CONUT predicts survival after gastric cancer resection

Last Updated: 2017-07-10

By Reuters Staff

NEW YORK (Reuters Health) - A scoring system that assesses nutritional and immune status can also predict long-term overall survival (OS) in gastric cancer patients, new research shows.

First proposed in 2005, Controlling Nutritional Status (CONUT) is based on serum albumin, total cholesterol concentration and total lymphocyte count. CONUT has been shown to predict survival in some cancers, chronic liver disease and chronic heart failure, Dr. Daisuke Kuroda and colleagues from Kumamoto University in Japan note.

In the new study, published online June 27 in Gastric Cancer, Dr. Kuroda and colleagues compared CONUT to Modified Glasgow Prognostic Score (mGPS), neutrophil to lymphocyte ratio (NLR), and pStage for predicting OS in patients with gastric cancer who underwent curative resection.

They calculated preoperative CONUT score for 416 gastric cancer patients treated at their center in 2005-2011. Based on TNM classification, 66.1% were stage I, 19.5% stage II, and 14.4% stage III.

Patients were divided into a low CONUT score group (n=354, score of 3 or lower) or a high CONUT score group (n=62, 4 or higher).

The median follow up was 61.2 months (range 1-134 months).

Five-year OS was 84.8% for the CONUT-low group and 43.8% for the CONUT-high group.

On multivariate analysis, CONUT score was independently associated with OS (hazard ratio 2.72), and the association was especially strong for earlier-stage cancers.

CONUT was correlated with age, body mass index, tumor size, infiltrative primary tumor, depth of invasion and tumor markers. It was better than other systems for predicting five-year OS, but not for five-year recurrence-free survival or cancer-specific survival.

“Because CONUT has a high ability to predict long-term overall survival, CONUT may be useful not only for predicting cancer progression but also for screening patients for nutritional reserve capacity and for selecting candidates for intensive nutritional support after gastrectomy,” Dr. Kuroda and colleagues write.

SOURCE: http://bit.ly/2tH3s7c

Gastric Cancer 2017.