Zeng D, Wen NY, Wang YQ, Cheng NS, Li B. Prognostic roles nutritional index in patients with resectable and advanced biliary tract cancers. World J Gastroenterol 2025; 31(6): 97697 [DOI: 10.3748/wjg.v31.i6.97697]
Corresponding Author of This Article
Nan-Sheng Cheng, PhD, Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. nanshengcheng@yeah.net
Research Domain of This Article
Geriatrics & Gerontology
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Feb 14, 2025; 31(6): 97697 Published online Feb 14, 2025. doi: 10.3748/wjg.v31.i6.97697
Prognostic roles nutritional index in patients with resectable and advanced biliary tract cancers
Di Zeng, Ning-Yuan Wen, Yao-Qun Wang, Nan-Sheng Cheng, Bei Li
Di Zeng, Ning-Yuan Wen, Yao-Qun Wang, Nan-Sheng Cheng, Bei Li, Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Di Zeng, Ning-Yuan Wen, Yao-Qun Wang, Nan-Sheng Cheng, Bei Li, Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Zeng D conceptualized and designed the research; curated and analyzed the data; developed the methodology; conducted investigations; prepared the original draft; and led the review and editing of the manuscript; Wen NY contributed to the conceptualization, formal analysis, and investigation, as well as the critical review and editing of the manuscript; Wang YQ was involved in investigations and contributed to the critical review and editing of the manuscript; Li B provided essential methodological support, supervised the project, and contributed to the manuscript review; Cheng NS secured funding for the research, supervised the entire project, and contributed to the manuscript review. Both Li B and Cheng NS have made critical and indispensable contributions as co-corresponding authors. Li B provided vital support in methodological design, supervised the research process, and ensured the scientific rigor of the manuscript. Cheng NS played a pivotal role in overseeing the project's progression, securing funding, interpreting results, and revising the manuscript. Their collaboration was instrumental in shaping the manuscript and bringing it to publication.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nan-Sheng Cheng, PhD, Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. nanshengcheng@yeah.net
Received: June 5, 2024 Revised: October 24, 2024 Accepted: December 16, 2024 Published online: February 14, 2025 Processing time: 218 Days and 20.9 Hours
Abstract
BACKGROUND
Biliary tract cancer (BTC) is a rare, aggressive malignancy with increasing incidence and poor prognosis. Identifying preoperative prognostic factors is crucial for effective risk-benefit assessments and patient stratification. The prognostic nutritional index (PNI), which reflects immune-inflammatory and nutritional status, has shown prognostic value in various cancers, but its significance in BTC remains unclear.
AIM
To assess the prognostic value of the preoperative PNI in BTC patients, with a focus on overall survival (OS) and disease-free survival (DFS).
METHODS
Comprehensive searches were conducted in the PubMed, EMBASE, and Web of Science databases from inception to April 2024. The primary outcomes of interest focused on the associations between the preoperative PNI and the prognosis of BTC patients, specifically OS and disease-free survival (DFS). Statistical analyses were conducted via STATA 17.0 software.
RESULTS
Seventeen studies encompassing 4645 patients met the inclusion criteria. Meta-analysis revealed that a low PNI was significantly associated with poorer OS [hazard ratio (HR) 1.91, 95%CI: 1.59-2.29; P < 0.001] and DFS (HR 1.93, 95%CI: 1.39-2.67; P < 0.001). Subgroup analyses revealed consistent results across BTC subtypes (cholangiocarcinoma and gallbladder cancer) and stages (resectable and advanced). Sensitivity analyses confirmed the robustness of these findings, and no significant publication bias was detected.
CONCLUSION
This study demonstrated that a low preoperative PNI predicts poor OS and DFS in BTC patients, highlighting its potential as a valuable prognostic tool. Further prospective studies are needed to validate these findings and enhance BTC patient management.
Core Tip: Preoperative prognostic nutritional index (PNI) serves as a valuable prognostic tool for patients with biliary tract cancer (BTC). Our meta-analysis, comprising 17 studies and 4645 patients, reveals that low preoperative PNI significantly correlates with poorer overall survival and disease-free survival in BTC patients, irrespective of subtype or stage. These findings underscore the importance of incorporating PNI assessment into preoperative evaluations for effective risk stratification and personalized treatment strategies in BTC. Further prospective studies are warranted to validate these results and optimize patient management approaches.
