Journal
NUTRITION
Volume 112, Issue -, Pages -Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.nut.2023.112078
Keywords
CONUT score; Rectal cancer; Prognosis; Nutrition; Chemoradiotherapy
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This study aimed to investigate the prognosis relevance of the Controlling Nutritional Status (CONUT) score in locally advanced rectal cancer patients treated with neoadjuvant chemoradiotherapy before radical surgery. The CONUT score was found to have good predictive ability for overall survival and was identified as an independent prognostic factor. The preoperative CONUT score may be a useful indicator in clinical scenarios.
ThisstudyaimedtoidentifytheprognosisrelevanttotheControllingNutritionalStatus(CONUT) scoreinlocallyadvancedrectalcancerpatientswhoweretreatedwithneoadjuvantchemoradiotherapybeforeradicalsurgery. Methods: Fromaretrospectivedatabaseof568patientsundergoingradicalsurgeryforrectalcancerattwoChineseinstitutionsbetween2012and2022, datafor300patientswithlocallyadvancedrectalcancerwereidentified. TheoptimalcutoffvaluefortheCONUTscoreinpredictingoverallsurvival(OS) wasdeterminedusingXtilesoftware. TheassociationsoftheCONUTscorewiththerecurrentmetastasisandclinicopathologicparameterswereanalyzed. TheCONUTscore'sabilitytopredictOSwasalsocomparedwithotherprognosticmarkers. UnivariateandmultivariateCoxregressionanalysisforOSwasperformed. SubgroupanalysiswasconductedtoevaluatefurthertheCONUTscore'spredictingvalue. Results: TheoptimalCONUTscorecutoffvaluewasdeterminedas5accordingtoX-tile. PatientsweredividedintoCONUThigh(CONUTscore < 5) andCONUT-low(CONUTscore< 5) groups. CONUTscoreissignificantlycorrelatedwithhemoglobin, globulin, andplatelets. Time-dependentreceiveroperatingcharacteristicoftheCONUTscorepredictingOSoutperformedallcommonprognosticmarkers. MultivariateCoxregressionanalysisidentifiedCONUTscoreasanindependentprognosticfactorforOS(hazardratio= 5.701; 95% CI, 2.336-13.914; P< 0.001). Inthesubgroupsofage, sex, carcinoembryonicantigen, ypTNM, andtumorresponsestatus, significantstatisticaldifferencescanbeobservedbetweenCONUT-highand-low. . Conclusions: ThepresentstudyfindsthatthepreoperativeCONUTscoremaybeausefulprognosticindicatorinclinicalscenarios.
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