Beyond the score: Diet and exercise as modifiers of inflammation-based prognosis in lenvatinib-treated hepatocellular carcinoma

doi:10.3748/wjg.v32.i22.118191

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Jun 14, 2026; 32(22): 118191
Published online Jun 14, 2026. doi: 10.3748/wjg.v32.i22.118191

Beyond the score: Diet and exercise as modifiers of inflammation-based prognosis in lenvatinib-treated hepatocellular carcinoma

Héctor Vázquez-Lorente, Jorge Olivares-Arancibia, Julio Plaza-Diaz

Héctor Vázquez-Lorente, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Reus 43201, Spain

Héctor Vázquez-Lorente, Julio Plaza-Diaz, Institut de Recerca Biomèdica Catalunya Sud, Hospital Universitari Sant Joan de Reus, Reus 43201, Spain

Héctor Vázquez-Lorente, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBERObn), Reus 43201, Spain

Héctor Vázquez-Lorente, Julio Plaza-Diaz, School of Health Sciences, Universidad Internacional de La Rioja, Logroño 26006, Spain

Jorge Olivares-Arancibia, AFySE Group, Research in Physical Activity and School Health, School of Physical Education, Faculty of Education, Universidad de Las Américas, Santiago 7500975, Región Metropolitana, Chile

Julio Plaza-Diaz, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBERObn), Alimentaciò, Nutrició Desenvolupament i Salut Mental, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Reus 43201, Spain

Author contributions: Vázquez-Lorente H, Olivares-Arancibia J, and Plaza-Diaz J designed the overall concept and outline of the manuscript, reviewed the literature, wrote and edited the manuscript.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Julio Plaza-Diaz, PhD, Senior Postdoctoral Fellow, Senior Researcher, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBERObn), Alimentaciò, Nutrició Desenvolupament i Salut Mental, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Carrer de Sant Llorenç 21, Reus 43201, Spain. julioramon.plaza@urv.cat

Received: December 28, 2025
Revised: February 6, 2026
Accepted: March 9, 2026
Published online: June 14, 2026
Processing time: 153 Days and 13.6 Hours

Core Tip

Core Tip: This article comments on Wu et al’s work, highlighting the prognostic nutritional index (PNI) as a powerful predictor of survival in patients with hepatocellular carcinoma treated with lenvatinib. Beyond its prognostic performance, the key message is that PNI reflects a dynamic and potentially modifiable state integrating nutrition, inflammation, and immune competence. Unlike static tumor characteristics, PNI may be improved through targeted lifestyle, nutritional, and supportive-care interventions. This perspective reframes inflammation-based scores from passive risk stratifiers to actionable clinical tools, supporting a more proactive and personalized approach to patient management, alongside systemic therapy.