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Ma X, Lu X, Jiang X, Wang J, Wang T, Zhang L. A nomogram combining prognostic nutritional index and platelet lymphocyte ratio predicts postoperative pulmonary infection following D2 radical gastrectomy for gastric cancer. NUTR HOSP 2024; 41:602-611. [PMID: 38726634 DOI: 10.20960/nh.05079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024] Open
Abstract
Introduction Introduction: the prognostic nutritional index (PNI) and platelet-lymphocyte ratio (PLR) have been found to correlate with outcomes following radical gastrectomy for gastric cancer (GC). Objectives: to construct a nomogram combining PNI and PLR for individually forecasting the risk of postoperative pulmonary infection (POI) following D2 radical gastrectomy for GC. Methods: retrospectively, clinical data was gathered from 404 patients treated with D2 radical gastrectomy for GC. The study used multivariate logistic regression analysis to screen independent risk factors for POI after surgery. Subsequently, a nomogram was developed based on the above factors to forecast the POI probability accurately. Results: the multivariate logistic regression analysis identified age, PNI, PLR, CA199 level, ASA score, and ICU treatment as independent risk variables for POI following D2 radical gastrectomy (p < 0.001 or 0.05). The nomogram's area under the receiver operating characteristic curve (AUC) for predicting the risk of POI was 0.736 (95 % confidence interval (CI) = 0.678-0.794). The nomogram was internally validated using the bootstrap approach, involving repeated sampling 1000 times. The result yielded a concordance index (c-index) of 0.707 (95 % CI = 0.705-0.709). The calibration curves demonstrated an excellent concordance between the predicted values of the nomogram and the observed values. The nomogram's clinical value was shown to be high using decision analysis curves. Conclusions: a nomogram combining PNI and PLR is a dependable tool for forecasting the probability of POI following D2 radical gastrectomy for GC.
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Affiliation(s)
- Xinghao Ma
- Department of Clinical Nutrition. Lu'an Hospital. Anhui Medical University
| | - Xiumin Lu
- Department of Gastrointestinal Surgery. Lu'an Hospital. Anhui Medical University
| | - Xiaoyang Jiang
- Department of Clinical Nutrition. Lu'an Hospital. Anhui Medical University
| | - Jiajia Wang
- Department of Clinical Nutrition. Lu'an Hospital. Anhui Medical University
| | - Tingting Wang
- Department of Clinical Nutrition. Lu'an Hospital. Anhui Medical University
| | - Li Zhang
- Department of Clinical Nutrition. Lu'an Hospital. Anhui Medical University
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Takemoto Y, Tanabe K, Chikuie E, Saeki Y, Ota H, Karakuchi N, Kohata A, Ohdan H. Preoperative High C-Reactive Protein to Albumin Ratio Predicts Short- and Long-Term Postoperative Outcomes in Elderly Gastric Cancer Patients. Cancers (Basel) 2024; 16:616. [PMID: 38339365 PMCID: PMC10854578 DOI: 10.3390/cancers16030616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/12/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Individualized preoperative assessment of the general condition of elderly patients with gastric cancer is necessary for appropriate surgical treatment planning. This study investigated the efficacy of preoperative markers that could be easily calculated from preoperative peripheral blood to predict the short- and long-term postoperative outcomes of gastrectomy. In total, 571 patients who underwent R0 surgical resection for gastric cancer were enrolled. In the elderly patient group (≥65 years old), univariate analyses revealed that the incidence of postoperative complications was associated with poor performance status (p = 0.012), more comorbidities (p = 0.020), high C-reactive protein to albumin ratio (CAR, p = 0.003), total gastrectomy (p = 0.003), open approach (p = 0.034), blood transfusion (p = 0.002), and advanced cancer (p = 0.003). Multivariate analysis showed that a high CAR was associated with a high incidence of postoperative complications (p = 0.046). High CAR was also associated with poor OS (p = 0.015) and RFS (p = 0.035). However, these trends were not observed among younger patients (<65 years old). Preoperative CAR may play a significant role in predicting short- and long-term surgical outcomes, particularly in elderly patients with gastric cancer.
