Departments of Gastroenterological Surgery, Sendai City Medical Center Sendai Open Hospital, 5-22-1 Tsurugaya, Miyagino-ku, Sendai, 983-0824, Japan.
Departments of Gastroenterology, Sendai City Medical Center Sendai Open Hospital, 5-22-1 Tsurugaya, Miyagino-ku, Sendai, 983-0824, Japan.
Surg Today. 2021 Jan;51(1):144-152. doi: 10.1007/s00595-020-02066-8. Epub 2020 Jul 4.
The Controlling Nutritional Status (CONUT) Score, originally developed as a nutritional screening tool, is a cumulative score calculated from the serum albumin level, total cholesterol level, and total lymphocyte count. Previous studies have demonstrated that the score has significant prognostic value in various malignancies. We investigated the relationship between the CONUT score and long-term survival in obstructive colorectal cancer (OCRC) patients who underwent self-expandable metallic colonic stent placement and subsequently received curative surgery.
We retrospectively analyzed 57 pathological stage II and III OCRC patients between 2013 and 2019. The associations between the preoperative CONUT score and clinicopathological factors and patient survival were evaluated.
A receiver operating characteristic curve analysis revealed that the optimal cut-off value for the CONUT score was 7. A CONUT score of ≥ 7 was significantly associated with elevated CA19-9 level (p = 0.03). Multivariate analyses revealed that a CONUT score of ≥ 7 was independently associated with cancer-specific survival (hazard ratio [HR] = 10.2, 95% confidence interval [CI] 1.2-85.9, p = 0.03) and disease-free survival (HR = 7.1, 95% CI 2.3-21.7, p = 0.0006).
The results demonstrated that the CONUT score was a potent prognostic indicator. Evaluating the CONUT score might result in more precise patient assessment and tailored treatment.
最初开发的控制营养状态（CONUT）评分是一种累积评分，由血清白蛋白水平、总胆固醇水平和总淋巴细胞计数计算得出。先前的研究表明，该评分在各种恶性肿瘤中具有显著的预后价值。我们研究了在接受自膨式金属结肠支架置入术并随后接受根治性手术的阻塞性结直肠癌（OCRC）患者中，CONUT 评分与长期生存之间的关系。
我们回顾性分析了 2013 年至 2019 年间的 57 例病理分期 II 期和 III 期 OCRC 患者。评估了术前 CONUT 评分与临床病理因素和患者生存之间的关系。
受试者工作特征曲线分析显示，CONUT 评分的最佳截断值为 7。CONUT 评分≥7 与 CA19-9 水平升高显著相关（p=0.03）。多变量分析显示，CONUT 评分≥7 与癌症特异性生存（风险比[HR] = 10.2，95%置信区间[CI] 1.2-85.9，p=0.03）和无病生存（HR=7.1，95%CI 2.3-21.7，p=0.0006）独立相关。
结果表明，CONUT 评分是一种强有力的预后指标。评估 CONUT 评分可能会导致更精确的患者评估和针对性治疗。
