Takamori Shinkichi, Toyokawa Gouji, Taguchi Kenichi, Edagawa Makoto, Shimamatsu Shinichiro, Toyozawa Ryo, Nosaki Kaname, Seto Takashi, Hirai Fumihiko, Yamaguchi Masafumi, Shoji Fumihiro, Okamoto Tatsuro, Takenoyama Mitsuhiro, Ichinose Yukito
Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Japan.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Clin Lung Cancer. 2017 Jul;18(4):e303-e313. doi: 10.1016/j.cllc.2017.01.008. Epub 2017 Feb 2.
Malignant pleural mesothelioma (MPM) is a devastating neoplasm; however, some patients exhibit a good response to chemotherapy or multidisciplinary therapy, including surgery and chemotherapy. It is therefore important to discover the factors that can be used to select patients who will benefit from such treatment. Although the Controlling Nutritional Status (CONUT) score has been used to predict the prognosis in other types of malignancy, its utility in patients with MPM is unknown. The aim of this study was to clarify the clinical significance of the CONUT in patients with MPM.
The data of 83 patients, who were treated with surgery, chemotherapy, or multidisciplinary therapy, were analyzed in the present study. A cut-off CONUT score of 2 was used to classify all of the patients into low or high CONUT groups.
Fifty-two of the 83 patients were classified into the low CONUT group. A high CONUT score was significantly correlated with chemotherapy alone (P = .011). The high CONUT group had significantly poorer overall survival (OS) (P < .001) and disease- or progression-free survival (DFS/PFS) (P < .001). The clinical stage and the CONUT score were found to be independent predictive factors for the OS: clinical stage, I/II and III/IV; P = .001 and CONUT score, ≥ 3 and ≤ 2; P = .011, respectively. The clinical stage and the CONUT score were also independent predictive factors for DFS/PFS: clinical stage, I/II and III/IV; P = .006 and CONUT score, ≥ 3 and ≤ 2; P = .013, respectively.
The CONUT score was an independent predictor of a poor prognosis in the patients with MPM. This score provides useful information for selecting patients who will benefit from the treatment.
恶性胸膜间皮瘤（MPM）是一种极具破坏性的肿瘤；然而，一些患者对化疗或包括手术和化疗在内的多学科治疗表现出良好反应。因此，发现可用于选择能从此类治疗中获益的患者的因素很重要。尽管控制营养状况（CONUT）评分已被用于预测其他类型恶性肿瘤的预后，但其在MPM患者中的效用尚不清楚。本研究的目的是阐明CONUT在MPM患者中的临床意义。
本研究分析了83例接受手术、化疗或多学科治疗的患者的数据。使用CONUT评分2作为临界值将所有患者分为CONUT低分组或高分组。
83例患者中有52例被归入CONUT低分组。高CONUT评分与单纯化疗显著相关（P = 0.011）。高CONUT组的总生存期（OS）显著更差（P < 0.001），疾病无进展生存期（DFS/PFS）也显著更差（P < 0.001）。临床分期和CONUT评分被发现是OS的独立预测因素：临床分期，I/II期和III/IV期；P = 0.001，CONUT评分，≥3和≤2；P分别为0.011。临床分期和CONUT评分也是DFS/PFS的独立预测因素：临床分期，I/II期和III/IV期；P = 0.006，CONUT评分，≥3和≤2；P分别为0.013。
CONUT评分是MPM患者预后不良的独立预测因素。该评分可为选择能从治疗中获益的患者提供有用信息。
