CONUT: a novel independent predictive score for colorectal cancer patients undergoing potentially curative resection

Tokunaga, Ryuma; Sakamoto, Yasuo; Nakagawa, Shigeki; Ohuchi, Mayuko; Izumi, Daisuke; Kosumi, Keisuke; Taki, Katsunobu; Higashi, Taishi; Miyamoto, Yuji; Yoshida, Naoya; Oki, Eiji; Watanabe, Masayuki; Baba, Hideo

doi:10.1007/s00384-016-2668-5

Cited by 122 publications

(144 citation statements)

References 31 publications

Supporting

Mentioning

134

Contrasting

Unclassified

Order By: Relevance

“…Postoperative major complications (CDc ≥3) were described in 7 studies [13,[16][17][18][19][20][21]. Three studies reported the CONUT score to be associated with an increased risk of major complications after esophagectomy (p = 0.034), colectomy (p < 0.001), and hepatectomy (p < 0.01) [13,16,19]. In contrast, no significant differences between groups were shown in 4 studies [17,18,20,21].…”

Section: Reported Postoperative Outcomesmentioning

confidence: 81%

“…However, the other 4 studies showed no statistical differences in patients following esophagectomy, hepatectomy, and pancreatectomy [12,13,20,21]. Postoperative major complications (CDc ≥3) were described in 7 studies [13,[16][17][18][19][20][21]. Three studies reported the CONUT score to be associated with an increased risk of major complications after esophagectomy (p = 0.034), colectomy (p < 0.001), and hepatectomy (p < 0.01) [13,16,19].…”

Section: Reported Postoperative Outcomesmentioning

confidence: 99%

“…Regarding the cutoff value of the CONUT score, patients were divided into 2 groups depending on CONUT scores as defined in the original studies: CONUT ≤1 vs. CONUT ≥2 in one study [20], CONUT ≤2 vs. CONUT ≥3 in 2 studies [12,15], CONUT ≤3 vs. CONUT ≥4 in 4 studies [14,17,19,21], and CONUT ≤4 vs. CONUT ≥5 in 3 studies [13,16,18]. The prevalence in patients with high CONUT score ranged between 6.0 and 43.7%.…”

Section: Characteristics and Quality Assessment Of Included Studiesmentioning

confidence: 99%

“…A total of 5,138 patients were selected for the meta-analysis, including patients with esophageal cancer [12,13], gastric cancer [14], colorectal cancer [15,16], primary liver cancer [17][18][19][20], and pancreatic cancer [21].…”

Section: Characteristics and Quality Assessment Of Included Studiesmentioning

confidence: 99%

See 3 more Smart Citations

The Controlling Nutritional Status Score and Postoperative Complication Risk in Gastrointestinal and Hepatopancreatobiliary Surgical Oncology: A Systematic Review and Meta-Analysis

Takagi¹,

Domagała²,

Polak

et al. 2019

Ann Nutr Metab

View full text Add to dashboard Cite

The controlling nutritional status (CONUT) score is associated with prognosis in gastrointestinal (GI) cancer patients, but the clinical significance of the CONUT score for postoperative short-term outcome remains controversial. The aim of this study was to investigate the impact of the CONUT score on postoperative outcomes in patients with GI and hepatopancreatobiliary (HPB) cancers. We conducted a systematic literature search of Embase, Medline Ovid, Web of Science, Cochrane CENTRAL, and Google Scholar. Meta-analyses were performed to estimate the pooled risk ratio (RR) for postoperative complications in patients with lower CONUT score versus higher CONUT score. Furthermore, we explored the most appropriate cutoff value of the CONUT score to predict postoperative complications. Ten retrospective studies (5,138 patients) were included in this meta-analysis. Patients with higher CONUT score had an increased risk of mortality (RR 5.38, 95% CI 2.19–13.2, p < 0.001, I² = 0%), postoperative major complications (RR 1.56, 95% CI 1.05–2.33, p= 0.03, I² = 79%), and overall complications (RR 1.38, 95% CI 1.16–1.63, p < 0.001, I² = 6%). We found that the cutoff of CONUT ≤4 vs. CONUT ≥5 had the highest pooled RR compared with other cutoff values (RR 4.79, 95% CI 0.97–23.5, p= 0.05, I² = 91%). In conclusion, the present study suggests that the preoperative CONUT score was associated with an increased risk of mortality and complications in GI and HPB surgical oncology. Patients with higher CONUT score as compared with those having a lower score had approximately a fivefold mortality risk and an increased risk up to 55% on major and overall complications after GI and HPB surgery. Our analysis indicates that the appropriate cutoff value of the CONUT score to predict postoperative major complications would be between 4 and 5. The preoperative evaluation of the CONUT score would be helpful for predicting the risk of postoperative outcomes.

