Impact of the Preoperative Controlling Nutritional Status (CONUT) Score on the Survival after Curative Surgery for Colorectal Cancer

Background Recently, the preoperative immune-nutritional status has been reported to correlate with the survival rate in patients with colorectal cancer (CRC). However, there have been no reports on the relationship between the controlling nutritional status (CONUT) score and the clinical outcome after curative surgery for CRC. We herein evaluated the prognostic significance of the CONUT score in patients with CRC, and then compared the accuracy of the CONUT score and the prognostic nutritional index (PNI) as a predictor of survival. Methods We retrospectively reviewed a database of 204 patients who underwent curative surgery for Stage II/III CRC. Patients were divided into two groups according to the CONUT score and the PNI. Results The five-year cancer-specific survival (CSS) rate was significantly higher at 92.7% in the low CONUT group, compared to a rate of 81.0% in the high CONUT group (p=0.0016). The five-year CSS was 71.2% in the low PNI group and 92.3% in the high PNI group, which showed a significant difference (p=0.0155). A multivariate analysis showed that lymph node metastasis and the CONUT score were independent risk factors for CSS. Conclusion This study suggested that the CONUT score is a strong independent predictor of the survival among CRC patients.

[1]  K. Hirakawa,et al.  Maintenance of the nutritional prognostic index predicts survival in patients with unresectable metastatic colorectal cancer , 2015, Journal of Cancer Research and Clinical Oncology.

[2]  K. Hirakawa,et al.  Low Nutritional Prognostic Index Correlates with Poor Survival in Patients with Stage IV Colorectal Cancer Following Palliative Resection of the Primary Tumor , 2014, World Journal of Surgery.

[3]  J. I. de Ulíbarri Pérez,et al.  Nutritional screening; control of clinical undernutrition with analytical parameters. , 2014, Nutricion hospitalaria.

[4]  C. Kwak,et al.  Influence of nutritional deficiency on prognosis of renal cell carcinoma (RCC) , 2013, BJU international.

[5]  Koji Tanaka,et al.  Prognostic Nutritional Index Predicts Postoperative Outcome in Colorectal Cancer , 2013, World Journal of Surgery.

[6]  T. Bering,et al.  Relationship between nutritional status and the Glasgow Prognostic Score in patients with colorectal cancer. , 2013, Nutrition.

[7]  T. Nozoe,et al.  The prognostic nutritional index can be a prognostic indicator in colorectal carcinoma , 2012, Surgery Today.

[8]  J. Culebras,et al.  Confirming the validity of the CONUT system for early detection and monitoring of clinical undernutrition: comparison with two logistic regression models developed using SGA as the gold standard. , 2012, Nutricion hospitalaria.

[9]  C. Mathers,et al.  Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008 , 2010, International journal of cancer.

[10]  T. Boonpipattanapong,et al.  Preoperative Carcinoembryonic Antigen and Albumin in Predicting Survival in Patients With Colon and Rectal Carcinomas , 2006, Journal of clinical gastroenterology.

[11]  A. Soran,et al.  Are pretreatment serum albumin and cholesterol levels prognostic tools in patients with colorectal carcinoma? , 2006, Medical science monitor : international medical journal of experimental and clinical research.

[12]  M. ChB.,et al.  Neutrophil‐lymphocyte ratio as a prognostic factor in colorectal cancer , 2005, Journal of surgical oncology.

[13]  B. D'Attoma,et al.  Serum Lipid Profile in Colorectal Cancer Patients with and without Synchronous Distant Metastases , 2005, Oncology.

[14]  C. McArdle,et al.  Tumour T-lymphocyte subset infiltration and tumour recurrence following curative resection for colorectal cancer. , 2004, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[15]  C. McArdle,et al.  Systemic inflammatory response predicts survival following curative resection of colorectal cancer , 2003, The British journal of surgery.

[16]  C. McArdle,et al.  Outcome following surgery for colorectal cancer: analysis by hospital after adjustment for case-mix and deprivation , 2002, British Journal of Cancer.

[17]  A. Viel,et al.  High prevalence of activated intraepithelial cytotoxic T lymphocytes and increased neoplastic cell apoptosis in colorectal carcinomas with microsatellite instability. , 1999, The American journal of pathology.

[18]  J. Cubiella,et al.  Prognostic factors in nonresectable pancreatic adenocarcinoma: a rationale to design therapeutic trials , 1999, American Journal of Gastroenterology.

[19]  T. Menges,et al.  Changes in blood lymphocyte populations after multiple trauma: association with posttraumatic complications. , 1999, Critical care medicine.

[20]  G. Kaysen,et al.  Factors influencing serum albumin in dialysis patients. , 1998, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[21]  D. Carter TNM Classification of Malignant Tumors , 1998 .

[22]  L. Walker,et al.  Serum albumin: a prognostic indicator in patients with colorectal cancer. , 1998, Journal of the Royal College of Surgeons of Edinburgh.

[23]  G. Delmore Assessment of nutritional status in cancer patients: widely neglected? , 1997, Supportive Care in Cancer.

[24]  V. Kosma,et al.  Prognostic value of tumour‐infiltrating lymphocytes (TILs) in colorectal cancer , 1997, The Journal of pathology.

[25]  A. Niendorf,et al.  Increased LDL receptor mRNA expression in colon cancer is correlated with a rise in plasma cholesterol levels after curative surgery , 1995, International journal of cancer.

[26]  G. Juliusson,et al.  Multilevel regulation of low-density lipoprotein receptor and 3-hydroxy- 3-methylglutaryl coenzyme A reductase gene expression in normal and leukemic cells , 1994 .

[27]  G. Gahrton,et al.  HYPOCHOLESTEROLAEMIA IN MALIGNANCY DUE TO ELEVATED LOW-DENSITY-LIPOPROTEIN-RECEPTOR ACTIVITY IN TUMOUR CELLS: EVIDENCE FROM STUDIES IN PATIENTS WITH LEUKAEMIA , 1985, The Lancet.

[28]  G. Kōsaki,et al.  [Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients]. , 1984, Nihon Geka Gakkai zasshi.

[29]  M. Oliver SERUM CHOLESTEROL-THE KNAVE OF HEARTS AND THE JOKER , 1981, The Lancet.

[30]  J. Fahey,et al.  Letter: Toxicity of intravenous Corynebacterium parvum. , 1975, Lancet.

[31]  I sabel Mortara,et al.  International Union against Cancer , 1938, Nature.

[32]  Jacques Ferlay,et al.  GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11 [Internet] , 2013 .

[33]  C. Mathers,et al.  GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer , 2013 .

[34]  小池 勇樹 Preoperative C-reactive protein as a prognostic and therapeutic marker for colorectal cancer , 2009 .

[35]  J Ignacio de Ulíbarri,et al.  CONUT: a tool for controlling nutritional status. First validation in a hospital population. , 2005, Nutricion hospitalaria.

[36]  J. Grutsch,et al.  Prognostic significance of Subjective Global Assessment (SGA) in advanced colorectal cancer , 2005, European Journal of Clinical Nutrition.

[37]  G. Juliusson,et al.  Multilevel regulation of low-density lipoprotein receptor and 3-hydroxy-3-methylglutaryl coenzyme A reductase gene expression in normal and leukemic cells. , 1994, Blood.

[38]  S. Kritchevsky,et al.  Serum cholesterol and cancer risk: an epidemiologic perspective. , 1992, Annual review of nutrition.

[39]  T. Irvin Letter: Preparation for colonic surgery. , 1975, Lancet.

[40]  H. Bartsch,et al.  International Agency for Research on Cancer. , 1969, WHO chronicle.