scholarly journals Preoperative Controlling Nutritional Status (CONUT) Score Predicts Short-Term Surgical Prognosis in Patients with Gastric Cancer After Laparoscopy-Assisted Radical Gastrectomy

2020 ◽  
Author(s):  
Yun Qian ◽  
Huaying Liu ◽  
Junhai Pan ◽  
Weihua Yu ◽  
Jiemin Lv ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Postoperative Complications ◽  
Nutritional Status ◽  
Assessment Tool ◽  
Predictive Ability ◽  
Short Term ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Conut Score

Abstract Background: The Controlling Nutritional Status (CONUT) score is an emerging nutrition assessment tool that is very useful in patients with gastric cancer who usually experience weight loss and malnutrition. The aim of our study was to assess the predictive ability of the preoperative CONUT score for short-term prognosis in patients with gastric cancer undergoing laparoscopy-assisted gastrectomy.Methods: We retrospectively reviewed medical records of 309 patients who underwent curative laparoscopy-assisted gastrectomy. The patients were divided into two groups according to the optimal cutoff value of the CONUT score. The clinical association for the CONUT score, characteristics, and postoperative complications were evaluated and analyzed. The risk factors for complications were identified by univariate and multivariate analysis.Results: The preoperative CONUT score showed a good predictive ability for postoperative complications (AUC=0.718，Youden index=0.343)，with an optimal cutoff value of 2.5. The patients with high CONUT scores had a higher incidence of overall complications (P<0.001) and mild complications (P<0.001). Univariate and multivariate analysis revealed that the CONUT score was independently associated with postoperative complications (P=0.012；OR=2.433；95%CI：1.218-4.862).Conclusions：The preoperative CONUT score was identified as a reliable nutritional assessment tool for predicting short-term prognosis in patients with gastric cancer after laparoscopy-assisted gastrectomy.

scholarly journals Preoperative Controlling Nutritional Status (CONUT) Score Predicts Short-term Surgical Outcomes in Patients with Gastric Cancer After Laparoscopy-assisted Radical Gastrectomy

2020 ◽  
Author(s):  
Yun Qian ◽  
Huaying Liu ◽  
Junhai Pan ◽  
Weihua Yu ◽  
Jiemin Lv ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Nutritional Status ◽  
Assessment Tool ◽  
Nutritional Assessment ◽  
Area Under The Curve ◽  
Predictive Ability ◽  
Youden Index ◽  
Short Term ◽  
Conut Score

Abstract Background: The Controlling Nutritional Status (CONUT) score is an emerging nutrition assessment tool that is useful in gastric cancer (GC) patients. The aim of our study was to assess the predictive ability of the preoperative CONUT score for short-term outcomes in GC patients undergoing laparoscopy-assisted gastrectomy.Methods: We retrospectively reviewed the medical records of 309 patients who underwent curative laparoscopy-assisted gastrectomy. The patients were divided into two groups according to the optimal cut-off value of the CONUT score. The clinical characteristics and postoperative complications were evaluated and analysed in the low- and high-score groups. The risk factors for complications were identified by univariate and multivariate analysis.Results: The preoperative CONUT score showed a good predictive ability for postoperative complications (area under the curve (AUC)=0.718, Youden index=0.343) compared with other indexes, with an optimal cut-off value of 2.5. Patients with high CONUT scores had a higher incidence of overall complications (P<0.001) and mild complications (P<0.001). Univariate and multivariate analyses revealed that the CONUT score was independently associated with postoperative complications (P=0.012; odds ratio (OR)=2.433; 95% confidence interval (CI): 1.218-4.862).Conclusions: The preoperative CONUT score is a reliable and useful nutritional assessment tool for predicting short-term outcomes in GC patients after laparoscopy-assisted gastrectomy.

scholarly journals Preoperative Controlling Nutritional Status (CONUT) Score Predicts Short-Term Outcomes of Patients with Gastric Cancer after Laparoscopy-Assisted Radical Gastrectomy

2020 ◽  
Author(s):  
Yun Qian ◽  
Huaying Liu ◽  
Junhai Pan ◽  
Weihua Yu ◽  
Jiemin Lv ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Postoperative Complications ◽  
Nutritional Status ◽  
Laparoscopic Gastrectomy ◽  
Nutritional Assessment ◽  
Tnm Classification ◽  
Youden Index ◽  
Short Term ◽  
Conut Score

