The CONUT Score Can Predict the Prognosis of Gastric Cancer Patients After Curative Treatment

Background/Aim: Malnutrition is a reported prognostic factor in patients with cancer. The controlling nutritional status (CONUT) score, an index calculated from routine laboratory tests, is correlated with the prognosis of various cancers. This study examined the relationship between the CONUT score and prognosis of patients with gastric cancer (GC) after radical gastrectomy.

Patients and Methods: Patients with GC who underwent curative gastrectomy were retrospectively reviewed. Patient characteristics, laboratory data, pathological findings, perioperative clinical course, and survival outcomes were recorded. The CONUT score was calculated using serum albumin (mg/dl), total cholesterol (mg/dl), and lymphocyte count (cells/mm³). Based on previous studies, patients were categorized into normal (CONUT score <2) and malnutrition (CONUT score ≥2) groups. Prognostic factors were compared between the groups.

Results: In total, 155 patients were included (median age, 69 years; male, n=110; female, n=45). Five-year overall survival (OS) was significantly lower in the malnutrition group (malnutrition group, 42.2%; normal group, 82.7% p<0.001). A multivariate analysis identified the CONUT score as an independent prognostic factor for OS [HR=2.506; 95% confidence interval (CI)=1.288-4.873, p=0.007]. Similar results were obtained for recurrence-free survival (RFS). Additionally, postoperative complications were more frequent (malnutrition group, 44.2%; normal group, 25.9%; p=0.027) and the chemotherapy introduction rate for pStage III or III was lower (malnutrition group, 55.6%; normal group, 78.8%, p=0.054) in the malnutrition group.

Conclusion: The CONUT score may be an independent prognostic factor for OS and RFS in patients with GC after curative gastrectomy. CONUT scores of ≥2 were associated with higher postoperative complications and lower chemotherapy rates, which may contribute to a poor prognosis.