Department of Thoracic Surgery, Kochi Medical School, Nankoku, Kochi, Japan.
Ann Thorac Cardiovasc Surg. 2024;30(1). doi: 10.5761/atcs.oa.24-00009.
This study evaluated the Controlling Nutritional Status (CONUT) score as a prognostic predictor in elderly non-small cell lung cancer (NSCLC) patients with surgical resection.
Overall, 114 patients over 80 years old undergoing curative resection for NSCLC were retrospectively analyzed. Receiver operating characteristic (ROC) analysis was conducted to evaluate the capacity of immune-inflammatory markers to predict overall survival (OS). Cox-proportional hazards regression analysis was implemented to investigate prognostic markers for OS.
Based on ROC curves, the CONUT score was found to be the most valuable prognostic marker (area under the curve = 0.716). The high CONUT (≥2) group included 54 patients, and the low CONUT (0 or 1) group included 60 patients. The high CONUT group had poorer prognosis rates compared to the low CONUT group with regard to OS (5-year OS: 46.3% vs. 86.0%, p = 0.0006). In the multivariate data analysis, histology, lymphatic invasion, and CONUT score (hazard ratio: 4.23, p = 0.0003) were found to be exclusive and independent prognostic markers for OS.
Preoperatively, the CONUT score can be used as a novel prognostic marker in elderly NSCLC patients. CONUT evaluations can also be used to design nutritional interventions to improve patient outcomes.
本研究评估了控制营养状况（CONUT）评分作为老年非小细胞肺癌（NSCLC）患者手术切除后的预后预测指标。
回顾性分析了 114 名 80 岁以上接受 NSCLC 根治性切除术的患者。采用受试者工作特征（ROC）曲线分析评价免疫炎症标志物预测总生存期（OS）的能力。采用 Cox 比例风险回归分析探讨 OS 的预后标志物。
根据 ROC 曲线，CONUT 评分是最有价值的预后标志物（曲线下面积=0.716）。高 CONUT（≥2）组 54 例，低 CONUT（0 或 1）组 60 例。与低 CONUT 组相比，高 CONUT 组的 OS 预后率更差（5 年 OS：46.3%比 86.0%，p=0.0006）。在多变量数据分析中，组织学、淋巴浸润和 CONUT 评分（风险比：4.23，p=0.0003）是 OS 的独立预后标志物。
术前，CONUT 评分可作为老年 NSCLC 患者的一种新的预后标志物。CONUT 评估也可用于设计营养干预措施，以改善患者预后。