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Affiliation(s)
- Yuki Takemoto
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (Y.T.)
| | - Kazuaki Tanabe
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
| | - Emi Chikuie
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (Y.T.)
| | - Yoshihiro Saeki
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (Y.T.)
| | - Hiroshi Ota
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (Y.T.)
| | - Nozomi Karakuchi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (Y.T.)
| | - Akihiro Kohata
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (Y.T.)
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan; (Y.T.)
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Sui C, Lin C, Tao T, Huang Y, Zhang H, Yu H, Tao L, Wang M, Wang F. Controlling Nutritional Status (CONUT) score as a prognostic marker for gastrointestinal stromal tumours. ANZ J Surg 2023; 93:2125-2131. [PMID: 37338039 DOI: 10.1111/ans.18573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/12/2023] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND The Controlling Nutritional Status (CONUT) score, regarded as the effective indicator of patient nutrition, has been demonstrated to be related to prognosis of numerous tumours. Nevertheless, the significance of CONUT for gastrointestinal stromal tumour (GIST) remains unclear. This study intended to clarify the association between CONUT and the prognosis of GISTs. METHODS Three hundred and fifty-five patients with GISTs undergoing surgical resection at our center were retrospectively assessed. Receiver operating characteristic curve analysis was used to help determine the cut-off value of CONUT score. Relapse-free survival (RFS) and overall survival (OS) were assessed by Kaplan-Meier curve analysis. Prognostic factors for RFS and OS were examined by Cox proportional hazards models. RESULTS A total of 355 patients were enrolled in this study. Areas under the curve (AUC) were 0.638 for CONUT score, and the cut-off value of CONUT was shown to be three. Kaplan-Meier curve analysis showed that high CONUT score was linked to poorer RFS and OS. Univariate and multivariate analyses ultimately revealed that CONUT was a risk factor for RFS and OS, independent of demographics and clinicopathological tumour characteristics. CONCLUSIONS CONUT score was an effective and novel predictor for prognosis of GIST patients treated with surgery, indicating its potential as a prognostic marker in the overall management.
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Affiliation(s)
- Chao Sui
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Chen Lin
- Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Tingting Tao
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yibo Huang
- Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Haoran Zhang
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Heng Yu
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Liang Tao
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Meng Wang
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
- Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Feng Wang
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
- Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
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Zhao XH, Shen WB, Wang D, Wang HS, Song CY, Deng WZ. The prognosis value of CONUT and SIS score for recurrent or metastatic esophageal squamous cell carcinoma patients treated with second-line immunotherapy. Front Oncol 2023; 13:1167625. [PMID: 37388223 PMCID: PMC10304838 DOI: 10.3389/fonc.2023.1167625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/26/2023] [Indexed: 07/01/2023] Open
Abstract
Objective To 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. Methods Forty-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. Results The 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). Conclusion R/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.