Abstract Background: As an emerging prediction tool, the Controlling Nutritional Status (CONUT) score has shown good assessment ability of postoperative outcomes in cancer patients. This study assessed the role of the preoperative CONUT score in short-term outcomes of gastric cancer (GC) after laparoscopic gastrectomy.Methods: Three hundred and nine patients undergoing laparoscopic gastrectomy from January 2016 to June 2019 were analyzed, retrospectively. GC patients were divided into two groups according to the optimal cut-off value of the CONUT. The clinical characteristics and postoperative complications were analyzed and evaluated in two groups. The risk factors of complications were identified by univariate and multivariate analysis.Results: 309 patients received laparoscopic gastrectomy, and 91 (29.4%) patients suffered from postoperative complications. The preoperative CONUT score showed a good predictive ability for postoperative complications (area under the curve (AUC)=0.718, Youden index=0.343) compared with other indexes, with an optimal cut-off value of 2.5. Patients with high CONUT score suffered a significantly higher incidence of overall complications (P<0.001). Age, haemoglobin level, C-reactive protein level, red blood cell level, CONUT scores, type of operative procedure, pathological TNM classification of T1, T4, N0, and N3, and pathological stage of I and III were associated with postoperative complications (P<0.05). Furthermore, preoperative CONUT score was identified as an independent risk predictor of postoperative complications (P=0.012; OR=2.433; 95% CI: 1.218-4.862) after multivariate analysis.Conclusions: The preoperative CONUT score is a practical nutritional assessment for predicting short-term outcomes in patients with gastric cancer after laparoscopy-assisted gastrectomy.

scholarly journals Preoperative Controlling Nutritional Status (CONUT) score predicts short-term outcomes of patients with gastric cancer after laparoscopy-assisted radical gastrectomy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yun Qian ◽  
Huaying Liu ◽  
Junhai Pan ◽  
Weihua Yu ◽  
Jiemin Lv ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Nutritional Status ◽  
Laparoscopic Gastrectomy ◽  
Nutritional Assessment ◽  
Tnm Classification ◽  
Area Under The Curve ◽  
Youden Index ◽  
Short Term ◽  
Conut Score

Abstract Background An emerging prediction tool, the Controlling Nutritional Status (CONUT) score, has shown good assessment ability of postoperative outcomes in cancer patients. This study evaluated the role of the preoperative CONUT score regarding the short-term outcomes of gastric cancer (GC) after laparoscopic gastrectomy. Methods Three hundred and nine GC patients undergoing laparoscopic gastrectomy from January 2016 to June 2019 were analysed, retrospectively. The patients were divided into two groups according to the CONUT optimal cut-off value. Clinical characteristics and postoperative complications in the two groups were analysed and evaluated. Risk factors for complications were identified by univariate and multivariate analyses. Results A total of 309 patients underwent laparoscopic gastrectomy; 91 (29.4%) patients experienced postoperative complications. The preoperative CONUT score showed a good predictive ability for postoperative complications (area under the curve (AUC) = 0.718, Youden index = 0.343) compared with other indices, with an optimal cut-off value of 2.5. Patients with high CONUT score had a significantly higher incidence of overall complications (P < 0.001). Age, haemoglobin, C-reactive protein, red blood cell levels, CONUT scores, surgical procedure type, T1, T4, N0 and N3 pathological TNM classification, and pathological stages of I and III were associated with postoperative complications (P < 0.05). Furthermore, the preoperative CONUT score was identified as an independent risk predictor of postoperative complications (P = 0.012; OR = 2.433; 95% CI, 1.218-4.862) after multivariate analysis. Conclusions The preoperative CONUT score is a practical nutritional assessment for predicting short-term outcomes in GC patients after laparoscopy-assisted gastrectomy.

scholarly journals Controlling Nutritional Status (CONUT) score as a predictive marker for short-term complications following gastrectomy of gastric cancer: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Feng Sun ◽  
Chen Zhang ◽  
Zhijian Liu ◽  
Shichao Ai ◽  
Wenxian Guan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Nutritional Status ◽  
Multivariate Analyses ◽  
Independent Predictor ◽  
Predictive Marker ◽  
Hospital Charges ◽  
Youden Index ◽  
Short Term ◽  
Conut Score

