J Cancer 2020; 11(23):7045-7056. doi:10.7150/jca.49383 This issue

Research Paper

The value of preoperative controlling nutritional status score in evaluating short-term and long-term outcomes of patients with colorectal cancer following surgical resection

Hailun Xie1*, Chao Nong1*, Guanghui Yuan1, Shizhen Huang1, Jiaan Kuang1, Ling Yan1, Guotian Ruan1, Shuangyi Tang2, Jialiang Gan1✉

1. Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, P.R. China.
2. Department of Pharmacy, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, P.R. China.
*These authors contributed equally to this work.

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Citation:
Xie H, Nong C, Yuan G, Huang S, Kuang J, Yan L, Ruan G, Tang S, Gan J. The value of preoperative controlling nutritional status score in evaluating short-term and long-term outcomes of patients with colorectal cancer following surgical resection. J Cancer 2020; 11(23):7045-7056. doi:10.7150/jca.49383. Available from https://www.jcancer.org/v11p7045.htm

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Abstract

Background: This study aimed to explore the value of controlling nutritional status (CONUT) score in assessing short-term and long-term outcomes of colorectal cancer (CRC) patients, and construct CONUT-based nomograms to predict risk of postoperative comorbidities and survival.

Methods: We retrospectively enrolled 512 patients from 2012 to 2014. Patients were categorized into low-CONUT and high-CONUT groups. Logistic regression analysis was used to determine characteristics influencing postoperative comorbidities. Kaplan-Meier survival curve and Cox proportional hazards analysis were used to determine characteristics affecting prognosis. The receiver operating characteristic was used to compare ability of the CONUT score with other immune-nutritional indicators to predict prognosis.

Results: Logistic regression analysis suggested that high CONUT score was an independent risk factor affecting postoperative comorbidities (odds ratio, 1.792; 95% confidence interval [CI], 1.113-2.886; P = 0.016). Patients with low-CONUT score had longer disease-free survival (DFS) (P < 0.001) and overall survival (OS) (P < 0.001) compared to those with high-CONUT score, especially at the early stage. CONUT score was an independent factor affecting both DFS (hazard ratio [HR], 1.820; 95% CI, 1.204-2.752; P = 0.005) and OS (HR, 1.815; 95% CI, 1.180-2.792; P = 0.007). The area under the curve of CONUT score was higher than for other immune-nutritional indicators. The CONUT-based nomograms had good predictive capability.

Conclusions: CONUT score is a strong independent predictor of postoperative comorbidities and long-term outcomes in CRC patients, and might be a better prognostic factor than other immune-nutritional indicators. The CONUT-based nomograms are conducive to the individualized formulation of follow-up strategies and treatment plans.

Keywords: colorectal cancer, controlling nutritional status, prognosis, postoperative comorbidities