Miyata Tatsunori, Yamashita Yo-Ichi, Higashi Takaaki, Taki Katsunobu, Izumi Daisuke, Kosumi Keisuke, Tokunaga Ryuma, Nakagawa Shigeki, Okabe Hirohisa, Imai Katsunori, Hashimoto Daisuke, Chikamoto Akira, Baba Hideo
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-0811, Japan.
World J Surg. 2018 Apr;42(4):1085-1091. doi: 10.1007/s00268-017-4214-1.
Several studies have examined controlling nutritional status (CONUT), which is one of the useful biomarkers for predicting patients' prognosis following cancer treatment. The aim of this study was to evaluate the value of CONUT as a postoperative prognostic marker in patients with intrahepatic cholangiocarcinoma (ICC) following curative hepatectomy.
We retrospectively analyzed 71 patients who underwent curative hepatectomy for ICC between May 2002 and November 2016. Patients were divided into two groups according to their preoperative CONUT score (i.e., CONUT ≧ 2 or CONUT < 2).
The number of patients assigned to the normal, mild, moderate, or severe malnutrition groups was 40, 28, two, and one, respectively. The high CONUT group (CONUT ≧ 2) consisted of 31 patients (43.7%) and had a poor prognosis with regard to overall survival (OS) (p = 0.0149). A high CONUT score is also identified as one of the independent predictors of poor prognosis in OS (hazard ratio 3.02; 95% confidence interval 1.4-6.8; p = 0.007). However, in the current study, a high CONUT score was not associated with postoperative complications (Clavien-Dindo classification ≧ III or more).
CONUT may be useful for the preoperative assessment of prognosis in patients with ICC who have undergone curative hepatectomy.
多项研究对控制营养状态(CONUT)进行了检验,CONUT是预测癌症治疗后患者预后的有用生物标志物之一。本研究旨在评估CONUT作为肝内胆管癌(ICC)患者根治性肝切除术后预后标志物的价值。
我们回顾性分析了2002年5月至2016年11月期间接受根治性肝切除术治疗ICC的71例患者。根据术前CONUT评分将患者分为两组(即CONUT≥2或CONUT<2)。
分配到正常、轻度、中度或重度营养不良组的患者人数分别为40、28、2和1。高CONUT组(CONUT≥2)由31例患者组成(43.7%),其总生存期(OS)预后较差(p = 0.0149)。高CONUT评分也被确定为OS预后不良的独立预测因素之一(风险比3.02;95%置信区间1.4 - 6.8;p = 0.007)。然而,在本研究中,高CONUT评分与术后并发症(Clavien-Dindo分类≥III级或更高级别)无关。
CONUT可能有助于对接受根治性肝切除术的ICC患者进行术前预后评估。