Preoperative Controlling Nutritional Status plus Tumor Burden Score for the Assessment of Prognosis after Curative Liver Resection for Hepatocellular Carcinoma

Abstract

Objective: There is no prior study analyzing the prognostic predictive value of adding the tumor factor (i.e., tumor burden score) to the Controlling Nutritional Status (CONUT) score for patients with hepatocellular carcinoma (HCC). This study aimed to investigate the value of the CONUT plus Tumor Burden (CONUT-TB) score as a prognostic predictor in patients with HCC undergoing liver resection. Methods: Between 2015 and 2018, 96 consecutive patients with HCC underwent liver resection at our institution. Patients undergoing repeated liver resection and combined resection of a metastatic lesion were excluded. Patients were divided into two groups according to their CONUT-TB scores according to a cutoff value. Clinicopathological prognostic factors for survival were analyzed using a database containing the medical records. Results: The optimal cutoff value of the CONUT-TB score determined by using a minimum p value approach was 13 points. Among the 81 patients included in the analytic cohort, 71 patients had low (<13) and 10 patients had high (>13) CONUT-TB scores. The overall 3-year survival rate of patients following liver resection for HCC in the high CONUT-TB group was significantly worse than that of patients in the low CONUT-TB group (62.5% vs. 89.3%, p=0.003). Multivariate analysis indicated that a high CONUT-TB score was independently associated with overall survival after liver resection (p=0.010). Conclusions: The CONUT-TB score is a valuable predictor of survival in patients with HCC after liver resection.

A radiographic tumor burden score-based preoperative model to predict overall survival in patients with hepatocellular carcinoma undergoing resection

“…42 ASA grade 3 is de ned as severe systemic disease (https://www.asahq.org/standardsand-guidelines/asa-physical-status-classi cation-system). Furthermore, poor nutritional status 15 and inadequate liver function reserve (i.e., the presence of CSPH or CP class B) 43 were associated with poor outcomes in patients with HCC undergoing LR. We thought that these prognostic factors would not be clinically relevant today.…”

“…9 The TBS is simple to use, and numerous studies have shown its predictive value in prognosing patients with HCC undergoing LR. [10][11][12][13][14][15][16][17][18][19][20][21] Of these studies, Lima et al developed a preoperative model comprising radiographic TBS, AFP, and Child − Pugh (CP) classi cation. This model was superior to the BCLC staging system in predicting OS and further strati ed patients within each BCLC stage relative to OS.…”

Nomograms including the controlling nutritional status score in patients with hepatocellular carcinoma undergoing transarterial chemoembolisation for prediction survival: a retrospective analysis

“…Many studies have shown that nutritional status is an important factor determining prognosis in malignant tumours (10,27,28) . The CONUT score focuses on the nutritional status of patients, which is a new prognostic scoring system for HCC.…”

Radiographic tumor burden score is useful for stratifying the overall survival of hepatocellular carcinoma patients undergoing resection at different Barcelona Clinic Liver Cancer stages

“…They found that the TBS was an accurate tool to predict the OS of patients with colorectal liver metastasis undergoing resection. The TBS is simple to use, and previous studies have demonstrated its impact in resected and non-resected HCC cases [9][10][11][12][13][14][15][16][17][18][19].…”