Division of Gastroenterological Surgery, Department of Surgery, Aichi Medical University, Nagakute, Japan,
Division of Gastroenterological Surgery, Department of Surgery, Aichi Medical University, Nagakute, Japan.
Med Princ Pract. 2021;30(2):131-137. doi: 10.1159/000514031. Epub 2020 Dec 24.
There are no previous studies analyzing the prognostic predictive value of adding the tumor factor (i.e., Tumor Burden (TB) score) to the Controlling Nutritional Status (CONUT) score for patients with hepatocellular carcinoma (HCC). This study aimed to investigate the value of the CONUT plus TB (CONUT-TB) score as a prognostic predictor in patients with HCC undergoing liver resection.
Between 2015 and 2018, 96 consecutive patients with HCC underwent liver resection at our institution. Patients undergoing repeated liver resection and combined resection of a metastatic lesion were excluded. Patients were divided into 2 groups according to their CONUT-TB scores according to a cutoff value. Clinicopathologic prognostic factors for survival were analyzed using a database containing the medical records.
The optimal cutoff value of the CONUT-TB score determined by using a minimum p value approach was 13 points. Among the 81 patients included in the analytic cohort, 71 patients had low (<13) and 10 patients had high (>13) CONUT-TB scores. The overall 3-year survival rate of patients following liver resection for HCC in the high-CONUT-TB group was significantly worse than that of patients in the low-CONUT-TB group (62.5 vs. 89.3%, p = 0.003). Multivariate analysis indicated that a high CONUT-TB score was independently associated with overall survival after liver resection (p = 0.010).
The CONUT-TB score is a valuable predictor of survival in patients with HCC after liver resection.
目前尚无研究分析在肝癌患者中，将肿瘤因素（即肿瘤负担（TB）评分）添加到控制营养状况（CONUT）评分中对预后预测的价值。本研究旨在探讨 CONUT 加 TB（CONUT-TB）评分作为接受肝切除术的 HCC 患者预后预测因子的价值。
2015 年至 2018 年间，我院对 96 例连续 HCC 患者进行了肝切除术。排除重复肝切除术和转移性病变联合切除术的患者。根据截断值，根据 CONUT-TB 评分将患者分为 2 组。使用包含病历的数据库分析与生存相关的临床病理预后因素。
使用最小 p 值方法确定的 CONUT-TB 评分的最佳截断值为 13 分。在纳入分析队列的 81 例患者中，71 例患者的 CONUT-TB 评分较低（<13），10 例患者的 CONUT-TB 评分较高（>13）。肝切除术后 HCC 患者中，高 CONUT-TB 组的总 3 年生存率明显低于低 CONUT-TB 组（62.5%比 89.3%，p = 0.003）。多变量分析表明，高 CONUT-TB 评分与肝切除术后总生存独立相关（p = 0.010）。
CONUT-TB 评分是肝切除术后 HCC 患者生存的有价值的预测因子。
