Tan FuYan, Xia RuMin, Zeng Lanjuan, Xie Huan, Long Xiaolu, Peng Caijiao
FuYan Tan, Department of Obstetric and Gynecologic, Hunan University of Medicine General Hospital, Huaihua 418000, Hunan, China.
RuMin Xia, Department of Obstetric and Gynecologic, Hunan University of Medicine General Hospital, Huaihua 418000, Hunan, China.
Pak J Med Sci. 2024 Jan-Feb;40(1Part-I):120-127. doi: 10.12669/pjms.40.1.7406.
To investigate whether the preoperative controlling nutritional status (COUNT) score is a prognostic factor of patients with high-risk factors for early-stage cervical cancer after surgery and concurrent chemoradiotherapy (CCRT).
This was a retrospective study. From July 2017 to March 2021, a total of 354 patients with histologically confirmed FIGO stage IB-IIA cervical cancer undergoing surgery and postoperative CCRT were included at Hunan University of Medicine General Hospital, China. According to receiver operating characteristic (ROC) curve analysis, the patients were divided into a low CONUT score (< 3) group and a high CONUT score (≥ 3) group. Overall survival (OS) was used as the primary outcome measure and disease-free survival (DFS) as the secondary outcome measure.
Among the 354 patients, 239(67.5%) were included in the low CONUT score group and 115 (32.5%) in the high CONUT score group. The 3, 5 and 10-year OS rates in the low CONUT score group and high CONUT score group were respectively presenting statistically significant differences (0.001). The 3, 5 and 10-year DFS rates in the low CONUT score group and in the high CONUT score group were respectively with statistically significant differences (0.001). Multivariate Cox regression analysis showed that CONUT score, histological type, PNI and lymph node metastasis were all independent predictors for OS and DFS (all 0.05).
High preoperative CONUT score indicates poor prognosis of patients with high-risk factors for early-stage cervical cancer after surgery and postoperative CCRT. In clinical practice, consolidation chemotherapy is recommended for patients with high CONUT scores.
探讨术前控制营养状况（CONUT）评分是否为早期宫颈癌术后同步放化疗（CCRT）高危因素患者的预后因素。
这是一项回顾性研究。2017年7月至2021年3月，中国湖南医药学院附属医院共纳入354例经组织学确诊为国际妇产科联盟（FIGO）分期IB-IIA期宫颈癌且接受手术及术后CCRT的患者。根据受试者工作特征（ROC）曲线分析，将患者分为低CONUT评分（<3）组和高CONUT评分（≥3）组。总生存（OS）作为主要结局指标，无病生存（DFS）作为次要结局指标。
354例患者中，低CONUT评分组239例（67.5%），高CONUT评分组115例（32.5%）。低CONUT评分组和高CONUT评分组的3年、5年和10年OS率分别存在统计学显著差异（P<0.001）。低CONUT评分组和高CONUT评分组的3年、5年和10年DFS率分别存在统计学显著差异（P<0.001）。多因素Cox回归分析显示，CONUT评分、组织学类型、预后营养指数（PNI）和淋巴结转移均为OS和DFS的独立预测因素（均P<0.05）。
术前高CONUT评分表明早期宫颈癌术后及术后CCRT高危因素患者预后不良。在临床实践中，建议对CONUT评分高的患者进行巩固化疗。
