Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Seiryomachi 4-1, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
Surg Today. 2024 Dec;54(12):1437-1444. doi: 10.1007/s00595-024-02860-8. Epub 2024 May 6.
Nutritional scores have been reported to be useful prognostic factors for various cancers. This study evaluated the usefulness of the preoperative controlling nutritional status (CONUT) score as a predictor of recurrence of non-small cell lung cancer (NSCLC).
The present study included 422 patients with stage I-IIIA NSCLC who underwent complete resection at Tohoku University Hospital between January 2010 and December 2016. The patients were divided into the low-CONUT and high-CONUT groups based on their CONUT scores. Overall survival (OS), recurrence-free survival (RFS), and cumulative recurrence rates in the low- and high-CONUT groups were evaluated retrospectively.
One hundred forty-seven patients (34.8%) were assigned to the high-CONUT group. The high-CONUT group had a significantly worse performance status, pleural invasion, vascular invasion, and lung metastasis. In the whole cohort, the low-CONUT group showed better overall survival, recurrence-free survival, and a low cumulative recurrence rate in comparison to the high-CONUT group. There was no significant difference in prognosis or recurrence between the low- and high-CONUT groups after propensity score matching.
Patients with a high CONUT score may be at high risk of recurrence because of the high frequency of pleural invasion, vascular invasion, and lung metastasis.
营养评分已被报道可作为多种癌症的有用预后因素。本研究评估了术前控制营养状况(CONUT)评分作为非小细胞肺癌(NSCLC)复发预测指标的有用性。
本研究纳入了 2010 年 1 月至 2016 年 12 月在日本东北大学医院接受完全切除术的 422 例 I 期-IIIA 期 NSCLC 患者。根据 CONUT 评分,患者分为低 CONUT 和高 CONUT 组。回顾性评估低 CONUT 和高 CONUT 组的总生存(OS)、无复发生存(RFS)和累积复发率。
147 例(34.8%)患者被分配到高 CONUT 组。高 CONUT 组的体能状态、胸膜侵犯、血管侵犯和肺转移的发生率明显更高。在整个队列中,与高 CONUT 组相比,低 CONUT 组的总生存、无复发生存和累积复发率更低。在倾向评分匹配后,低 CONUT 和高 CONUT 组之间的预后或复发无显著差异。
由于胸膜侵犯、血管侵犯和肺转移的发生率较高,CONUT 评分较高的患者可能有较高的复发风险。