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Affiliation(s)
- Xiao-Han Zhao
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wen-Bin Shen
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Duo Wang
- Hebei Key Laboratory of Animal Physiology, Biochemistry and Molecular Biology, College of Life Sciences, Hebei Normal University, Shijiazhuang, China
| | - He-Song Wang
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chun-Yang Song
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wen-Zhao Deng
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Yin J, Qu J, Liang X, Wang M. Prognostic significance of controlling nutritional status score for patients with gastric cancer: A systematic review and meta‑analysis. Exp Ther Med 2023; 25:202. [PMID: 37090072 PMCID: PMC10119667 DOI: 10.3892/etm.2023.11901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/03/2023] [Indexed: 04/25/2023] Open
Abstract
There is a need to identify potentially useful biomarker(s) for the prediction of prognostic outcomes in patients diagnosed with gastric cancer. This meta-analysis provided updated evidence on the association of controlling nutritional status (CONUT) score with survival and other clinicopathological outcomes in patients with gastric cancer. PubMed and Scopus databases were systematically searched. The review included studies, observational in design, that were conducted among patients with gastric cancer and had documented the association of CONUT score with outcomes of interest. The primary outcomes of interest were overall survival (OS), cancer-specific survival (CSS) and recurrence-free survival (RFS) along with tumour size and extent (T status), nodal status (N status) and tumour staging (TNM staging). STATA was used for statistical analysis. The meta-analysis was conducted with 17 studies. The 5-year OS [hazard ratio (HR), 1.75; 95% confidence interval (CI): 1.55, 1.96], RFS (HR, 1.58; 95% CI: 1.30, 1.91) and CSS (HR, 1.89; 95% CI: 1.01, 3.52) were comparatively poorer in the high CONUT group, than in low CONUT group. High CONUT score was associated with increased risk of having T3/T4 tumour [odds ratio (OR), 1.64; 95% CI: 1.16, 2.34], N2/N3 nodal status (OR, 1.44; 95% CI: 1.17, 1.77) and stage III/IV tumour (OR, 1.64; 95% CI: 1.43, 1.88). The risk of microvascular invasion (OR, 1.46; 95% CI: 1.20, 1.77) and post-operative complications (OR, 1.64; 95% CI: 1.31, 2.06) was higher in those with high CONUT. There were no differences in the risk of poorly differentiated tumour and need for adjuvant chemotherapy between the two groups. Findings suggested that preoperative assessment of CONUT score may be included in the routine assessment of patients with gastric cancer due to its association with survival and other clinical as well as pathological outcomes.
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Affiliation(s)
- Jian Yin
- Third Department of Chest Medicine, The Fifth People's Hospital of Dalian, Dalian, Liaoning 116021, P.R. China
| | - Jin Qu
- Third Department of Chest Medicine, The Fifth People's Hospital of Dalian, Dalian, Liaoning 116021, P.R. China
| | - Xiaoxiao Liang
- Third Department of Chest Medicine, The Fifth People's Hospital of Dalian, Dalian, Liaoning 116021, P.R. China
| | - Meimei Wang
- Third Department of Chest Medicine, The Fifth People's Hospital of Dalian, Dalian, Liaoning 116021, P.R. China
- Correspondence to: Dr Meimei Wang, Third Department of Chest Medicine, The Fifth People's Hospital of Dalian, 890 Huanghe Road, Dalian, Liaoning 116021, P.R. China
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Cai YS, Li XY, Ye X, Li X, Fu YL, Hu B, Li H, Miao JB. Preoperative controlling nutritional status score (CONUT) predicts postoperative complications of patients with bronchiectasis after lung resections. Front Nutr 2023; 10:1000046. [PMID: 36742422 PMCID: PMC9895366 DOI: 10.3389/fnut.2023.1000046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023] Open
Abstract
Background The Controlled Nutritional Status (CONUT) score is a valid scoring system for assessing nutritional status and has been shown to correlate with clinical outcomes in many surgical procedures; however, no studies have reported a correlation between postoperative complications of bronchiectasis and the preoperative CONUT score. This study aimed to evaluate the value of the CONUT score in predicting postoperative complications in patients with bronchiectasis. Methods We retrospectively analyzed patients with localized bronchiectasis who underwent lung resection at our hospital between April 2012 and November 2021. The optimal nutritional scoring system was determined by receiver operating characteristic (ROC) curves and incorporated into multivariate logistic regression. Finally, independent risk factors for postoperative complications were determined by univariate and multivariate logistic regression analyses. Results A total of 240 patients with bronchiectasis were included, including 101 males and 139 females, with an average age of 49.83 ± 13.23 years. Postoperative complications occurred in 59 patients (24.6%). The incidence of complications, postoperative hospital stay and drainage tube indwelling time were significantly higher in the high CONUT group than in the low CONUT group. After adjusting for sex, BMI, smoking history, lung function, extent of resection, intraoperative blood loss, surgical approach and operation time, multivariate analysis showed that the CONUT score remained an independent risk factor for postoperative complications after bronchiectasis. Conclusions The preoperative CONUT score is an independent predictor of postoperative complications in patients with localized bronchiectasis.
