Prognostic significance of the controlling nutritional status (CONUT) score in patients undergoing hepatectomy for hepatocellular carcinoma: a systematic review and meta-analysis

Abstract

BackgroundThe clinical value of the controlling nutritional status (CONUT) score in hepatocellular carcinoma (HCC) has increased. The aim of this meta-analysis was to systematically review the association between the CONUT score and outcomes in patients undergoing hepatectomy for HCC.MethodsEmbase, Medline Ovid, Web of Science, Cochrane CENTRAL, and Google Scholar were systematically searched. Random effects meta-analyses were conducted to examine the prognostic value of the CONUT score in HCC patients.ResultsA total of five studies including 4679 patients were found to be eligible and analyzed in the meta-analysis. The CONUT score was significantly associated with overall survival (HR 1.78, 95%CI = 1.20–2.64, P = 0.004, I2 = 79%), recurrence-free survival (HR 1.34, 95%CI = 1.17–1.53, P < 0.001, I2 = 16%) and postoperative major complications (OR 1.85, 95%CI: 1.19–2.87, P = 0.006, I2 = 72%) in HCC patients. Moreover, the CONUT score was associated with the Child–Pugh classification, liver cirrhosis, ICGR15, and tumor differentiation. However, it was not associated with tumor size, tumor number, and microvascular invasion.ConclusionsThe CONUT score is an independent prognostic indicator of the prognosis and is associated with postoperative major complications and hepatic functional reserve in HCC patients.

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

“…Previous studies have reported that ALBI grade, AFP level, and BCLC stage are independent factors for OS in patients with HCC treated with LEN [7,9], indicating that our results showed good agreement with those of previous reports. The CONUT score has previously been reported as a prognostic factor for patients with HCC treated with hepatic resection [24,25,34]. However, we are the first to reveal that the CONUT score is an independent factor for OS in patients with HCC treated with LEN.…”

“…The CONUT score has been reported to predict the risk of postoperative complications of grades III-V [23], as well as the prognosis of patients who undergo hepatic resection for HCC [24,25]. Thus, the CONUT score is a useful index for the management of patients who undergo hepatic resection for HCC; however, the impact of a CONUT score on the prognosis for HCC patients treated with LEN has been unclear until now.…”

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].…”