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Controlling nutritional status (CONUT) score as a preoperative risk assessment index for older patients with colorectal cancer.

ABSTRACT: BACKGROUND:Assessment of preoperative general condition to predict postoperative outcomes is important, particularly in older patients who typically suffer from various comorbidities and exhibit impaired functional status. In addition to various indices such as Charlson Comorbidity Index (CCI), National Institute on Aging and National Cancer Institute Comorbidity Index (NIA/NCI), Adult Comorbidity Evaluation-27 (ACE-27), and American Society of Anesthesiologists Physical Status classification (ASA-PS), controlling nutritional status (CONUT) score is recently gaining attention as a tool to evaluate the general condition of patients from a nutritional perspective. However, the utility of these indices in older patients with colorectal cancer has not been compared. METHODS:The study population comprised 830 patients with Stage I - IV colorectal cancer aged 75?years or older who underwent surgery at the National Cancer Center Hospital from January 2000 to December 2014. Associations of each index with overall survival (OS) (long-term outcome) and postoperative complications (short-term outcome) were examined. RESULTS:For the three indices with the highest Akaike information criterion values (i.e., CONUT score, CCI and ACE-27), but not the remaining indices (NIA/NCI and ASA-PS), OS significantly worsened as general condition scores decreased, after adjusting for known prognostic factors. In contrast, for postoperative complications, only CONUT score was identified as a predictive factor (?4 versus 0-3; odds ratio: 1.90; 95% CI: 1.13-3.13; P?=?0.016). CONCLUSION:For older patients with colorectal cancer, only CONUT score was a predictive factor of both long-term and short-term outcomes after surgery, suggesting that CONUT score is a useful preoperative risk assessment index.

SUBMITTER: Ahiko Y

PROVIDER: S-EPMC6833132 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Controlling nutritional status (CONUT) score as a preoperative risk assessment index for older patients with colorectal cancer.

Ahiko Yuka Y Shida Dai D Horie Tomoko T Tanabe Taro T Takamizawa Yasuyuki Y Sakamoto Ryohei R Moritani Konosuke K Tsukamoto Shunsuke S Kanemitsu Yukihide Y

BMC cancer 20191106 1

<h4>Background</h4>Assessment of preoperative general condition to predict postoperative outcomes is important, particularly in older patients who typically suffer from various comorbidities and exhibit impaired functional status. In addition to various indices such as Charlson Comorbidity Index (CCI), National Institute on Aging and National Cancer Institute Comorbidity Index (NIA/NCI), Adult Comorbidity Evaluation-27 (ACE-27), and American Society of Anesthesiologists Physical Status classific ...[more]

PMID: 31690275

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Project description:The nutritional status of a patient has prognostic potency concerning short- and long-term outcomes, including survival, in many diseases. The controlling nutritional status (CONUT) score is a method for assessing nutritional status and predicting outcomes of several diseases. This study sought to systematically identify the prognostic role of preoperative CONUT score on posttreatment overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival (CSS) in patients with cancer. The PubMed, SCOPUS, and Google Scholar databases and Google were searched for all dates until December 2019. Original articles investigating the association of preoperative CONUT score with survival in cancer patients who underwent surgery were included. Duplicate and irrelevant reports were screened out and the remaining articles assessed for quality and data extracted during critical analysis. Results of multivariate analysis were used to evaluate the prognostic competence of CONUT score in predicting survival. The search method identified an initial 181 articles, of which 32 were included in the final analysis. Lower OS, CSS, and RFS rates were reported by 100%, 100%, and 87.0% of the included studies, respectively, in cancer patients with high CONUT scores. A prognostic role of the CONUT score for prediction of OS, CSS, and RFS in cancer patients was shown by 91.7%, 90.9%, and 52.6% of the studies, respectively. The receiver operating characteristic curve area under the curve (AUC) value of the CONUT score for predicting OS, CSS, and RFS was at an acceptable level (>0.5) in all studies with available AUC values (n = 19). Sixty percent (12 of 20) of the studies reported that high CONUT score was significantly related to lower BMI. The findings promote confidence that a high preoperative CONUT score is associated with poor survival rate and is an independent prognostic factor of OS and CSS in patients with various types of cancer. Evaluation of the preoperative CONUT score might help clinicians in decision-making with respect to surgical implications.

Dataset Information

Controlling nutritional status (CONUT) score as a preoperative risk assessment index for older patients with colorectal cancer.

Publications

Controlling nutritional status (CONUT) score as a preoperative risk assessment index for older patients with colorectal cancer.

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