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Liu H, Yang XC, Liu DC, Tong C, Wen W, Chen RH. Clinical significance of the controlling nutritional status (CONUT) score in gastric cancer patients: A meta-analysis of 9,764 participants. Front Nutr 2023; 10:1156006. [PMID: 37113291 PMCID: PMC10126262 DOI: 10.3389/fnut.2023.1156006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023] Open
Abstract
Background The clinical value of the controlling nutritional status (CONUT) score has been widely reported in multiple malignancies. The aim of this study is to investigate the association between the CONUT score and clinical outcomes in patients with gastric cancer. Methods A comprehensive literature search of electronic databases including PubMed, Embase, and Web of Science was performed up to December 2022. The primary endpoints were survival outcomes and postoperative complications. Subgroup analysis and sensitivity analysis were performed during the pooled analysis. Results Nineteen studies including 9,764 patients were included. The pooled results indicated that patients in the high CONUT group had a worse overall survival (HR = 1.70 95%CI: 1.54-1.87; P < 0.0001; I 2 = 33%) and recurrence-free survival (HR = 1.57; 95%CI: 1.36-1.82; P < 0.0001; I 2 = 30%), and a higher risk of complications (OR = 1.96; 95%CI: 1.50-2.57; P < 0.0001; I 2 = 69%). In addition, a high CONUT score was significantly associated with larger tumor size, higher percentage of microvascular invasion, later TNM stage and fewer patients receiving adjuvant chemotherapy, but not with tumor differentiation. Conclusion Based on existing evidence, the CONUT score could act as a valuable biomarker to predict clinical outcomes in patients with gastric cancer. Clinicians could use this useful indicator to stratify patients and formulate individual treatment plans.
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Affiliation(s)
- Hui Liu
- Department of Interventional Radiology, Xiangya School of Medicine Affiliated Haikou Hospital, Central South University, Haikou, Hainan, China
| | - Xiao-Chuan Yang
- Department of Interventional Radiology, Xiangya School of Medicine Affiliated Haikou Hospital, Central South University, Haikou, Hainan, China
| | - Ding-Cheng Liu
- Department of Interventional Radiology, Xiangya School of Medicine Affiliated Haikou Hospital, Central South University, Haikou, Hainan, China
| | - Chao Tong
- Department of Interventional Radiology, Xiangya School of Medicine Affiliated Haikou Hospital, Central South University, Haikou, Hainan, China
| | - Wen Wen
- Department of Hepatobiliary Surgery, Xiangya School of Medicine Affiliated Haikou Hospital, Central South University, Haikou, Hainan, China
- *Correspondence: Wen Wen,
| | - Ri-Hui Chen
- Department of Interventional Radiology, Xiangya School of Medicine Affiliated Haikou Hospital, Central South University, Haikou, Hainan, China
- Ri-Hui Chen,
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Feng J, Wang L, Yang X, Chen Q, Cheng X. The usefulness of pretreatment controlling nutritional status score for predicting recurrence in patients with esophageal squamous cell carcinoma undergoing neoadjuvant immunochemotherapy: A real-world study. Front Immunol 2022; 13:1015365. [PMID: 36505443 PMCID: PMC9729701 DOI: 10.3389/fimmu.2022.1015365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background The controlling nutritional status (CONUT) score, as an immune-nutritional index, has been reported to be related to prognosis in several cancers. Neoadjuvant immunochemotherapy (nICT) is an emerging pattern for cancer treatment in recent years. However, the usefulness of CONUT in esophageal squamous cell carcinoma (ESCC) with nICT has not been reported so far. This study attempted to clarify the usefulness of CONUT in predicting disease-free survival (DFS) in ESCC with nICT. Methods Two hundred sixteen ESCC patients receiving nICT between 2019 and 2021 were retrospectively enrolled. Based on CONUT, the patients were divided into two groups: low groups (score ≤ 2) and high (score ≥ 3) groups. The relationships between CONUT and clinical characteristics were estimated. Cox regression analyses with hazard ratios (HRs) and 95% confidence intervals (CIs) were also performed to evaluate the prognostic factors of DFS. Results Fifty-nine (27.3%) patients achieved pathologic complete response (pCR), and 30 (13.9%) cases had a recurrence. There were 150 cases (69.4%) in low CONUT group and 66 cases (30.6%) in high CONUT group, respectively. The results revealed that vessel invasion (P = 0.037), postoperative pneumonia (P = 0.001), advanced ypT stage (P = 0.011), cTNM stage (P = 0.007), and ypTNM stage (P < 0.001) were significantly related to patients with a high CONUT score. A high pCR rate was found in patients with a low CONUT score (33.3% vs. 13.6%, P = 0.003), and a high recurrence rate was found in patients with a high CONUT score (24.2% vs. 9.3%, P = 0.004), respectively. Patients with a low CONUT score had a better 1-year DFS than those with a high CONUT score (90.7% vs. 75.8%, P = 0.004). Multivariate analyses indicated that the pretreatment CONUT score was an independent predictor regarding DFS (HR = 2.221, 95% CI: 1.067-4.625, P = 0.033). Conclusion A better response and a lower recurrence were found in ESCC patients with a lower pretreatment CONUT. As a useful index for immune-nutritional status, the CONUT might be a reliable prognostic indicator in ESCC patients with nICT.
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Affiliation(s)
- Jifeng Feng
- Department of Thoracic Oncological Surgery, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Science, Hangzhou, China,Zhejiang Provincial Research Center for Upper Gastrointestinal Tract Cancer, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Science, Hangzhou, China,The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Liang Wang
- Department of Thoracic Oncological Surgery, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Science, Hangzhou, China
| | - Xun Yang
- Department of Thoracic Oncological Surgery, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Science, Hangzhou, China
| | - Qixun Chen
- Department of Thoracic Oncological Surgery, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Science, Hangzhou, China,*Correspondence: Qixun Chen, ; Xiangdong Cheng,
| | - Xiangdong Cheng
- Zhejiang Provincial Research Center for Upper Gastrointestinal Tract Cancer, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Science, Hangzhou, China,*Correspondence: Qixun Chen, ; Xiangdong Cheng,
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Chantharakhit C, Sujaritvanichpong N, Chantharakhit C. Prognostic Value of the Pre-Treatment Prognostic Nutritional Index for Patients with Unresectable Locally-Advanced and Advanced Stage Upper Gastrointestinal Tract Cancer. Int J Gen Med 2022; 15:6681-6689. [PMID: 36016983 PMCID: PMC9397539 DOI: 10.2147/ijgm.s372684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/11/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The prognostic nutritional index (PNI) is used to distinguish immune-nutritional status. Previous studies have shown that it is significantly associated with patient outcomes for various malignancies. This study aimed to evaluate the prognostic impact of PNI in patients with unresectable locally-advanced and advanced stage upper gastrointestinal tract cancer, including esophageal cancer and gastric cancer. Methods A retrospective study of 170 unresectable stage III–IV esophageal cancer and gastric cancer patients was conducted from January 2018 to December 2020. In our retrospective analysis, the pretreatment PNI of patients was calculated and analyzed. The Youden index was estimated to select the optimal cut-off value for PNI. Univariate and multivariate flexible parametric proportional hazards models with restricted cubic splines (RCS) were used to identify independent prognostic factors, and the Kaplan–Meier method was used to estimate survival curves. Results The median follow-up period was 5 months (ranging from 0.06 to 36.92 months). We determined 52.9 as the cut-off value by using the maximum Youden index. Subsequently, patients in the testing group were classified into high PNI and low PNI groups. Kaplan–Meier curves showed the low PNI group had significantly poorer overall survival (OS) than the high PNI group. Median OS in the low PNI group was 4.43 months compared with 8.23 months in the high PNI group (HR 2.42, 95% CI 1.33–4.40, p = 0.004). In the univariate analysis, low PNI, ECOG PS 2, and ECOG PS 3–4 were associated with OS. According to multivariate analysis, low PNI was an independent prognostic factor for OS (HR 2.31, 95% CI 1.24–4.29, p = 0.008). Conclusion Pretreatment PNI is useful for independent prognosis of unresectable stage III–IV esophageal cancer and gastric cancer in patients.
