BACKGROUND Biliary tract cancer(BTC)is a rare,aggressive malignancy with increasing inci-dence and poor prognosis.Identifying preoperative prognostic factors is crucial for effective risk-benefit assessments and patie...BACKGROUND Biliary tract cancer(BTC)is a rare,aggressive malignancy with increasing inci-dence 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.展开更多
We would like to thank you and other reviewers for reading our papers and sharing valuable comments. We are also appreciative of your conscientiousness and broad knowledge on relevant research fields. Recent advances ...We would like to thank you and other reviewers for reading our papers and sharing valuable comments. We are also appreciative of your conscientiousness and broad knowledge on relevant research fields. Recent advances in robotic hepatectomy (RH) were briefly summarized in your letter, especially its non-inferiority compared with the conventional laparoscopic liver resection (LLR). Here, we would like to address several points relevant to the comments.展开更多
文摘BACKGROUND Biliary tract cancer(BTC)is a rare,aggressive malignancy with increasing inci-dence 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.
文摘We would like to thank you and other reviewers for reading our papers and sharing valuable comments. We are also appreciative of your conscientiousness and broad knowledge on relevant research fields. Recent advances in robotic hepatectomy (RH) were briefly summarized in your letter, especially its non-inferiority compared with the conventional laparoscopic liver resection (LLR). Here, we would like to address several points relevant to the comments.
