Song Ryo1,2, Mitsuro Kanda3, Seiji Ito4, Yoshinari Mochizuki5, Hitoshi Teramoto6, Kiyoshi Ishigure1, Toshifumi Murai7, Takahiro Asada2, Akiharu Ishiyama8, Hidenobu Matsushita9, Chie Tanaka10, Daisuke Kobayashi10, Michitaka Fujiwara10, Kenta Murotani11, Yasuhiro Kodera10. 1. Department of Surgery, Konan Kosei Hospital, Konan, Japan. 2. Department of Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Japan. 3. Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan. m-kanda@med.nagoya-u.ac.jp. 4. Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan. 5. Department of Surgery, Komaki Municipal Hospital, Komaki, Japan. 6. Department of Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan. 7. Department of Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan. 8. Department of Surgery, Okazaki City Hospital, Okazaki, Japan. 9. Department of Surgery, Tosei General Hospital, Seto, Japan. 10. Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan. 11. Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume, Japan.
Abstract
BACKGROUND: This study aimed to evaluate the predictive value of the preoperative Controlling Nutritional Status (CONUT) score, which comprehensively reflects protein and lipid metabolism as well as the immunocompetence among patients with stage 2 or 3 gastric cancer. METHODS: From a retrospective database of 3484 patients who underwent gastrectomy for gastric cancer at nine Japanese institutions between 2010 and 2014, data for 626 patients with stage 2 or 3 cancer were retrieved. The study evaluated the significance of the associations between the optimal CONUT score cutoff values with the prognosis and the incidence of postoperative complications. RESULTS: The study determined that 2 was the optimal CONUT score cutoff value for predicting mortality 2 years after surgery. The patients with a CONUT score of 2 or higher (CONUT-high group) were significantly older and had a worse Eastern Cooperative Oncology Group performance status, lower body mass index, and more advanced tumor-node-metastasis stage than the patients with a CONUT score lower than 2 (CONUT-low group). Overall, the survival time was significantly shorter in the CONUT-high group than in the CONUT-low group [hazard ratio (HR) 1.97; P < 0.0001]. A multivariable analysis showed that the CONUT score was an independent prognostic factor of overall survival. The CONUT score more significantly reflected the overall survival for patients who underwent postoperative adjuvant chemotherapy than for those who underwent surgery alone. Additionally, a high preoperative CONUT score was significantly associated with an increased incidence of postoperative pneumonia and prolonged hospitalization. CONCLUSIONS: The study results suggest that the preoperative CONUT score may be a useful predictor of postoperative short- and long-term outcomes for patients with stage 2 or 3 gastric cancer.
BACKGROUND: This study aimed to evaluate the predictive value of the preoperative Controlling Nutritional Status (CONUT) score, which comprehensively reflects protein and lipid metabolism as well as the immunocompetence among patients with stage 2 or 3 gastric cancer. METHODS: From a retrospective database of 3484 patients who underwent gastrectomy for gastric cancer at nine Japanese institutions between 2010 and 2014, data for 626 patients with stage 2 or 3 cancer were retrieved. The study evaluated the significance of the associations between the optimal CONUT score cutoff values with the prognosis and the incidence of postoperative complications. RESULTS: The study determined that 2 was the optimal CONUT score cutoff value for predicting mortality 2 years after surgery. The patients with a CONUT score of 2 or higher (CONUT-high group) were significantly older and had a worse Eastern Cooperative Oncology Group performance status, lower body mass index, and more advanced tumor-node-metastasis stage than the patients with a CONUT score lower than 2 (CONUT-low group). Overall, the survival time was significantly shorter in the CONUT-high group than in the CONUT-low group [hazard ratio (HR) 1.97; P < 0.0001]. A multivariable analysis showed that the CONUT score was an independent prognostic factor of overall survival. The CONUT score more significantly reflected the overall survival for patients who underwent postoperative adjuvant chemotherapy than for those who underwent surgery alone. Additionally, a high preoperative CONUT score was significantly associated with an increased incidence of postoperative pneumonia and prolonged hospitalization. CONCLUSIONS: The study results suggest that the preoperative CONUT score may be a useful predictor of postoperative short- and long-term outcomes for patients with stage 2 or 3 gastric cancer.
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: Kosei Takagi; Piotr Domagala; Wojciech G Polak; Stefan Buettner; Bas P L Wijnhoven; Jan N M Ijzermans Journal: BMC Surg Date: 2019-09-05 Impact factor: 2.102