The prognosis value of CONUT and SIS score for recurrent or metastatic esophageal squamous cell carcinoma patients treated with second-line immunotherapy

Abstract

ObjectiveTo investigate the predictive value of Controlling Nutritional Status (CONUT) score and systemic inflammation (SIS) score in the prognosis, short-term efficacy, and immune-related side effects of patient with recurrent or metastatic esophageal squamous cell carcinoma (R/M ESCC) receiving immunotherapy as second line therapy combined with or without radiotherapy.MethodsForty-eight patients with R/M ESCC who received second-line therapy with Camrelizumab were retrospectively studied. They were divided into the high and low score groups according to the CONUT and SIS score. Univariate and multivariate analyses were used to analyze factors that might affect patient prognosis and the effects of different CONUT score and SIS on the short-term efficacy and immune-related toxic and side effects of patients.ResultsThe 1- and 2-year overall survival (OS) and progression-free survival (PFS) rates were 42.9% and 22.5%, and 29.0% and 5.8%, respectively. The CONUT score ranged from 0 to 6 (3.31 ± 1.43), whereas the SIS score ranged from 0 to 2 (1.19 ± 0.73). Multivariate analysis showed that treatment related toxicity, number of cycles of Camrelizumab used, short-term effect and SIS score were independent prognostic factors for OS (P=0.044, 0.021, 0.021, 0.030, respectively), whereas SIS and CONUT scores were independent prognostic factors for PFS (P=0.005, 0.047, respectively). Patients with low CONUT/SIS score had a low incidence rate of immune-related adverse reactions (X2 = 9.735, 5.693; P=0.002, 0.017) and better short-term efficacy (X2 = 4.427, 7.438; P=0.035, 0.006).ConclusionR/M ESCC patients with low CONUT/SIS score have better prognosis, higher objective response rate, lower incidence of immune-related toxic and side effects after receiving immunotherapy as second-line therapy. CONUT scores and SIS scores may be reliable prognostic indicators for patient receiving immunotherapy as second-line therapy for R/M ESCC.

Prognostic value of controlling nutritional status on clinical and survival outcomes in cancer patients treated with immunotherapy

“…103 articles were deemed unsuitable for further consideration based on an evaluation of their title and abstract within the literature. Upon thorough examination, a total of 8 articles with complete text, including 663 patients were ultimately incorporated into our meta-analysis 23 , 24 , 26 – 31 .

Figure 1 The flow diagram for identifying eligible studies.

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“…The salient features of the incorporated articles are succinctly outlined in Table 2 . Three of these investigations were conducted in Japan 23 , 28 , 29 , and five in China 24 , 26 , 27 , 30 , 31 . The range of NOS scores observed in the research encompassed values between 6 and 9, signifying that all included studies exhibited a high level of quality.…”

“…The range of NOS scores observed in the research encompassed values between 6 and 9, signifying that all included studies exhibited a high level of quality. All seven studies included in the analysis were retrospective 23 , 24 , 26 , 28 – 31 , while one was single-arm study 27 . Two studies were conducted in patients diagnosed with ESCC patients 30 , 31 ; one study was in HCC patients 27 , one study was in esophageal cancer (EC) patients 26 , one study was in GC patients 24 , one study was in NSCLC patients 23 , one study was in squamous cell carcinoma of the head and neck (HNSCC) patients 28 , and one study was in RCC patients 29 .…”

“…All seven studies included in the analysis were retrospective 23 , 24 , 26 , 28 – 31 , while one was single-arm study 27 . Two studies were conducted in patients diagnosed with ESCC patients 30 , 31 ; one study was in HCC patients 27 , one study was in esophageal cancer (EC) patients 26 , one study was in GC patients 24 , one study was in NSCLC patients 23 , one study was in squamous cell carcinoma of the head and neck (HNSCC) patients 28 , and one study was in RCC patients 29 . Furthermore, 7 studies reported CONUT’s role in prognosticating OS outcome 23 , 24 , 26 , 28 – 31 , all 8 studies provided the data of CONUT for PFS prognosis 23 , 24 , 26 – 31 , 3 studies provided the data of CONUT for DCR prognosis 23 , 26 , 28 , and 4 studies provided the data of CONUT for ORR prognosis 23 , 26 , 28 , 31 .…”

Nutritional Status Indices and Monoclonal Gammopathy of Undetermined Significance Risk in the Elderly Population: Findings from the National Health and Nutrition Examination Survey

“…GNRI and PNI were classified by quartiles, and participants in the first quartile (lowest score) indicated a relatively higher risk of malnutrition, while participants in the fourth quartile (highest score) indicated a relatively lower risk of malnutrition. The CONUT grouping was based on clinically meaningful cut-off value reported in previous studies [22][23][24][25], and the population was divided into low CONUT group (<3 scores) and high CONUT group (≥3 scores), with the high CONUT group having a relatively higher risk of malnutrition. For serum albumin levels >3.5, between 3.0 and 3.49, between 2.5 and 2.99 and <2.5 g/dL, 0, 2, 4, and 6 points were assigned, respectively.…”