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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

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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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Acknowledgements

We thank Jodi Smith, PhD, from the Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

DISCLOSURE

The author declares that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, Konan Kosei Hospital, Konan, Japan

    Song Ryo MD & Kiyoshi Ishigure MD

  2. Department of Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Japan

    Song Ryo MD & Takahiro Asada MD

  3. Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan

    Mitsuro Kanda MD, FACS, Chie Tanaka MD, Daisuke Kobayashi MD, Michitaka Fujiwara MD & Yasuhiro Kodera MD, FACS

  4. Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan

    Seiji Ito MD

  5. Department of Surgery, Komaki Municipal Hospital, Komaki, Japan

    Yoshinari Mochizuki MD

  6. Department of Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan

    Hitoshi Teramoto MD

  7. Department of Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan

    Toshifumi Murai MD

  8. Department of Surgery, Okazaki City Hospital, Okazaki, Japan

    Akiharu Ishiyama MD

  9. Department of Surgery, Tosei General Hospital, Seto, Japan

    Hidenobu Matsushita MD

  10. Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume, Japan

    Kenta Murotani MD

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  1. Song Ryo MD
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  2. Mitsuro Kanda MD, FACS
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  14. Kenta Murotani MD
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  15. Yasuhiro Kodera MD, FACS
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Correspondence to Mitsuro Kanda MD, FACS.

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Ryo, S., Kanda, M., Ito, S. et al. 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. Ann Surg Oncol 26, 456–464 (2019). https://doi.org/10.1245/s10434-018-07121-w

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  • DOI: https://doi.org/10.1245/s10434-018-07121-w

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