TITLE:
Current Evidence on the Impact of Preoperative Nutritional Assessment on Outcomes after Liver Resection
AUTHORS:
Zichen Yang, Yanliang Yang, Kaiming Zhang, Haofeng Lu
KEYWORDS:
Liver Resection, Nutritional Scoring, Prognostic Nutritional Index, Controlling Nutritional Status, Geriatric Nutritional Risk Index, Naples Prognostic Score, Sarcopenia, Textbook Outcome, Prognosis
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.9,
September
17,
2026
ABSTRACT: Hepatectomy is the primary treatment for hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and certain benign liver diseases; however, postoperative complications, post-hepatectomy liver failure (PHLF), and tumor recurrence remain major determinants of prognosis. In recent years, preoperative nutritional status has received increasing attention as a modifiable prognostic factor. The Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT), Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), Hemoglobin-Albumin-Lymphocyte-Platelet Score (HALP), Naples Prognostic Score (NPS), and Nutritional Risk Screening 2002 (NRS-2002) can capture nutritional reserves, immune function, and systemic inflammatory status. Numerous studies have shown that low PNI, high CONUT, low GNRI, low HALP, and high NPS are associated with a higher incidence of postoperative complications, increased risk of PHLF, and shorter overall survival (OS) and recurrence-free survival (RFS). Based on a scoping review of the published literature from the past decade, this review summarizes recent advances in the application of preoperative nutritional scoring in patients undergoing liver resection, with a focus on its predictive value for short- and long-term outcomes, potential mechanisms, and perioperative intervention strategies. We also discuss emerging directions, including sarcopenia assessment, artificial intelligence-based prediction, and textbook outcome (TO) evaluation, with the aim of providing evidence-based support for accurate risk stratification and individualized perioperative management.