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Affiliation(s)
- Chaichana Chantharakhit
- Division of Medical Oncology, Department of Internal Medicine, Buddhasothorn Hospital, Chachoengsao, Thailand
| | - Nantapa Sujaritvanichpong
- Division of Medical Oncology, Department of Internal Medicine, Buddhasothorn Hospital, Chachoengsao, Thailand
| | - Chanachai Chantharakhit
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Buddhasothorn Hospital, Chachoengsao, Thailand
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Chen J, Song P, Peng Z, Liu Z, Yang L, Wang L, Zhou J, Dong Q. The Controlling Nutritional Status (CONUT) Score and Prognosis in Malignant Tumors: A Systematic Review and Meta-Analysis. Nutr Cancer 2022; 74:3146-3163. [PMID: 35382655 DOI: 10.1080/01635581.2022.2059091] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Increasing evidences indicate that the controlling nutritional status (CONUT) score is associated with cancer prognosis. This study was conducted to investigate the prognostic significance of pretreatment CONUT score on patients with various malignant tumors. The correlation between CONUT score and clinical outcomes of tumor patients were studied by electronic literature retrieval. Pooled hazard ratios (HR), odds ratios (OR) and 95% confidence intervals (95% CI) were calculated to clarify the conclusion. Subgroup analysis were conducted in line with cancer type, cancer stage, treatment, sample size and cut-off value. A total of 62 studies involving 25224 patients were included in this study. Pooled analysis showed that higher CONUT scores were associated with shorter overall survival (HR 1.62, 95% CI 1.45-1.79, p < 0.001), cancer-specific survival (HR 1.80, 95% CI 1.48-2.13, p < 0.001), progress/recurrence-free survival (HR 1.54, 95% CI 1.23-1.85, p < 0.001) and disease-free survival (HR 1.56, 95% CI 1.39-1.74, p < 0.001). In addition, high CONUT score was correlated to higher incidence of postoperative complications (OR 1.64, 95% CI 1.38-1.95, p < 0.001) and mortality (OR 4.22, 95% CI 2.22-8.02, p < 0.001). Consequently, the pretreatment CONUT score is a valuable indicator to predict the clinical outcomes of patients with various malignant tumors.
