Correlation between preoperative controlling nutritional status (CONUT) score and adjuvant chemotherapy in stage II-III gastric cancer after curative resection

中华普通外科杂志 Pub Date : 2019-10-25 DOI:10.3760/CMA.J.ISSN.1007-631X.2019.10.008

G. Xie, Hao-tang Wei, Feng Chen, Min Ni, S. Gao

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Abstract

Objectives To elucidate the prognostic impact of preoperative control of nutritional status (CONUT) scores on gastric cancer patients undergoing adjuvant chemotherapy after radical gastrectomy. Methods A retrospective analysis of 536 stage Ⅱ-Ⅲ gastric cancer patients undergoing adjuvant chemotherapy after radical resection from Jul 1998 to Dec 2014 was performed. Patients were divided into high (≥3) and low (≤2) CONUT groups with a CONUT score of 3 divided into critical values. Results The 5-year survival rate of the high CONUT group was significantly lower than that of the low CONUT group (37.3 % vs. 55.7%, P<0.001). Univariate analysis showed that the high CONUT group was associated with larger tumors, more lymph node metastasis, lower body mass index, higher prognostic nutritional index, and preoperative anemia (all P<0.05). Multivariate analysis showed that the CONUT score was an independent prognostic factor for patients with gastric cancer (HR: 1.564, 95% CI: 1.090-2.321, P=0.016). The 5-year survival rate of the high CONUT group was significantly lower than that of the low CONUT group (P<0.05). Conclusion The CONUT score is an indicator for predicting the prognosis of patients with stage Ⅱ-Ⅲ gastric cancer after adjuvant chemotherapy. The nutritional evaluation is helpful to develop a plan for preoperative nutritional intervention. Key words: Stomach neoplasms; Nutrition assessment; Prognosis

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II-III期胃癌根治性切除后术前控制营养状况(CONUT)评分与辅助化疗的相关性

目的探讨术前营养状态控制(CONUT)评分对胃癌根治术后辅助化疗患者预后的影响。方法回顾性分析1998年7月至2014年12月期间536例Ⅱ-Ⅲ期胃癌根治术后辅助化疗患者的资料。将患者分为CONUT高(≥3)组和低(≤2)组，CONUT评分为3分分为临界值。结果高CONUT组5年生存率明显低于低CONUT组(37.3% vs. 55.7%， P<0.001)。单因素分析显示，高CONUT组肿瘤较大，淋巴结转移较多，体质量指数较低，预后营养指数较高，术前贫血(P<0.05)。多因素分析显示，CONUT评分是胃癌患者预后的独立影响因素(HR: 1.564, 95% CI: 1.090 ~ 2.321, P=0.016)。高CONUT组5年生存率显著低于低CONUT组(P<0.05)。结论CONUT评分可作为预测Ⅱ-Ⅲ期胃癌患者辅助化疗后预后的指标。营养评价有助于制定术前营养干预计划。关键词:胃肿瘤;营养评估;预后

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中华普通外科杂志

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