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控制营养状况评分对胰腺导管腺癌根治性切除术后预后的影响

Impact of the Controlling Nutritional Status Score on the Prognosis After Curative Resection of Pancreatic Ductal Adenocarcinoma.

作者信息

Kato Yoshiyasu, Yamada Suguru, Suenaga Masaya, Takami Hideki, Niwa Yukiko, Hayashi Masamichi, Iwata Naoki, Kanda Mitsuro, Tanaka Chie, Nakayama Goro, Koike Masahiko, Fujiwara Michitaka, Kodera Yasuhiro

机构信息

From the Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Pancreas. 2018 Aug;47(7):823-829. doi: 10.1097/MPA.0000000000001105.

Abstract

OBJECTIVES

The controlling nutritional status (CONUT) score is a useful tool to evaluate immune-nutritional status. This study aimed to investigate the impact of the CONUT score on short- and long-term outcomes after curative resection of pancreatic ductal adenocarcinoma (PDAC).

METHODS

Consecutive 344 PDAC patients receiving pancreatectomy without neoadjuvant therapy were examined retrospectively. After the best predictive value of the CONUT score for survival was identified, association between the CONUT score and long-term outcomes was evaluated using log-rank tests and a Cox regression model. Then correlations between the CONUT score and postoperative complications were analyzed.

RESULTS

The optimal cutoff value of the CONUT score was 4. The high CONUT score group showed significantly lower overall survival than the low CONUT score group (P = 0.002). In contrast, no significant difference in recurrence-free survival was found (P = 0.43). A multivariate analysis demonstrated that high CONUT score had an independent association with overall survival (hazard ratio, 1.64; P = 0.003). The CONUT score showed no association with postoperative pancreatic fistula, Clavien-Dindo grade, or postoperative hospital stay.

CONCLUSION

The CONUT score had an independent association with survival in patients with PDAC after pancreatectomy and was not associated with recurrence or postoperative complications.

摘要

目的

控制营养状况(CONUT)评分是评估免疫营养状况的有用工具。本研究旨在探讨CONUT评分对胰腺导管腺癌(PDAC)根治性切除术后短期和长期预后的影响。

方法

回顾性研究344例接受胰切除术且未接受新辅助治疗的连续PDAC患者。确定CONUT评分对生存的最佳预测价值后,使用对数秩检验和Cox回归模型评估CONUT评分与长期预后之间的关联。然后分析CONUT评分与术后并发症之间的相关性。

结果

CONUT评分的最佳临界值为4。高CONUT评分组的总生存期显著低于低CONUT评分组(P = 0.002)。相比之下,无复发生存期无显著差异(P = 0.43)。多因素分析表明,高CONUT评分与总生存期独立相关(风险比,1.64;P = 0.003)。CONUT评分与术后胰瘘、Clavien-Dindo分级或术后住院时间无关。

结论

CONUT评分与PDAC患者胰切除术后的生存独立相关,与复发或术后并发症无关。

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