Evidence mapPaperPMID 41350642Full record

SynthesisBMC cancer2025

Prognostic nutritional index and the survival of patients with hepatocellular carcinoma on immune checkpoint inhibitors: a meta-analysis.

Jia Fu, Wei Peng, Jinqiong Jiang, Tan Deng, Huaxin Duan, Kanghan Liu

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jia FuDepartment of Oncology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, 410005, China.
Wei PengDepartment of Oncology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, 410005, China.
Jinqiong JiangDepartment of Oncology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, 410005, China.
Tan DengDepartment of Oncology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, 410005, China.
Huaxin DuanDepartment of Oncology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, 410005, China.
Kanghan LiuDepartment of Nephrology and Laboratory of Kidney Disease, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Hunan Clinical Research Center for Chronic Kidney Disease, No. 61 Jiefang West Road, Changsha, Hunan, 410005, China. liukanghan@163.com.

Funding

Natural Science Foundation of Hunan Province 2025JJ80744
6 · The paper itself

Abstract

backgroundThe prognostic nutritional index (PNI), reflecting both nutritional and immune status, may be associated with survival in hepatocellular carcinoma (HCC) patients treated with immune checkpoint inhibitors (ICIs). However, findings across individual studies remain inconsistent. This meta-analysis aimed to assess the association between pretreatment PNI and survival outcomes in HCC patients receiving ICIs.

methodsA systematic search of PubMed, Embase, and Web of Science was conducted from inception to May 31, 2025. Cohort studies reporting hazard ratios (HRs) for overall survival (OS) and/or progression-free survival (PFS) by baseline PNI levels in HCC patients on ICIs were included. Pooled HRs with 95% confidence intervals (CIs) were calculated using random-effects models to account for the influence of heterogeneity.

resultsEleven retrospective cohort studies with 2,944 patients were included. A low PNI was significantly associated with poorer OS (HR: 1.78, 95% CI: 1.40 to 2.26, p < 0.001; I² = 56%) and PFS (HR: 1.46, 95% CI: 1.22 to 1.74, p < 0.001; I² = 43%). Subgroup analyses showed consistent associations across mean age, Barcelona Clinic Liver Cancer stage C proportion, PNI cutoff, follow-up duration, and study quality scores, with all p-values for subgroup differences > 0.05. Sensitivity analyses by excluding one study at a time did not significantly affect the results, which also confirmed the stability of findings.

conclusionsLow pretreatment PNI was associated with poorer OS and PFS in HCC patients receiving ICIs. These findings suggest that PNI may be a promising and practical prognostic marker in this setting. However, prospective studies are needed to validate its utility before it can be considered an established biomarker.

Indexed as

Carcinoma, HepatocellularImmune Checkpoint InhibitorsLiver NeoplasmsNutritional StatusNutrition AssessmentHumansPrognosisRetrospective StudiesImmune Checkpoint InhibitorsHepatocellular carcinomaImmune checkpoint inhibitorsMeta-analysisPrognostic nutritional indexSurvival

Identifiers

PMID41350642
PMCPMC12798109

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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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 Socratic graph.