Abstract Background It is well established that the controlling nutritional status (CONUT) score was correlated with long-term outcomes in gastric cancer (GC), but the significance of CONUT for postoperative short-term outcomes remains unclear. The study aimed to characterize the relationship between CONUT and short-term complications following gastrectomy of GC. Methods We collected data on 1479 consecutive GC patients at Nanjing Drum Tower Hospital between January 2016 and December 2018. Univariate and multivariate analyses of predictive factors for postoperative complications were performed. The cutoff value of the CONUT score was determined by Youden index. Results Among all of the patients, 431 (29.3%) patients encountered postoperative complications. Multivariate analyses identified CONUT was an independent predictor for postoperative short-term complications (OR 1.156; 95% CI 1.077–1.240; P < 0.001). Subgroup analysis elucidated that CONUT was related to postoperative complications both in early gastric cancer and advanced gastric cancer. We further explored that patients with high CONUT score had prolonged hospital stay (12.3 ± 6.0 vs 11.1 ± 4.6, P < 0.001) and more total hospital charges (7.6 ± 2.4 vs 7.1 ± 1.6, P < 0.001). Conclusions The present study demonstrated that the preoperative CONUT was an independent predictor for short-term complications following gastrectomy of GC.

scholarly journals Multicenter Study of Controlling Nutritional Status (CONUT) Score as a Prognostic Factor in Patients With HIV-Related Renal Cell Carcinoma

2021 ◽  
Vol 12 ◽  
Author(s):  
Wenrui Xue ◽  
Yu Zhang ◽  
Hua Wang ◽  
Yu Zhang ◽  
Xiaopeng Hu
Keyword(s):  
Renal Cell Carcinoma ◽  
Nutritional Status ◽  
T Lymphocyte ◽  
Independent Predictor ◽  
Tumor Grade ◽  
Optimal Cutoff ◽  
Fuhrman Grade ◽  
Cutoff Value ◽  
Urological Neoplasms ◽  
Conut Score

ObjectiveIn recent years, the controlled nutritional status (CONUT) score has been widely recognized as a new indicator for assessing survival in patients with urological neoplasms, including renal, ureteral, and bladder cancer. However, the CONUT score has not been analyzed in patients with HIV-related urological neoplasms. Therefore, we aimed to evaluate the prognostic significance of the CONUT score in patients with HIV-related renal cell carcinoma (RCC).MethodsA total of 106 patients with HIV-related RCC were recruited from four hospitals between 2012 and 2021, and all included patients received radical nephrectomy or partial nephrectomy. The CONUT score was calculated by serum albumin, total lymphocyte counts, and total cholesterol concentrations. Patients with RCC were divided into two groups according to the optimal cutoff value of the CONUT score. Survival analysis of different CONUT groups was performed by the Kaplan–Meier method and a log rank test. A Cox proportional risk model was used to test for correlations between clinical variables and cancer-specific survival (CSS), overall survival (OS), and disease-free survival (DFS). Clinical variables included age, sex, hypertension, diabetes, tumor grade, Fuhrman grade, histology, surgery, and CD4+ T lymphocyte count.ResultThe median age was 51 years, with 93 males and 13 females. At a median follow-up of 41 months, 25 patients (23.6%) had died or had tumor recurrence and metastasis. The optimal cutoff value for the CONUT score was 3, and a lower CONUT score was associated with the Fuhrman grade (P=0.024). Patients with lower CONUT scores had better CSS (HR 0.197, 95% CI 0.077-0.502, P=0.001), OS (HR 0.177, 95% CI 0.070-0.446, P&lt;0.001) and DFS (HR 0.176, 95% CI 0.070-0.444, P&lt;0.001). Multivariate Cox regression analysis indicated that a low CONUT score was an independent predictor of CSS, OS and DFS (CSS: HR=0.225, 95% CI 0.067-0.749, P=0.015; OS: HR=0.201, 95% CI 0.061-0.661, P=0.008; DFS: HR=0.227, 95% CI 0.078-0.664, P=0.007). In addition, a low Fuhrman grade was an independent predictor of CSS (HR 0.192, 95% CI 0.045-0.810, P=0.025), OS (HR 0.203, 95% CI 0.049-0.842, P=0.028), and DFS (HR 0.180, 95% CI 0.048-0.669, P=0.010), while other factors, such as age, sex, hypertension, diabetes, tumor grade, histology, surgery, and CD4+ T lymphocyte count, were not associated with survival outcome.ConclusionThe CONUT score, an easily measurable immune-nutritional biomarker, may provide useful prognostic information in HIV-related RCC.

scholarly journals Clinical impact of creatine phosphokinase and c-reactive protein as predictors of postgastrectomy complications in patients with gastric cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Keishi Okubo ◽  
Takaaki Arigami ◽  
Daisuke Matsushita ◽  
Takashi Kijima ◽  
Masataka Shimonosono ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Creatine Phosphokinase ◽  
Early Period ◽  
C Reactive Protein ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Reactive Protein

