The Prognostic Impact of Controlling Nutritional Status (CONUT) in Intrahepatic Cholangiocarcinoma Following Curative Hepatectomy: A Retrospective Single Institution Study

Miyata, Tatsunori; Yamashita, Yo‐ichi; Higashi, Taishi; Taki, Katsunobu; Izumi, Daisuke; Kosumi, Keisuke; Tokunaga, Ryuma; Nakagawa, Shigeki; Okabe, Hidetoshi; Imai, Katsunori; Hashimoto, Daisuke; Chikamoto, Akira; Baba, Hideo

doi:10.1007/s00268-017-4214-1

Cited by 65 publications

(63 citation statements)

References 42 publications

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“…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: 98%

“…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%

“…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%

“…Five studies reported postoperative mortality [12,13,18,20,21]. One study showed that the high CONUT group had a significantly higher incidence of mortality after hepatectomy (p = 0.002), and was an independent predictor of mortality after hepatectomy in multivariable analyses (RR 9.41, p = 0.038) [18].…”

Section: Reported Postoperative Outcomesmentioning

confidence: 99%

“…One study showed that the high CONUT group had a significantly higher incidence of mortality after hepatectomy (p = 0.002), and was an independent predictor of mortality after hepatectomy in multivariable analyses (RR 9.41, p = 0.038) [18]. 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].…”

Section: Reported Postoperative Outcomesmentioning

confidence: 99%

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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

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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.

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Section: Reported Postoperative Outcomesmentioning

confidence: 98%

Section: Characteristics and Quality Assessment Of Included Studiesmentioning

confidence: 99%

Section: Characteristics and Quality Assessment Of Included Studiesmentioning

confidence: 99%

Section: Reported Postoperative Outcomesmentioning

confidence: 99%

Section: Reported Postoperative Outcomesmentioning

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

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Prognostic impact of preoperative skeletal muscle change from diagnosis to surgery in patients with perihilar cholangiocarcinoma

Hayashi

Abe

Kitago

et al. 2022

Annals of Gastroent Surgery

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Background Loss of skeletal muscle mass is a prognostic factor after surgery for gastrointestinal cancers. The treatment for perihilar cholangiocarcinoma (PHC) is a highly invasive surgery. Biliary drainage and portal vein embolization, which can prolong the preoperative waiting time (PWT), are often required before surgery. Assuming that the skeletal muscle mass can change during PWT, we investigated the clinical effect of skeletal muscle change on surgical outcomes of PHC. Methods We retrospectively reviewed the medical records of 89 patients who underwent curative surgery for PHC from January 2013 to December 2019. We defined the psoas muscle area (PMA) at the third lumbar vertebra as the skeletal muscle mass. The PMA just before surgery was divided by that at the time of diagnosis, and we defined it as the rate of change of PMA (CPMA). Patients were divided into two groups according to CPMA: wasting (n = 44, below the median CPMA) and no‐change (n = 45, above the median CPMA). Results The median PWT was 63 d, and CPMA was 96.1%. The median recurrence‐free survival and overall survival were significantly shorter in the wasting group than in the no‐change group (8.0 vs 33.2 mo, P = 0.001 and 14.2 vs 48.7 mo, P < 0.001, respectively). Multivariate analysis revealed that histological differentiation, R1 resection, lymph node metastasis, and preoperative skeletal muscle wasting were independent prognostic factors of PHC. Conclusion This study suggests that preoperative skeletal muscle wasting in patients with PHC has a negative effect on survival outcomes.

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C-reactive protein : albumin ratio in patients with resectable intrahepatic cholangiocarcinoma

et al. 2020

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Background: The C-reactive protein : albumin ratio (CAR) has been reported as a novel prognostic marker in several cancers. The aim of this study was to investigate the prognostic value of CAR in patients with intrahepatic cholangiocarcinoma (ICC). Methods: This was a single-centre retrospective study of patients who underwent surgery for ICC in a university hospital in Japan between 1998 and 2018. CAR, Glasgow Prognostic Score (GPS) and modified GPS (mGPS) were calculated. Their correlation with recurrence-free survival (RFS) and overall survival (OS) was analysed with Cox proportional hazards models. Results: Seventy-two patients were included in the study. Patients were divided into two groups according to the optimal CAR cutoff value of 0⋅02. CAR above 0⋅02 was associated with higher carbohydrate antigen 19-9 levels (20⋅5 versus 66⋅1 units/ml for CAR of 0⋅02 or less; P = 0⋅002), larger tumour size (3⋅2 versus 4⋅4 cm respectively; P = 0⋅031) and a higher rate of microvascular invasion (9 of 28 versus 25 of 44; P = 0⋅041). RFS and OS were shorter in patients with CAR above 0⋅02: hazard ratio (HR) 4⋅31 (95 per cent c.i. 2⋅02 to 10⋅63) and HR 4⋅80 (1⋅85 to 16⋅40) respectively. In multivariable analysis CAR above 0⋅02 was an independent prognostic factor of RFS (HR 3⋅29 (1⋅33 to 8⋅12); P < 0⋅001), but not OS. Conclusions: CAR was associated with prognosis in patients who had hepatic resection for ICC.

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The Prognostic Impact of Controlling Nutritional Status (CONUT) in Intrahepatic Cholangiocarcinoma Following Curative Hepatectomy: A Retrospective Single Institution Study

Abstract: CONUT may be useful for the preoperative assessment of prognosis in patients with ICC who have undergone curative hepatectomy.

Cited by 65 publications

References 42 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

Prognostic impact of preoperative skeletal muscle change from diagnosis to surgery in patients with perihilar cholangiocarcinoma

C-reactive protein : albumin ratio in patients with resectable intrahepatic cholangiocarcinoma

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