Publication Name	World Journal of Gastroenterology
Manuscript ID	118191
Country	Spain

Category	Endocrinology & Metabolism
Manuscript Type	Editorial
Article Title	Beyond the score: Diet and exercise as modifiers of inflammation-based prognosis in lenvatinib-treated hepatocellular carcinoma
Manuscript Source	Invited Manuscript
All Author List	Héctor Vázquez-Lorente, Jorge Olivares-Arancibia and Julio Plaza-Diaz
Funding Agency and Grant Number
Corresponding Author	Julio Plaza-Diaz, 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
Key Words	Hepatocellular carcinoma; Lenvatinib; Inflammation-based prognostic indices; Nutritional status; Sarcopenia; Anti-inflammatory diet; Exercise/physical activity
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.
Citation	Vázquez-Lorente H, Olivares-Arancibia J, Plaza-Diaz J. Beyond the score: Diet and exercise as modifiers of inflammation-based prognosis in lenvatinib-treated hepatocellular carcinoma. World J Gastroenterol 2026; In press

Received	2025-12-28 08:55
Peer-Review Started	2025-12-28 08:55
First Decision by Editorial Office Director	2026-01-30 09:07
Return for Revision	2026-01-30 09:07
Revised	2026-02-06 12:58
Publication Fee Transferred
Second Decision by Editor	2026-03-09 02:46
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-03-09 08:45
Articles in Press	2026-03-09 08:45
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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