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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2019

01-02-2019 | Gastrointestinal Oncology

The Controlling Nutritional Status Score Serves as a Predictor of Short- and Long-Term Outcomes for Patients with Stage 2 or 3 Gastric Cancer: Analysis of a Multi-institutional Data Set

Authors: Song Ryo, MD, Mitsuro Kanda, MD, FACS, Seiji Ito, MD, Yoshinari Mochizuki, MD, Hitoshi Teramoto, MD, Kiyoshi Ishigure, MD, Toshifumi Murai, MD, Takahiro Asada, MD, Akiharu Ishiyama, MD, Hidenobu Matsushita, MD, Chie Tanaka, MD, Daisuke Kobayashi, MD, Michitaka Fujiwara, MD, Kenta Murotani, MD, Yasuhiro Kodera, MD, FACS

Published in: Annals of Surgical Oncology | Issue 2/2019

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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.
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Metadata
Title
The Controlling Nutritional Status Score Serves as a Predictor of Short- and Long-Term Outcomes for Patients with Stage 2 or 3 Gastric Cancer: Analysis of a Multi-institutional Data Set
Authors
Song Ryo, MD
Mitsuro Kanda, MD, FACS
Seiji Ito, MD
Yoshinari Mochizuki, MD
Hitoshi Teramoto, MD
Kiyoshi Ishigure, MD
Toshifumi Murai, MD
Takahiro Asada, MD
Akiharu Ishiyama, MD
Hidenobu Matsushita, MD
Chie Tanaka, MD
Daisuke Kobayashi, MD
Michitaka Fujiwara, MD
Kenta Murotani, MD
Yasuhiro Kodera, MD, FACS
Publication date
01-02-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 2/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-07121-w

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