Norifumi Harimoto1,2, Tomoharu Yoshizumi3, Shoichi Inokuchi3, Shinji Itoh3, Eisuke Adachi4, Yasuharu Ikeda5, Hideaki Uchiyama6, Tohru Utsunomiya7, Kiyoshi Kajiyama8, Koichi Kimura9, Fumiaki Kishihara10, Keishi Sugimachi11, Eiji Tsujita11, Mizuki Ninomiya12, Kengo Fukuzawa13, Takashi Maeda14, Ken Shirabe15, Yoshihiko Maehara3. 1. Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan. nharimotoh1@gunma-u.ac.jp. 2. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. nharimotoh1@gunma-u.ac.jp. 3. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 4. Department of Surgery, Kyushu Central Hospital, Fukuoka, Japan. 5. Department of Surgery, Fukuoka City Hospital, Fukuoka, Japan. 6. Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan. 7. Department of Surgery, Oita Prefectural Hospital, Oita, Japan. 8. Department of Surgery, Iizuka Hospital, Fukuoka, Japan. 9. Department of Surgery, Munakata Medical Association Hospital, Fukuoka, Japan. 10. Department of Gastroenterological Surgery, Steel Memorial Yawata Hospital, Fukuoka, Japan. 11. Department of Hepato-Biliary-Pancreatic Surgery, National Kyushu Cancer Center, Fukuoka, Japan. 12. Department of Surgery, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan. 13. Department of Surgery, Oita Red Cross Hospital, Oita, Japan. 14. Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan. 15. Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan.
Abstract
BACKGROUND: The Controlling Nutritional Status (CONUT) score is an objective tool that is widely used to assess the nutritional status in patients, including those with cancer. The relationship between the CONUT score and prognosis in patients who have undergone hepatic resection has not been evaluated in a multi-institutional study. METHODS: Data were retrospectively collected for 2461 consecutive patients with hepatocellular carcinoma (HCC) who had undergone hepatic resection with curative intent at 13 institutions between January 2004 and December 2015. Patients were assigned to two groups: preoperative CONUT scores ≤ 3 (low CONUT score) and ≥ 4 (high CONUT score). Clinicopathological characteristics, surgical outcomes, and long-term survival were compared using propensity score matching analysis. RESULTS: Of the 2461 patients, 540 (21.9%) had high (≥ 4) and 1921 (78.1%) had low (≤ 3) preoperative CONUT scores. Overall, a high CONUT score was significantly associated with older age, female sex, low body mass index, low serum albumin, high serum total bilirubin, low lymphocyte count, low serum cholesterol, shorter prothrombin time, higher indocyanine green retention test at 15 min, Child-Pugh B (vs. A), liver cirrhosis, minor resection, shorter operation time, massive blood loss, blood transfusion, and postoperative complications. After propensity score matching, a higher CONUT score was significantly associated with poor overall survival (OS) and recurrence-free survival (RFS) using multivariate analysis. CONCLUSIONS: This retrospective, multi-institutional analysis showed that, in patients who undergo curative hepatectomy for HCC, the preoperative CONUT score is predictive of worse OS and RFS, even after propensity score matching analysis.
BACKGROUND: The Controlling Nutritional Status (CONUT) score is an objective tool that is widely used to assess the nutritional status in patients, including those with cancer. The relationship between the CONUT score and prognosis in patients who have undergone hepatic resection has not been evaluated in a multi-institutional study. METHODS: Data were retrospectively collected for 2461 consecutive patients with hepatocellular carcinoma (HCC) who had undergone hepatic resection with curative intent at 13 institutions between January 2004 and December 2015. Patients were assigned to two groups: preoperative CONUT scores ≤ 3 (low CONUT score) and ≥ 4 (high CONUT score). Clinicopathological characteristics, surgical outcomes, and long-term survival were compared using propensity score matching analysis. RESULTS: Of the 2461 patients, 540 (21.9%) had high (≥ 4) and 1921 (78.1%) had low (≤ 3) preoperative CONUT scores. Overall, a high CONUT score was significantly associated with older age, female sex, low body mass index, low serum albumin, high serum total bilirubin, low lymphocyte count, low serum cholesterol, shorter prothrombin time, higher indocyanine green retention test at 15 min, Child-Pugh B (vs. A), liver cirrhosis, minor resection, shorter operation time, massive blood loss, blood transfusion, and postoperative complications. After propensity score matching, a higher CONUT score was significantly associated with poor overall survival (OS) and recurrence-free survival (RFS) using multivariate analysis. CONCLUSIONS: This retrospective, multi-institutional analysis showed that, in patients who undergo curative hepatectomy for HCC, the preoperative CONUT score is predictive of worse OS and RFS, even after propensity score matching analysis.
Authors: Lejia Sun; Si Su; Jianping Xiong; Wenmo Hu; Lei Liu; Haifeng Xu; Shunda Du; Haitao Zhao; Xin Lu; Xinting Sang; Shouxian Zhong; Huayu Yang; Yilei Mao Journal: Ann Transl Med Date: 2021-04
Authors: Lukas Müller; Felix Hahn; Aline Mähringer-Kunz; Fabian Stoehr; Simon J Gairing; Friedrich Foerster; Arndt Weinmann; Peter R Galle; Jens Mittler; Daniel Pinto Dos Santos; Michael B Pitton; Christoph Düber; Roman Kloeckner Journal: Front Oncol Date: 2021-06-10 Impact factor: 6.244