show abstract

Section: Reported Postoperative Outcomesmentioning

confidence: 81%

Section: Reported Postoperative Outcomesmentioning

confidence: 99%

Section: Characteristics and Quality Assessment Of Included Studiesmentioning

confidence: 99%

Section: Characteristics and Quality Assessment Of Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

The Controlling Nutritional Status Score and Postoperative Complication Risk in Gastrointestinal and Hepatopancreatobiliary Surgical Oncology: A Systematic Review and Meta-Analysis

Takagi¹,

Domagała²,

Polak

et al. 2019

Ann Nutr Metab

View full text Add to dashboard Cite

show abstract

“…Preoperative malnutrition has been reported to correlate with unfavorable long-term outcomes in patients who undergo surgery for gastroenterological cancers, including esophageal (1-4), gastric (5), colorectal (6), and pancreatic (7) cancers and hepatocellular carcinoma (8). Appropriate methods are needed to preoperatively assess malnutrition likely to adversely affect long-term outcome.…”

mentioning

confidence: 99%

Preoperative malnutrition and prognosis after neoadjuvant chemotherapy followed by subsequent esophagectomy

Yoshida

Baba

2017

J. Thorac. Dis.

Self Cite

View full text Add to dashboard Cite

Validation of the preoperative controlling nutritional status score as an independent predictor in a large Chinese cohort of patients with upper tract urothelial carcinoma

Tan

Jin

et al. 2018

Cancer Medicine

View full text Add to dashboard Cite

BackgroundPretreatment controlling nutritional status (CONUT) score is a novel index which was used to predict outcomes in cancer patients. We aim to explore the prognostic significance of CONUT score in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU).Patients and methodsA total of 662 UTUC patients between 2004 and 2016 were retrospectively analyzed. Patients were categorized into three groups based on CONUT score (Normal: 0‐1; Light: 2‐4; Moderate/severe: 5‐12). Associations of CONUT score with oncological outcomes were analyzed using Logistic and Cox regression analysis. Harrell concordance index was used to assess the predictive accuracy of the multivariate models. Subgroup analyses were conducted according to tumor grade and stage.ResultsThe median follow‐up duration was 41 months. Multivariate Logistic analysis showed that high CONUT score was independently associated with high‐grade disease, high pT stage, lymphovascular invasion, sessile carcinoma, variant histology, and positive surgical margins (each P < 0.05). Multivariate analysis demonstrated that CONUT score 5‐12 was an independent factor for worse cancer‐specific survival (CSS, hazard ratio [HR]:2.39, 95% confidence interval [CI] 1.55‐3.68, P < 0.0001), disease recurrence‐free‐survival (RFS, HR: 1.80, 95% CI 1.24‐2.60, P = 0.002), and overall survival (OS, HR: 2.26, 95% CI 1.53‐3.34, P < 0.0001). The estimated c‐index of the multivariate models for CSS, RFS, and OS increased from 0.755, 0.715 and 0.745 to 0.772, 0.723, and 0.756 when CONUT score supplemented. Subgroup analyses showed that especially in patients with high‐grade carcinoma and advanced stage (≥pT3), higher CONUT score predicts decreased CSS, RFS, and OS (all P < 0.05).ConclusionPreoperative CONUT score is a negative independent prognostic indicator for both pathologic and survival outcomes in UTUC, especially in those with high‐grade carcinoma and advanced stage. Adding this parameter into our clinical prediction model is appropriate so as to improve its predictive accuracy.

show abstract

CONUT: a novel independent predictive score for colorectal cancer patients undergoing potentially curative resection

Abstract: CONUT score may predict survival and postoperative severe complications in CRC patients undergoing potentially curative resection. Management of CRC patients may need consideration of host nutritional status.

Cited by 122 publications

References 31 publications

The Controlling Nutritional Status Score and Postoperative Complication Risk in Gastrointestinal and Hepatopancreatobiliary Surgical Oncology: A Systematic Review and Meta-Analysis

The Controlling Nutritional Status Score and Postoperative Complication Risk in Gastrointestinal and Hepatopancreatobiliary Surgical Oncology: A Systematic Review and Meta-Analysis

Preoperative malnutrition and prognosis after neoadjuvant chemotherapy followed by subsequent esophagectomy

Validation of the preoperative controlling nutritional status score as an independent predictor in a large Chinese cohort of patients with upper tract urothelial carcinoma

Contact Info

Product

Resources

About