Prognostic effect of preoperative Controlling Nutritional Status score in patients with locally advanced rectal cancer: A two-center, retrospective study

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.

Automated summary

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.