Nutritional and inflammatory measures predict survival of patients with stage IV colorectal cancer

Abstract

Background This study aimed to evaluate the prognostic impact of nutritional and inflammatory measures (controlling nutritional status (CONUT) score, prognostic nutritional index (PNI), and modified Glasgow prognostic score (mGPS)) on overall survival (OS) in patients with stage IV colorectal cancer (CRC). Methods Subjects were 996 patients with stage IV CRC who were referred to the National Cancer Center Hospital between 2001 and 2015. We retrospectively investigated correlations between OS and CONUT score, PNI, and mGPS. Multivariate analyses were performed using Cox proportional hazards regression models. Results After adjusting for known factors (age, gender, BMI, ECOG performance status, location of primary tumor, CEA levels, histological type, M category, and prior surgical treatment), all three measures were found to be independent prognostic factors for OS in patients with stage (CONUT score, p < 0.001; PNI, p < 0.001; mGPS, p < 0.001). Significant differences in OS were found between low CONUT score (0/1) (n = 614; 61%) and intermediate CONUT score (2/3) (n = 276; 28%) (hazard ratio (HR) = 1.20, 95% confidence interval (CI): 1.02–1.42, p = 0.032), and intermediate CONUT score and high CONUT score (≥4) (n = 106; 11%) (HR = 1.30, 95% CI: 1.01–1.67, p = 0.045). Significant differences in OS were found between mGPS = 0 (n = 633; 64%) and mGPS = 1 (n = 234; 23%) (HR = 1.84, 95% CI: 1.54–2.19, p < 0.001), but not between mGPS = 1 and mGPS = 2 (n = 129; 13%) (HR = 1.12, 95% CI: 0.88–1.41, p = 0.349). Patients with low PNI (< 48.0) (n = 443; 44%) showed a significantly lower OS rate than those with high PNI (≥48.0) (n = 553; 56%) (HR = 1.39, 95% CI: 1.19–1.62, p < 0.001). Conclusions CONUT score, PNI, and mGPS were found to be independent prognostic factors for OS in patients with stage IV CRC, suggesting that nutritional and inflammatory status is a useful host-related prognostic indicator in stage IV CRC.

Geriatric nutritional risk index predicts prognosis in hepatocellular carcinoma after hepatectomy: a propensity score matching analysis

“…Furthermore, cancer-related systemic inflammation induces catabolism of patients, which causes metastasis 5 , 6 . Some inflammatory indices—neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and the modified Glasgow prognostic score—and several nutritional indices—the prognostic nutritional index, controlling nutritional status score (CONUT), sarcopenia, and geriatric nutritional index (GNRI)—can predict postoperative complications and long-term outcomes of several cancers 7 – 9 . These scores are also useful for evaluating postoperative complications and prognosis of HCC 10 – 12 .…”

Body composition and immunonutritional status in patients treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC) for gastrointestinal peritoneal metastases: a prospective single-center analysis

“…Moreover, for their derived indexes PNI and NLR, cut offs of 36.5 and 4.8 were respectively calculated, but, due to the small sample size, they need further validation on a larger and more selected population. PNI is an unexpensive and easy to calculate parameter, which reflects the nutrition and inflammatory status of patients [ 30 ], whose role as a prognostic index for OS in many oncological settings has been widely recognised [ 31 ], [ 32 ], [ 33 ]. In our study, a PNI under the identified cut off value (36.5) resulted the only independently correlated factor with a worse OS (HR 2.41), and similar results were reported in a recent large retrospective study conducted on PM patients [ 34 ].…”

Prognostic impact of the controlling nutritional status score in patients with hematologic malignancies: A systematic review and meta-analysis

“…Over the past decade, relevant research has validated the prognostic impact of the CONUT score for solid tumors (6)(7)(8)(9). More recently, many studies have explored the association between the CONUT score and prognosis for hematologic malignancies most of which concluded that the CONUT score was an independent prognostic factor in patients with hematologic malignancies.…”