yoichi Hiasa Takashi Kumada Geriatric nutritional risk index and newly developed scoring system as prognosis prediction for unresectable hepatocellular carcinoma patients treated with lenvatinib Scientific Reports Hepatocellular carcinoma Lenvatinib GNRI CRP GNRI-C |
| title | Geriatric nutritional risk index and newly developed scoring system as prognosis prediction for unresectable hepatocellular carcinoma patients treated with lenvatinib |
| title_full | Geriatric nutritional risk index and newly developed scoring system as prognosis prediction for unresectable hepatocellular carcinoma patients treated with lenvatinib |
| title_fullStr | Geriatric nutritional risk index and newly developed scoring system as prognosis prediction for unresectable hepatocellular carcinoma patients treated with lenvatinib |
| title_full_unstemmed | Geriatric nutritional risk index and newly developed scoring system as prognosis prediction for unresectable hepatocellular carcinoma patients treated with lenvatinib |
| title_short | Geriatric nutritional risk index and newly developed scoring system as prognosis prediction for unresectable hepatocellular carcinoma patients treated with lenvatinib |
| title_sort | geriatric nutritional risk index and newly developed scoring system as prognosis prediction for unresectable hepatocellular carcinoma patients treated with lenvatinib |
| topic | Hepatocellular carcinoma Lenvatinib GNRI CRP GNRI-C |
| url | https://doi.org/10.1038/s41598-024-78539-4 |
| work_keys_str_mv | AT hidekoohama geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT atsushihiraoka geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT toshifumitada geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT masashihirooka geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT kazuyakariyama geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT jojitani geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT masanoriatsukawa geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT koichitakaguchi geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT eiitobayashi geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT shinyafukunishi geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT kunihikotsuji geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT toruishikawa geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT kazutotajiri geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT hironoriochi geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT satoshiyasuda geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT hidenoritoyoda geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT chikaraogawa geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT takashinishimura geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT takeshihatanaka geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT satorukakizaki geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT noritomoshimada geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT kazuhitokawata geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT atsushinaganuma geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT hisashikosaka geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT tomomitsumatono geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT hidekatsukuroda geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT yutakayata geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT hironoritanaka geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT hirokinishikawa geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT hiroshishibata geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT fujimasatada geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT kazuhironouso geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT asahiromorishita geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT akemitsutsui geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT takuyanagano geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT norioitokawa geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT tomomiokubo geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT taeangarai geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT michitakaimai geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT yoheikoizumi geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT shinichironakamura geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT hirokoiijima geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT masakikaibori geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT yoichihiasa geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib AT takashikumada geriatricnutritionalriskindexandnewlydevelopedscoringsystemasprognosispredictionforunresectablehepatocellularcarcinomapatientstreatedwithlenvatinib |