Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
Updates Surg. 2021 Feb;73(1):251-259. doi: 10.1007/s13304-020-00792-9. Epub 2020 May 15.
The controlling nutritional status (CONUT) score was developed as a nutritional score that can be calculated from the serum albumin level, total cholesterol concentration, and total lymphocyte count. The aim of this study was to assess the prognostic factors for the overall survival (OS) of pancreatic cancer patients following a curative resection and to compare the CONUT score with other prognostic factors to demonstrate its utility. Between January 2007 and December 2015, 307 consecutive patients who underwent surgery for pancreatic ductal adenocarcinoma (PDAC) were divided into a low CONUT group (LC; CONUT score ≤ 3) and a high CONUT group (HC; CONUT score ≥ 4) according to the results of their preoperative blood examination. The clinicopathological characteristics and prognosis of the patients were evaluated retrospectively. The prognostic factors of PDAC were detected using multivariate analyses. The LC and HC groups included 279 and 28 patients, respectively. The overall survival of the LC group was better than that of the HC group (LC, median survival time [MST] 27.9 months, 5-year survival rate 33.4%, respectively; HC, 13.9 months, 6.7%, p < 0.001). The multivariate analyses showed that age ≥ 70 years, lymph node metastasis, absence of postoperative adjuvant chemotherapy, CA19-9 ≥ 200 U/ml, and a preoperative CONUT score ≥ 4 were independently associated with poor survival. However, the Glasgow prognostic score, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and prognostic nutritional index were not significant factors. The CONUT score may be useful for predicting the long-term survival of patients with PDAC.
控制营养状态（CONUT）评分是一种可以根据血清白蛋白水平、总胆固醇浓度和总淋巴细胞计数计算出来的营养评分。本研究旨在评估可切除胰腺癌患者总体生存率（OS）的预后因素，并将 CONUT 评分与其他预后因素进行比较，以证明其应用价值。2007 年 1 月至 2015 年 12 月，307 例接受胰腺导管腺癌（PDAC）手术的连续患者根据术前血液检查结果分为低 CONUT 组（LC；CONUT 评分≤3）和高 CONUT 组（HC；CONUT 评分≥4）。回顾性评估患者的临床病理特征和预后。采用多因素分析检测 PDAC 的预后因素。LC 组和 HC 组分别包括 279 例和 28 例患者。LC 组的总体生存率优于 HC 组（LC 组中位生存时间[MST]为 27.9 个月，5 年生存率为 33.4%；HC 组为 13.9 个月，6.7%，p<0.001）。多因素分析显示，年龄≥70 岁、淋巴结转移、术后无辅助化疗、CA19-9≥200 U/ml 和术前 CONUT 评分≥4 与生存不良独立相关。然而，格拉斯哥预后评分、中性粒细胞-淋巴细胞比值、血小板-淋巴细胞比值和预后营养指数不是显著因素。CONUT 评分可能有助于预测 PDAC 患者的长期生存。
