控制营养状况（CONUT）对接受多药化疗的不可切除晚期胰腺癌患者的影响：一项单中心回顾性队列研究。

Impact of Controlling nutritional status (CONUT) in patients with unresectable advanced pancreatic cancer receiving multi-agent chemotherapy: A single center, retrospective cohort study.

作者信息

Uemura Shinya, Iwashita Takuji, Ichikawa Hironao, Iwasa Yuhei, Mita Naoki, Shiraki Makoto, Shimizu Masahito

机构信息

First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan.

出版信息

Pancreatology. 2022 Mar;22(2):304-310. doi: 10.1016/j.pan.2022.01.010. Epub 2022 Feb 2.

DOI:10.1016/j.pan.2022.01.010

PMID:35153128

Abstract

UNLABELLED

Controlling nutritional status (CONUT) calculated using the serum albumin concentration, total lymphocyte count, and total cholesterol, was developed as a screening tool for the early detection of undernutrition. In addition, CONUT has been reported to be a prognostic predictor of various malignancies.

AIM

To investigate the impact of CONUT in patients with advanced pancreatic cancer (APC).

METHODS

Between June 2014 and October 2020, 110 consecutive patients with APC who received multi-agent chemotherapy were retrospectively reviewed. Patients were classified into four categories (normal, 1; light, 2; moderate, 3; severe, 4) based on CONUT. Progression-free survival (PFS) and overall survival (OS) were evaluated.

RESULTS

Thirty-nine (35.4%), 63 (57.2%), and 8 (7.2%) patients had CONUT 1, 2, and 3, respectively, but no patients for CONUT 4. The baseline characteristics did not differ significantly between CONUT classifications. In the multivariate analyses, the presence of metastasis (hazard ratio [HR], 2.06; 95% confidence interval [CI], 1.22-3.52), CONUT 2 (HR, 2.15; 95% CI, 1.32-3.54), and CONUT 3 (HR, 9.18; 95% CI, 2.67-23.50) were independent risk factors for PFS. The presence of metastasis (HR, 1.76; 95% CI, 1.04-3.07), CONUT 2 (HR, 1.92; 95% CI, 1.16-3.24), and CONUT 3 (HR, 10.71; 95% CI, 3.87-27.63) were also independent risk factors for OS. A median OS in CONUT 1, 2, and 3 were 20, 14.5, and 3.5 months (CONUT 1 vs. CONUT 2, p = 0.02; CONUT 1 vs. CONUT 3, p < 0.01; CONUT 2 vs. CONUT 3, p < 0.01), respectively.

CONCLUSION

CONUT could be a predictor of prognosis for survival in patients with APC.

摘要

未标注

使用血清白蛋白浓度、总淋巴细胞计数和总胆固醇计算得出的控制营养状态（CONUT），被开发为一种用于早期检测营养不良的筛查工具。此外，据报道CONUT是各种恶性肿瘤的预后预测指标。

目的

研究CONUT对晚期胰腺癌（APC）患者的影响。

方法

回顾性分析2014年6月至2020年10月期间连续收治的110例接受多药化疗的APC患者。根据CONUT将患者分为四类（正常，1；轻度，2；中度，3；重度，4）。评估无进展生存期（PFS）和总生存期（OS）。

结果

分别有39例（35.4%）、63例（57.2%）和8例（7.2%）患者的CONUT为1、2和3，但无CONUT为4的患者。CONUT分类之间的基线特征无显著差异。在多因素分析中，转移的存在（风险比[HR]，2.06；95%置信区间[CI]，1.22 - 3.52）、CONUT 2（HR，2.15；95% CI，1.32 - 3.54）和CONUT 3（HR，9.18；95% CI，2.67 - 23.50）是PFS的独立危险因素。转移的存在（HR，1.76；95% CI，1.04 - 3.07）、CONUT 2（HR，1.92；95% CI，1.16 - 3.24）和CONUT 3（HR，10.71；95% CI，3.87 - 27.63）也是OS的独立危险因素。CONUT 1、2和3的中位OS分别为20个月、14.5个月和3.5个月（CONUT 1与CONUT 2比较，p = 0.02；CONUT 1与CONUT 3比较，p < 0.01；CONUT 2与CONUT 3比较，p < 0.01）。