Abstract Background Postoperative complications have been linked to the morbidity and mortality of several cancers. However, predicting whether complications will occur in the early period after surgery or not is challenging. Hence, this study aimed to examine the diagnostic accuracy of serum creatine phosphokinase (CPK) and c-reactive protein (CRP) in predicting the development of postgastrectomy complications. Methods We retrospectively analyzed 188 patients with gastric cancer (GC) who underwent gastrectomy. The diagnostic accuracy of serum CPK and CRP was investigated using the areas under the curves (AUC). The CPK ratio was defined as the CPK on postoperative day (POD) 1 to the CPK on a preoperative day. Results Out of 188 patients, 48 (25.5%) developed postoperative complications. The complications group had a greater operative time (p = 0.037), higher CPK ratio on POD1 (p < 0.0001), and a higher serum CRP level on POD3 (p = 0.001). The AUC for the CPK ratio was 0.772, with an optimal cutoff value of 7.05, whereas that for CRP was 0.659, with an optimal cutoff value of 11.4 mg/L. The CPK ratio on POD1 (p < 0.0001) and the CRP on POD3 (p = 0.007) were independent factors for predicting the development of postgastrectomy complications. The CPK ratio on POD1 and the CRP on POD3 predicted postgastrectomy complications in 41 patients (85.4%). According to combined value of both CPK ratio and CRP level, the positive predictive value and the negative predictive value was 0.70 and 0.829. And sensitivity and specificity were 0.438 and 0.936. Conclusion The CPK ratio on POD1 and the CRP on POD3 after gastrectomy for GC were predictive factors for complication development and may be employed to prevent the development of such complications and improve the prognosis of patients with GC.

scholarly journals Clinical significance of controlling nutritional status score (CONUT) in evaluating outcome of postoperative patients with gastric cancer

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Qi Xiao ◽  
Xiaoqing Li ◽  
Baojun Duan ◽  
Xiaofan Li ◽  
Sida Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Regression Analysis ◽  
Risk Factor ◽  
Postoperative Complications ◽  
Nutritional Status ◽  
Independent Risk Factor ◽  
Multivariate Regression Analysis ◽  
Psychological Status ◽  
The Relationship ◽  
Conut Score

AbstractThe stomach is the main digestive organ in humans. Patients with gastric cancer often develop digestive problems, which result in poor nutrition. Nutritional status is closely related to postoperative complications and quality of life (QoL) in patients with gastric cancer. The controlling nutritional status (CONUT) score is a novel tool to evaluate the nutritional status of patients. However, the relationship of the CONUT score with postoperative complications, QoL, and psychological status in patients with gastric cancer has not been investigated. The present follow-up study was conducted in 106 patients who underwent radical gastrectomy in our hospital between 2014 and 2019. The CONUT score, postoperative complications, psychological status, postoperative QoL scores, and overall survival (OS) of patients with gastric cancer were collected, and the relationship between them was analyzed. A significant correlation was observed between the CONUT score and postoperative complications of gastric cancer (P < 0.001), especially anastomotic leakage (P = 0.037). The multivariate regression analysis exhibited that the CONUT score (P = 0.002) is an independent risk factor for postoperative complications. The CONUT score was correlated with the state anxiety questionnaire (S-AI) for evaluating psychological status (P = 0.032). However, further regression analysis exhibited that the CONUT score was not an independent risk factor for psychological status. Additionally, the CONUT score was associated with postoperative QoL. The multivariate regression analysis exhibited that the CONUT score was an independent risk factor for the global QoL (P = 0.048). Moreover, the efficiency of CONUT score, prognostic nutrition index, and serum albumin in evaluating complications, psychological status, and QoL was compared, and CONUT score was found to outperform the other measures (Area Under Curve, AUC = 0.7368). Furthermore, patients with high CONUT scores exhibited shorter OS than patients with low CONUT scores (P = 0.005). Additionally, the postoperative complications (HR 0.43, 95% CI 0.21–0.92, P = 0.028), pathological stage (HR 2.26, 95% CI 1.26–4.06, P = 0.006), and global QoL (HR 15.24, 95% CI 3.22–72.06, P = 0.001) were associated with OS. The CONUT score can be used to assess the nutritional status of patients undergoing gastric cancer surgery and is associated with the incidence of postoperative complications and QoL.

scholarly journals Immunonutritive Scoring in Patients With Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization: Prognostic Nutritional Index or Controlling Nutritional Status Score?

