控制营养状况（CONUT）评分在肝切除术后结直肠癌肝转移患者中的临床意义。
Clinical Significance of Controlling Nutritional Status (CONUT) Score in Patients With Colorectal Liver Metastases After Hepatectomy.
机构信息
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
出版信息
In Vivo. 2023 Nov-Dec;37(6):2678-2686. doi: 10.21873/invivo.13377.
BACKGROUND/AIM: The prognostic outcome of the controlling nutritional status (CONUT) score in patients with colorectal liver metastases (CRLM) who underwent hepatectomy has not been investigated. The aim of this study was to investigate the prognostic value of preoperative CONUT score and other systemic inflammation-related biomarkers in patients who underwent hepatectomy for CRLM.
PATIENTS AND METHODS
The subjects included 145 patients with CRLM who underwent hepatectomy and retrospectively investigated the association of preoperative CONUT score with disease-free survival (DFS), surgical failure-free survival (SFS), and overall survival (OS) using univariate and multivariate analyses.
RESULTS
In this study, the cut-off of the CONUT score was 4. In the univariate analysis, the high CONUT score was associated with worse SFS and OS (p=0.01, 0.01). The multivariate analysis showed significant and independent predictors of OS were lymph node metastases (p=0.03) and a high CONUT score (p=0.04). In patients with a high CONUT score, postoperative complications due to infections were significantly more than in those with a low CONUT score (27% vs. 9%, p=0.04).
CONCLUSION
The CONUT score can be useful for predicting not only short-term but also long-term outcomes in patients with CRLM after hepatectomy.
背景/目的：控制营养状态（CONUT）评分在接受肝切除术的结直肠癌肝转移（CRLM）患者中的预后结果尚未得到研究。本研究旨在探讨术前 CONUT 评分和其他与全身炎症相关的生物标志物在接受肝切除术治疗 CRLM 患者中的预后价值。
患者和方法
本研究纳入了 145 例接受肝切除术的 CRLM 患者，回顾性分析了术前 CONUT 评分与无疾病生存（DFS）、手术失败无生存（SFS）和总生存（OS）的相关性，采用单因素和多因素分析。
结果
在本研究中，CONUT 评分的截断值为 4。单因素分析显示，高 CONUT 评分与较差的 SFS 和 OS 相关（p=0.01，0.01）。多因素分析显示，淋巴结转移（p=0.03）和高 CONUT 评分（p=0.04）是 OS 的显著且独立的预测因素。在 CONUT 评分较高的患者中，术后因感染导致的并发症明显多于 CONUT 评分较低的患者（27%比 9%，p=0.04）。
结论
CONUT 评分不仅可用于预测接受肝切除术的 CRLM 患者的短期预后，还可用于预测长期预后。
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