Prognostic significance of the controlling nutritional status (CONUT) score in patients undergoing gastrectomy for gastric cancer: a systematic review and meta-analysis

Abstract

Background In recent years, the clinical evidence of the controlling nutritional status (CONUT) score has increased in patients with gastrointestinal cancers. The purpose of this systematic review and meta-analysis was to investigate the association between the preoperative CONUT score and outcomes in patients undergoing gastrectomy for gastric cancer (GC). Methods A systematic literature search for studies reporting the prognostic impact of the CONUT score in patients with GC was conducted. Meta-analyses of survival, postoperative outcomes, and postoperative clinico-pathological parameters were conducted. Results Five studies with 2482 patients were found to be eligible and subsequently reviewed and analyzed. The CONUT score was significantly associated with overall survival (HR 1.85, 95%CI 1.38–2.48, P < 0.001), cancer-specific survival (HR 2.56, 95%CI 1.24–5.28, P = 0.01) and recurrence/relapse-free survival (HR 1.43, 95%CI 1.12–1.82, P = 0.004). Moreover, the CONUT score was associated with the incidence of postoperative complications (OR 1.39, P = 0.003) and mortality (OR 6.97, P = 0.04), and clinico-pathological parameters (T factor [OR 1.75, P < 0.001], N factor [OR 1.51, P < 0.001], TNM stage [OR 1.73, P < 0.001], and microvascular invasion [OR 1.50, P = 0.006]), but not with tumor differentiation (OR 0.85, P = 0.13). Conclusions The preoperative CONUT score is an independent prognostic indicator of survival and postoperative complications, and is associated with clinico-pathological parameters in patients with GC. Electronic supplementary material The online version of this article (10.1186/s12893-019-0593-6) contains supplementary material, which is available to authorized users.

Prognostic significance of the controlling nutritional status (CONUT) score in patients with colorectal cancer: A systematic review and meta-analysis

“…Two studies reported the association between the CONUT score and complications in multivariable analyses [10,18], in contrast no association between the CONUT score and postoperative infectious diseases was shown [14,15]. Recent meta-analyses have indicated that patients with higher CONUT score had an increased risk of complications as well as mortality after gastroenterological and hepatopancreatobiliary surgery [6][7][8]. Therefore, the CONUT score might be helpful in predicting complication risks in CRC surgery.…”

“…The queries were constructed using suitable terms concerning the CONUT score and CRC (Supplementary Table 1). The methods of our systematic literature review strategy have been described previously [6][7][8]. No ethical approval or informed consent statement was required for this review article.…”

“…Due to its simplicity and efficiency in evaluating patients' nutritional status, which is calculated using three values such as serum albumin level, total cholesterol level and total lymphocyte count [4], it is potentially broadly applicable. Recently the clinical evidence of the CONUT score for short-term and long-term outcomes has increased in gastroenterological and hepatopancreatobiliary surgical oncology [5][6][7][8]. The impact of the CONUT score on outcomes in patients undergoing surgery for colorectal cancer (CRC) was first reported in 2015 [9].…”

Hypoalbuminemia on Admission as an Independent Risk Factor for Acute Functional Decline after Infection

“…Albumin is one of the indicators of nutritional status and is included in nutritional assessment scores, such as CONUT score [ 18 ]. It was reported that serum albumin level on admission is associated with nosocomial infection or mortality during admission [ 22 , 23 , 24 ]. While albumin can be a good marker of nutritional status in a clinically stable elderly people in the community [ 25 ], serum albumin level is also lowered by inflammation, liver disfunction, and kidney disfunction [ 26 , 27 , 28 ] and is not a good marker of nutrition during acute phase; however, because of its long half-life of 14–20 days, serum albumin levels on admission immediately after the onset of the disease are less susceptible to changes due to inflammation and may reflect baseline status [ 28 , 29 ].…”

<p>CONUT Score or/and Peripheral Blood CD4+/CD8+ Ratio-Based Web Dynamic Nomograms to Predict the Individualized Survival of Patients with Advanced Osteosarcoma</p>

“…CONUT score is a comprehensive nutritional and immune index calculated from serum albumin, serum total cholesterol concentration, and peripheral TLC, as previously reported. 40 The three constituent parameters of CONUT score were scored based on the cut-off values reported in previous studies, [41][42][43] and the sum of the score was the CONUT score. Patients were stratified into four groups according to the CONUT score listed in Table 1.…”