Controlling nutritional status (CONUT) score as a preoperative risk assessment index for older patients with colorectal cancer

Abstract

BackgroundAssessment of preoperative general condition to predict postoperative outcomes is important, particularly in older patients who typically suffer from various comorbidities and exhibit impaired functional status. In addition to various indices such as Charlson Comorbidity Index (CCI), National Institute on Aging and National Cancer Institute Comorbidity Index (NIA/NCI), Adult Comorbidity Evaluation-27 (ACE-27), and American Society of Anesthesiologists Physical Status classification (ASA-PS), controlling nutritional status (CONUT) score is recently gaining attention as a tool to evaluate the general condition of patients from a nutritional perspective. However, the utility of these indices in older patients with colorectal cancer has not been compared.MethodsThe study population comprised 830 patients with Stage I - IV colorectal cancer aged 75 years or older who underwent surgery at the National Cancer Center Hospital from January 2000 to December 2014. Associations of each index with overall survival (OS) (long-term outcome) and postoperative complications (short-term outcome) were examined.ResultsFor the three indices with the highest Akaike information criterion values (i.e., CONUT score, CCI and ACE-27), but not the remaining indices (NIA/NCI and ASA-PS), OS significantly worsened as general condition scores decreased, after adjusting for known prognostic factors. In contrast, for postoperative complications, only CONUT score was identified as a predictive factor (≥4 versus 0–3; odds ratio: 1.90; 95% CI: 1.13–3.13; P = 0.016).ConclusionFor older patients with colorectal cancer, only CONUT score was a predictive factor of both long-term and short-term outcomes after surgery, suggesting that CONUT score is a useful preoperative risk assessment index.

Nutritional and Inflammatory Measures Predict Survival of Patients with Stage IV Colorectal Cancer

“…In the present study, we focused on stage IV CRC including curative resected stage IV CRC and unresectable metastatic CRC, and demonstrated that CONUT score, PNI, and mGPS are independent prognostic factors for OS in patients with stage IV CRC regardless of curative potential. Our results are compatible with previous reports that PNI, mGPS, and CONUT score were prognostic factors in CRC patients undergoing curative resection [5,7,8,14,17], and that CONUT score was a prognostic factor in metastatic CRC patients undergoing chemotherapy [16]. To our knowledge, this is the largest study to date that comprehensively assessed the prognostic signi cance of nutritional and in ammatory measures in patients with stage IV CRC.…”

Controlling Nutritional Status (CONUT) Score is Associated with Overall Survival in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib: A Multicenter Cohort Study

“…The CONUT scores, used to assess immuno-nutritional status, were calculated from the following three parameters, as previously described [15,26]: (1) albumin levels of 3.5, 3.0-3.49, 2.5-2.99, and <2.5 g/dL were scored as 0, 2, 4, and 6 points, respectively; (2) total lymphocyte counts of ≥1600, 1200-1599, 800-1199, and <800/µL were scored as 0, 1, 2, and 3 points, respectively; (3) total cholesterol levels of ≥180, 140-179, 100-139, and <100 mg/dL were scored as 0, 1, 2, and 3 points, respectively. Separately, the Child-Pugh classification [27] and ALBI grade [28] were used to assess hepatic functional reserve.…”

CONUT score is associated with mortality in patients with COVID-19: a retrospective study in Wuhan

“…The Controlling Nutritional Status(CONUT) score, which is calculated from serum level of albumin, lymphocyte and cholesterol, actually re ects state of systemic in ammation, nutrition and immune responsiveness [14]. The prognostic value of CONUT has been con rmed in various clinical settings including cardiovascular disease, liver disease and cancer [15][16][17][18][19]. We designed this study to explore the correlation between CONUT and mortality of COVID-19 patients.…”