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Affiliation(s)
- Junhao Chen
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Pan Song
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Zhufeng Peng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenghuan Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Luchen Yang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Linchun Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Jing Zhou
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Qiang Dong
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Liu XY, Zhang X, Zhang Q, Xie HL, Ruan GT, Liu T, Song MM, Ge YZ, Xu HX, Song CH, Shi HP. The value of the controlling nutritional status score in predicting the prognosis of patients with lung cancer: A multicenter, retrospective study. JPEN J Parenter Enteral Nutr 2021; 46:1343-1352. [PMID: 34961947 DOI: 10.1002/jpen.2321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The body's immune-nutritional status affects prognosis in patients with lung cancer. The Controlling Nutritional Status (CONUT) score is an immune-nutrition-related index associated with prognosis in other tumors. We aimed to assess the value of CONUT in predicting prognosis in patients with lung cancer. METHODS In this retrospective multicenter study, 1,339 patients with lung cancer were divided into low- and high-CONUT score groups. The relationship between CONUT scores and overall survival (OS) was assessed by survival curves and Cox's proportional hazards regression modelling. A nomogram including CONUT and other clinical variables was established. RESULTS There were 659 (49.2%; mean age 59.91 years) low- and 680 (50.8%; mean age 62.23 years) high-CONUT score patients. OS was significantly worse in patients with high than in those with low CONUT scores (P < 0.001), even after stratification by pathological types (non-small-cell lung cancer and small-cell lung cancer) and Tumor-Node-Metastasis (TNM) stages. A high CONUT score independently predicted risk in patients with lung cancer (adjusted hazard ratio: 1.48, 95% confidence interval: 1.26-1.73; P < 0.001). The CONUT-based nomogram could predict prognosis well (C-index: 0.701), with better resolution and accuracy than TNM staging for predicting OS at 1, 2, and 3 years (Area under the ROC curve: 0.735 vs. 0.678; 0.742 vs. 0.696; and 0.768 vs. 0.743). CONCLUSION The CONUT score can predict prognosis in patients with lung cancer. A CONUT-based nomogram can improve the accuracy of survival prediction in such patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Xiao-Yue Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Xi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China.,Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, 071000, China
| | - Qi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Hai-Lun Xie
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Guo-Tian Ruan
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Tong Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Meng-Meng Song
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Yi-Zhong Ge
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Hong-Xia Xu
- Department of Clinical Nutrition, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Chun-Hua Song
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
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Liu C, Zhu M, Yang X, Cui H, Li Z, Wei J. Controlling Nutritional Status Score as a Predictive Marker of In-hospital Mortality in Older Adult Patients. Front Nutr 2021; 8:738045. [PMID: 34616765 PMCID: PMC8488127 DOI: 10.3389/fnut.2021.738045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/24/2021] [Indexed: 12/14/2022] Open
Abstract
The controlling nutritional status (CONUT) score assesses nutritional status and is associated with short- and long-term prognoses in some diseases, but the significance of the CONUT score for the prediction of in-hospital mortality in older adults is unknown. The purpose was to determine the importance of the CONUT score for the prediction of in-hospital mortality, short-term complications, length of hospital stay, and hospital costs in older adults. Our retrospective cohort study analyzed data from 11,795 older adult patients from two multicenter cohort studies. We performed receiver operating characteristic curve analysis using in-hospital mortality as the endpoint and determined the appropriate CONUT score cut-off by the Youden index. The patients were divided into two high and low groups according to the CONUT cut-off value, and the differences in clinical characteristics and in-hospital clinical outcomes between the two groups were compared. We compared the accuracy of the CONUT score and other nutrition-related tools in predicting in-hospital mortality by calculating the area under the receiver operating characteristic curve and performed univariate and multivariate analyses of predictors of in-hospital mortality. Among all the patients, 178 (1.5%) patients experienced in-hospital death. The optimal cut-off values was 5.5 for the CONUT score. The high CONUT group had a higher incidence of short-term complications and prolonged hospital stay than the low CONUT group (CONUT score <6), but hospital costs were not significantly higher. The CONUT score had the highest predictive ability for in-hospital mortality among the five nutrition-related parameters compared. Multivariate analysis showed that a high CONUT score (CONUT score ≥ 6) was an independent predictor of in-hospital mortality. In conclusion, the present study demonstrated that the CONUT score could be used to predict in-hospital mortality in older adults.
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Affiliation(s)
- Chengyu Liu
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Mingwei Zhu
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Yang
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hongyuan Cui
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Zijian Li
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Junmin Wei
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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