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术前控制营养状态(CONUT)评分可预测腹腔镜辅助根治性胃切除术后胃癌患者的短期预后。

Preoperative Controlling Nutritional Status (CONUT) score predicts short-term outcomes of patients with gastric cancer after laparoscopy-assisted radical gastrectomy.

作者信息

Qian Yun, Liu Huaying, Pan Junhai, Yu Weihua, Lv Jiemin, Yan Jiafei, Gao Jiaqi, Wang Xianfa, Ge Xiaolong, Zhou Wei

机构信息

Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, China.

Department of Medicine, GuangXi Medical College, Nanning, China.

出版信息

World J Surg Oncol. 2021 Jan 23;19(1):25. doi: 10.1186/s12957-021-02132-6.

Abstract

BACKGROUND

An emerging prediction tool, the Controlling Nutritional Status (CONUT) score, has shown good assessment ability of postoperative outcomes in cancer patients. This study evaluated the role of the preoperative CONUT score regarding the short-term outcomes of gastric cancer (GC) after laparoscopic gastrectomy.

METHODS

Three hundred and nine GC patients undergoing laparoscopic gastrectomy from January 2016 to June 2019 were analysed, retrospectively. The patients were divided into two groups according to the CONUT optimal cut-off value. Clinical characteristics and postoperative complications in the two groups were analysed and evaluated. Risk factors for complications were identified by univariate and multivariate analyses.

RESULTS

A total of 309 patients underwent laparoscopic gastrectomy; 91 (29.4%) patients experienced postoperative complications. The preoperative CONUT score showed a good predictive ability for postoperative complications (area under the curve (AUC) = 0.718, Youden index = 0.343) compared with other indices, with an optimal cut-off value of 2.5. Patients with high CONUT score had a significantly higher incidence of overall complications (P < 0.001). Age, haemoglobin, C-reactive protein, red blood cell levels, CONUT scores, surgical procedure type, T1, T4, N0 and N3 pathological TNM classification, and pathological stages of I and III were associated with postoperative complications (P < 0.05). Furthermore, the preoperative CONUT score was identified as an independent risk predictor of postoperative complications (P = 0.012; OR = 2.433; 95% CI, 1.218-4.862) after multivariate analysis.

CONCLUSIONS

The preoperative CONUT score is a practical nutritional assessment for predicting short-term outcomes in GC patients after laparoscopy-assisted gastrectomy.

摘要

背景

一种新兴的预测工具——控制营养状况(CONUT)评分,已显示出对癌症患者术后结局良好的评估能力。本研究评估了术前CONUT评分在腹腔镜胃切除术后胃癌(GC)短期结局中的作用。

方法

回顾性分析2016年1月至2019年6月期间接受腹腔镜胃切除术的309例GC患者。根据CONUT最佳临界值将患者分为两组。分析和评估两组患者的临床特征及术后并发症。通过单因素和多因素分析确定并发症的危险因素。

结果

共有309例患者接受了腹腔镜胃切除术;91例(29.4%)患者发生术后并发症。与其他指标相比,术前CONUT评分对术后并发症显示出良好的预测能力(曲线下面积(AUC)=0.718,约登指数=0.343),最佳临界值为2.5。CONUT评分高的患者总体并发症发生率显著更高(P<0.001)。年龄、血红蛋白、C反应蛋白、红细胞水平、CONUT评分、手术方式类型、T1、T4、N0和N3病理TNM分类以及I期和III期病理分期与术后并发症相关(P<0.05)。此外,多因素分析后,术前CONUT评分被确定为术后并发症的独立风险预测因素(P=0.012;OR=2.433;95%CI,1.218 - 4.862)。

结论

术前CONUT评分是预测腹腔镜辅助胃切除术后GC患者短期结局的一种实用营养评估方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b887/7827975/74575fa2ffb6/12957_2021_2132_Fig1_HTML.jpg

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