Controlling Nutritional Status (CONUT) score is a prognostic marker for gastric cancer patients after curative resection

Kuroda, Daisuke; Shinmoto, Hiroshi; Kurashige, Junji; Iwatsuki, Masaaki; Eto, Tsugio; Tokunaga, Ryuma; Yamamura, Kensuke; Ouchi, Mayuko; Nakamura, Kenichi; Baba, Yoshifumi; Sakamoto, Yasuo; Yamashita, Yo‐ichi; Yoshida, Naoya; Chikamoto, Akira

doi:10.1007/s10120-017-0744-3

Cited by 252 publications

(227 citation statements)

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“…The CONUT score not only reflects the nutritional status of patients with GC but also predicts long‐term OS after surgery for GC 8. Takagi et al19 suggested that the CONUT score was a reliable predictor of long‐term prognosis after hepatectomy for hepatocellular carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…Takagi et al19 suggested that the CONUT score was a reliable predictor of long‐term prognosis after hepatectomy for hepatocellular carcinoma. In addition, the predictive ability of the CONUT score is better than that of classic indicators, such as the neutrophil to lymphocyte ratio (NLR), prognostic nutritional index (PNI), and modified Glasgow Prognostic Score (mGPS) 8, 19. However, whether the predictive power of the CONUT score is superior to that of sarcopenia has not been previously reported.…”

Section: Discussionmentioning

confidence: 99%

“…Although Kuroda et al8 found that the CONUT score was an independent risk factor for long‐term survival after surgery for GC and was superior to NLR and mGPS, it was not included among the factors for SMI. The present study included both the CONUT score and SMI and revealed that the prognostic ability of SMI was better than that of the CONUT score.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, accurate evaluation of prognosis in patients with GC may contribute to the development of individualized treatment programs and improve patient prognoses. Recently, nutritional status has been reported as a prognostic factor in patients with cancer 3, 4, 5, 6, 7, 8, 9…”

Section: Introductionmentioning

confidence: 99%

“…The CONUT score, derived from serum albumin (ALB), total lymphocyte count (TLC), and cholesterol measurements, is an effective tool for assessing the status of immune nutrition 17. The Controlling Nutritional Status (CONUT) score is a prognostic factor for various cancers, including GC 8, 18, 19, 20. Nevertheless, no studies have determined whether SMI or the CONUT score is a better predictor of long‐term prognosis in GC.…”

Section: Introductionmentioning

confidence: 99%

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Preoperative skeletal muscle index vs the controlling nutritional status score: Which is a better objective predictor of long‐term survival for gastric cancer patients after radical gastrectomy?

et al. 2018

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Skeletal muscle index (SMI) and the controlling nutritional status (CONUT) score are useful for evaluating nutritional status, which is closely associated with cancer prognosis. This study compared the prognostic value of these indicators in patients with gastric cancer (GC) after radical gastrectomy (RG). We retrospectively enrolled 532 patients between 2010 and 2011. SMI was measured via CT images to determine low SMI. The CONUT score was calculated based on serum albumin, total lymphocyte count, and cholesterol. Patients were grouped according to SMI and the CONUT score based on previous research. Spearman's correlation coefficient, the Kaplan‐Meier method, and Cox regression were used. There was no significant correlation between SMI and the CONUT score. Five‐year overall survival (OS) and recurrence‐free survival (RFS) in patients with low SMI were significantly worse than those in patients with high SMI (P < .001). The normal nutrition group had better OS and RFS than did the light and moderate or severe malnutrition groups (P < .05), but the OS and RFS were not significantly different between the light and moderate or severe malnutrition groups (P = .726). Univariate analysis showed that SMI and the CONUT score were associated with OS and RFS, but only SMI remained prognostic in multivariate analysis. Preoperative SMI based on CT images is a more objective predictor than the CONUT score of long‐term survival in GC after RG, but this finding must be confirmed by prospective trials.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Preoperative skeletal muscle index vs the controlling nutritional status score: Which is a better objective predictor of long‐term survival for gastric cancer patients after radical gastrectomy?

et al. 2018

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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

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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.

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From the completion of neoadjuvant chemotherapy to surgery for colorectal cancer liver metastasis: What is the optimal timing?

et al. 2020

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Background Neoadjuvant chemotherapy (NAC) has been widely performed in the treatment of colorectal cancer liver metastasis (CRLM) patients, but the optimal timing of surgery after NAC is unclear. The aim of this study was to investigate the optimal timing of surgery. Methods From December 2010 to May 2018, 101 consecutive patients who received NAC followed by liver resection for CRLM were included in this study. The main outcome parameters were pathological response, progression‐free survival (PFS), and overall survival (OS). The effect of time to surgery (TTS) on patient outcomes, defined as a high TTS and a low TTS according to an X‐tile analysis, was investigated. To adjust for potential selection bias, propensity score matching at 1:2 was performed with two high TTS patients matched to one low TTS patient. Kaplan‐Meier curves, logistic regression analyses, and Cox regression models were used for the data analysis. Results The optimal cut‐off value for the TTS was 5 weeks by X‐tile analysis. The patients in this study were divided into low (≤5 weeks, n = 27) and high (>5 weeks, n = 74) TTS groups. Patients with a high TTS were more likely to have an unfavorable pathological response (75.7% vs 48.1%, P = .008). In multivariate analysis, a low TTS significantly predicted a better pathological response (OR = 3.397, 95% CI: 1.116‐10.344, P = .031). Compared to patients with a high TTS, patients with a low TTS had significantly better PFS (P < .001, mPFS: 16 months vs 7 months) and better OS (P = .037, mOS: not reached vs 36 months). Multivariate analysis revealed that a TTS > 5 weeks was an independent predictor of decreased PFS (HR = 2.041, 95% CI: 1.152‐3.616, P = .014) but not OS. After propensity matching, the patients with a low TTS had significantly better PFS (P < .001, mPFS: 18.2 months vs 10 months) and an equivalent OS (P = .115, mOS: not reached vs 41 months). Multivariate analysis revealed that a TTS > 5 weeks was an independent predictor of decreased PFS (HR = 3.031, 95% CI: 1.494‐6.149, P = .002) but not OS. Conclusion The longer TTS after the completion of NAC may be disadvantageous for a favorable pathological response and long‐term PFS. These results should be validated prospectively in a randomized trial.

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Controlling Nutritional Status (CONUT) score is a prognostic marker for gastric cancer patients after curative resection

Abstract: CONUT is useful for not only estimating nutritional status but also for predicting long-term OS in gastric cancer patients after curative resection.

Cited by 252 publications

References 28 publications

Preoperative skeletal muscle index vs the controlling nutritional status score: Which is a better objective predictor of long‐term survival for gastric cancer patients after radical gastrectomy?

Preoperative skeletal muscle index vs the controlling nutritional status score: Which is a better objective predictor of long‐term survival for gastric cancer patients after radical gastrectomy?

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

From the completion of neoadjuvant chemotherapy to surgery for colorectal cancer liver metastasis: What is the optimal timing?

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