2021 ◽  
Vol 11 ◽  
Author(s):  
Lukas Müller ◽  
Felix Hahn ◽  
Aline Mähringer-Kunz ◽  
Fabian Stoehr ◽  
Simon J. Gairing ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multivariate Analysis ◽  
Prognostic Factor ◽  
Nutritional Status ◽  
Transarterial Chemoembolization ◽  
Predictive Ability ◽  
Prognostic Nutritional Index ◽  
Independent Prognostic Factor ◽  
Nutritional Index ◽  
Conut Score

ObjectivesThe Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) score are immunonutritive scoring systems with proven predictive ability in various cancer entities, including hepatocellular carcinoma (HCC). We performed the first evaluation of the CONUT score for patients undergoing transarterial chemoembolization (TACE) and compared CONUT and PNI in the ability to predict median overall survival (OS).MethodsBetween 2010 and 2020, we retrospectively identified 237 treatment-naïve patients with HCC who underwent initial TACE at our institution. Both scores include the albumin level and total lymphocyte count. The CONUT additionally includes the cholesterol level. Both scores were compared in univariate and multivariate regression analyses taking into account established risk factors. In a second step, a subgroup analysis was performed on BCLC stage B patients, for whom TACE is the recommended first-line treatment.ResultsA high CONUT score and low PNI were associated with impaired median OS (8.7 vs. 22.3 months, p&lt;0.001 and 6.8 vs. 20.1 months, p&lt;0.001, respectively). In multivariate analysis, only the PNI remained an independent prognostic predictor (p=0.003), whereas the CONUT score lost its predictive ability (p=0.201). In the subgroup of recommended TACE candidates, both CONUT and PNI were able to stratify patients according to their median OS (6.6 vs. 17.9 months, p&lt;0.001 and 10.3 vs. 22.0 months, p&lt;0.001, respectively). Again, in the multivariate analysis, only the PNI remained an independent prognostic factor (p=0.012).ConclusionBoth scores were able to stratify patients according to their median OS, but only the PNI remained an independent prognostic factor. Therefore, PNI should be preferred when evaluating the nutritional status of patients undergoing TACE.

scholarly journals The Controlling Nutritional Status Score and Postoperative Complication Risk in Gastrointestinal and Hepatopancreatobiliary Surgical Oncology: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 74 (4) ◽  
pp. 303-312 ◽  
Author(s):  
Kosei Takagi ◽  
Piotr Domagala ◽  
Wojciech G. Polak ◽  
Stefan Buettner ◽  
Jan N.M. Ijzermans
Keyword(s):  
Postoperative Complications ◽  
Nutritional Status ◽  
Meta Analysis ◽  
Surgical Oncology ◽  
Postoperative Outcomes ◽  
Cutoff Value ◽  
Major Complications ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Conut Score

The controlling nutritional status (CONUT) score is associated with prognosis in gastrointestinal (GI) cancer patients, but the clinical significance of the CONUT score for postoperative short-term outcome remains controversial. The aim of this study was to investigate the impact of the CONUT score on postoperative outcomes in patients with GI and hepatopancreatobiliary (HPB) cancers. We conducted a systematic literature search of Embase, Medline Ovid, Web of Science, Cochrane CENTRAL, and Google Scholar. Meta-analyses were performed to estimate the pooled risk ratio (RR) for postoperative complications in patients with lower ­CONUT score versus higher CONUT score. Furthermore, we explored the most appropriate cutoff value of the CONUT score to predict postoperative complications. Ten retrospective studies (5,138 patients) were included in this meta-analysis. Patients with higher CONUT score had an increased risk of mortality (RR 5.38, 95% CI 2.19–13.2, p < 0.001, I2 = 0%), postoperative major complications (RR 1.56, 95% CI 1.05–2.33, p= 0.03, I2 = 79%), and overall complications (RR 1.38, 95% CI 1.16–1.63, p < 0.001, I2 = 6%). We found that the cutoff of CONUT ≤4 vs. CONUT ≥5 had the highest pooled RR compared with other cutoff values (RR 4.79, 95% CI 0.97–23.5, p= 0.05, I2 = 91%). In conclusion, the present study suggests that the preoperative CONUT score was associated with an increased risk of mortality and complications in GI and HPB surgical oncology. Patients with higher CONUT score as compared with those having a lower score had approximately a fivefold mortality risk and an increased risk up to 55% on major and overall complications after GI and HPB surgery. Our analysis indicates that the appropriate cutoff value of the CONUT score to predict postoperative major complications would be between 4 and 5. The preoperative evaluation of the CONUT score would be helpful for predicting the risk of postoperative outcomes.

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