Preoperative controlling nutritional status (CONUT) score as a predictor of long-term outcome after curative resection followed by adjuvant chemotherapy in stage II-III gastric Cancer

Abstract

BackgroundThe prognostic value of preoperative controlling nutritional status (CONUT) has been reported in many malignancies. In present study, we aimed to clarify the prognostic impact of CONUT in gastric cancer (GC) receiving curative resection and adjuvant chemotherapy.MethodsWe retrospectively reviewed 697 consecutive patients undergoing curative surgery followed by adjuvant chemotherapy for Stage II-III GC between November 2000 and September 2012. Patients were classified into high (≥3) and low (≤2) CONUT groups according to the receiver operating characteristic (ROC) analysis.ResultsOf the included patients, 217 (31.1%) belonged to the high CONUT group. The high CONUT group had a significantly lower 5-year cancer-specific survival (CSS) rate than the low CONUT group (39.3 vs. 55.5%, P < 0.001). High CONUT score was significantly associated with larger tumor size, more lymph node metastasis, and poorer nutritional status, including lower body mass index (BMI), higher prognostic nutritional index (PNI) and the presence of preoperative anemia (all P < 0.05). Multivariate analysis revealed that CONUT score was an independent prognostic factor (HR: 1.553; 95% CI: 1.080–2.232; P = 0.017). Of note, in the low PNI group, CONUT score still effectively stratified CSS (P = 0.016). Furthermore, the prognostic significance of CONUT score was also maintained when stratified by TNM stage (all P < 0.05).ConclusionsCONUT score is considered a useful nutritional marker for predicting prognosis in stage II-III GC patients undergoing curative resection and adjuvant chemotherapy, and may help to facilitate the planning of preoperative nutritional interventions.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4616-y) contains supplementary material, which is available to authorized users.

Combined Features Based on Preoperative Controlling Nutritional Status Score and Circulating Tumour Cell Status Predict Prognosis for Colorectal Cancer Patients Treated with Curative Resection

“…To the best of our knowledge, this is the first study to uncover that preoperative CONUT-CTC score is associated with tumour progression and can be considered an independent marker for better predicting the prognosis of patients with CRC treated with curative resection. The CONUT score is proposed as a blood-based marker for reflecting host immune-nutritional status [20,23], and growing evidence has shown that higher preoperative CONUT score indicates worse nutritional condition and pro-tumour immunity status [20,[22][23][24], which facilitates the migration, invasion and metastasis of tumour cells [31][32][33][34][35] and affects patients' prognosis with multiple solid tumours [21], including lung [36], liver [37], gastric [38] and colorectal cancer [22][23][24]. As a component of peripheral blood in patients with cancer, CTC was originally considered to be an important mediator of tumour recurrence and metastasis [6] and was also reported to be significantly associated with poor prognosis in a variety of malignancies [9,11,39].…”

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

“…Given the potential role of systematic inflammation and nutrition status in tumor progression and their associations with oncological outcomes, several biomarkers that reflect the above two status have been explored in UTUC including neutrophil to lymphocyte ratio, albumin to globulin ratio, nutritional index, and controlling nutritional status (CONUT) score . Of them, CONUT score, a novel biomarker which is calculated from serum albumin, total lymphocyte counts, and total cholesterol concentrations, has shown its independent prognostic significance in various solid tumor types such as hepatocellular carcinoma, gastric cancer, and colorectal cancer . It reflects individuals’ nutrition status, immunological function, protein and lipids metabolism.…”

<p>High Preoperative Controlling Nutritional Status Score Predicts a Poor Prognosis in Patients with Localized Upper Tract Urothelial Cancer: A Propensity Score Matching Study in a Large Chinese Center</p>

“…In our study, it was 3 according to the ROC curve, which was in accordance with previous studies. [19][20][21] PSM analysis has been used in many studies to balance subgroups across selected factors. 22 In our study, to balance the baseline characteristics of preoperative covariates between the two groups, we used the PSM method.…”