Calculating the preoperative controlling nutritional status (CONUT) score may be an easy and cost-effective way to predict outcomes among patients with localized upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy, according to researchers.
The CONUT score is an index calculated from total lymphocyte count, serum albumin concentration, and total cholesterol level that may reflect immune response and protein and lipid metabolism (nutritional status). It has been used in studies of other cancers such as colorectal, esophageal, and gastric cancer, and renal cell carcinoma.
Liqun Zhou, MD, of Peking University First Hospital in China, and colleagues stratified 908 Chinese patients into a “high” and “low” CONUT group using a cutoff score of 3. Having a high preoperative CONUT score (reflecting lower lymphocyte, albumin, and/or cholesterol concentrations) significantly correlated with adverse clinicopathologic characteristics, including older age, low body mass index (BMI), poor American Society of Anesthesiologists score, advanced pathological T stage, and tumor squamous or glandular differentiation.
To minimize confounding, investigators propensity score matched patients from both groups. According to results published in Cancer Management and Research, Kaplan-Meier analyses showed significantly worse overall, cancer-specific, and disease-free survival among patients with a high CONUT score, both in the propensity score matched and overall cohort. Furthermore, in multivariate analyses, high preoperative CONUT score independently predicted worse disease-free survival (DFS) before matching and independently predicted poor DFS and overall survival after matching.
If validated, “the CONUT score may be a useful index for the selection of patients who need perioperative nutritional intervention in UTUC treatment,” according to Dr Zhou’s team.
Bao Z, Li Y, Guan B, et al. High preoperative controlling nutritional status score predicts a poor prognosis in patients with localized upper tract urothelial cancer: A propensity score matching study in a large Chinese center [published online January 15, 2020]. Cancer Manag Res. 2020;12:323-335. doi: 10.2147/CMAR.S225711