The preoperative controlling nutritional status (CONUT) score is an independent prognostic marker for pancreatic ductal adenocarcinoma.
Aged
Biomarkers, Tumor
/ blood
Carcinoma, Pancreatic Ductal
/ diagnosis
Cholesterol
/ blood
Female
Humans
Lymphocyte Count
Male
Nutritional Status
Pancreatic Neoplasms
/ diagnosis
Pancreaticoduodenectomy
Predictive Value of Tests
Prognosis
Research Design
Retrospective Studies
Serum Albumin
Survival Rate
CONUT score
Pancreatic ductal adenocarcinoma
Pancreatoduodenectomy
Journal
Updates in surgery
ISSN: 2038-3312
Titre abrégé: Updates Surg
Pays: Italy
ID NLM: 101539818
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
03
07
2019
accepted:
05
05
2020
pubmed:
16
5
2020
medline:
4
8
2021
entrez:
16
5
2020
Statut:
ppublish
Résumé
The controlling nutritional status (CONUT) score was developed as a nutritional score that can be calculated from the serum albumin level, total cholesterol concentration, and total lymphocyte count. The aim of this study was to assess the prognostic factors for the overall survival (OS) of pancreatic cancer patients following a curative resection and to compare the CONUT score with other prognostic factors to demonstrate its utility. Between January 2007 and December 2015, 307 consecutive patients who underwent surgery for pancreatic ductal adenocarcinoma (PDAC) were divided into a low CONUT group (LC; CONUT score ≤ 3) and a high CONUT group (HC; CONUT score ≥ 4) according to the results of their preoperative blood examination. The clinicopathological characteristics and prognosis of the patients were evaluated retrospectively. The prognostic factors of PDAC were detected using multivariate analyses. The LC and HC groups included 279 and 28 patients, respectively. The overall survival of the LC group was better than that of the HC group (LC, median survival time [MST] 27.9 months, 5-year survival rate 33.4%, respectively; HC, 13.9 months, 6.7%, p < 0.001). The multivariate analyses showed that age ≥ 70 years, lymph node metastasis, absence of postoperative adjuvant chemotherapy, CA19-9 ≥ 200 U/ml, and a preoperative CONUT score ≥ 4 were independently associated with poor survival. However, the Glasgow prognostic score, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and prognostic nutritional index were not significant factors. The CONUT score may be useful for predicting the long-term survival of patients with PDAC.
Identifiants
pubmed: 32410163
doi: 10.1007/s13304-020-00792-9
pii: 10.1007/s13304-020-00792-9
doi:
Substances chimiques
Biomarkers, Tumor
0
Serum Albumin
0
Cholesterol
97C5T2UQ7J
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
251-259Références
Siegel RL, Miller KD, Jemal A (2015) Cancer statistics, 2015. CA Cancer J Clin 65:5–29
pubmed: 25559415
Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics, 2012. CA Cancer J Clin 65:87–108
pubmed: 25651787
pmcid: 25651787
Roch AM, House MG, Cioffi J, Ceppa EP, Zyromski NJ, Nakeeb A et al (2016) Significance of Portal Vein Invasion and Extent of invasion in patients undergoing pancreatoduodenectomy for pancreatic adenocarcinoma. J Gastrointest Surg Off J Soc Surg Aliment Tract 20:479–487 (discussion 87)
Oettle H, Neuhaus P, Hochhaus A, Hartmann JT, Gellert K, Ridwelski K et al (2013) Adjuvant chemotherapy with gemcitabine and long-term outcomes among patients with resected pancreatic cancer: the CONKO-001 randomized trial. JAMA 310:1473–1481
pubmed: 24104372
Uesaka K, Boku N, Fukutomi A, Okamura Y, Konishi M, Matsumoto I et al (2016) Adjuvant chemotherapy of S-1 versus gemcitabine for resected pancreatic cancer: a phase 3, open-label, randomised, non-inferiority trial (JASPAC 01). Lancet (London, England) 388:248–257
Yamada S, Fujii T, Yabusaki N, Murotani K, Iwata N, Kanda M et al (2016) Clinical Implication of inflammation-based prognostic score in pancreatic cancer: glasgow prognostic score is the most reliable parameter. Medicine 95:e3582
pubmed: 27149487
pmcid: 4863804
Imaoka H, Mizuno N, Hara K, Hijioka S, Tajika M, Tanaka T et al (2016) Evaluation of modified glasgow prognostic score for pancreatic cancer: a retrospective cohort study. Pancreas 45:211–217
pubmed: 26495775
Garcea G, Ladwa N, Neal CP, Metcalfe MS, Dennison AR, Berry DP (2011) Preoperative neutrophil-to-lymphocyte ratio (NLR) is associated with reduced disease-free survival following curative resection of pancreatic adenocarcinoma. World J Surg 35:868–872
pubmed: 21312035
Yang JJ, Hu ZG, Shi WX, Deng T, He SQ, Yuan SG (2015) Prognostic significance of neutrophil to lymphocyte ratio in pancreatic cancer: a meta-analysis. World J Gastroenterol 21:2807–2815
pubmed: 25759553
pmcid: 4351235
Asari S, Matsumoto I, Toyama H, Shinzeki M, Goto T, Ishida J et al (2016) Preoperative independent prognostic factors in patients with borderline resectable pancreatic ductal adenocarcinoma following curative resection: the neutrophil–lymphocyte and platelet–lymphocyte ratios. Surg Today 46:583–592
pubmed: 26108488
Lee SH, Chung MJ, Kim B, Lee HS, Lee HJ, Heo JY et al (2017) The significance of the prognostic nutritional index for all stages of pancreatic cancer. Nutr Cancer 69:512–519
pubmed: 27967240
Kanda M, Fujii T, Kodera Y, Nagai S, Takeda S, Nakao A (2011) Nutritional predictors of postoperative outcome in pancreatic cancer. Br J Surg 98:268–274
pubmed: 20960457
Chawla A, Huang TL, Ibrahim AM, Hardacre JM, Siegel C, Ammori JB (2018) Pretherapy neutrophil to lymphocyte ratio and platelet to lymphocyte ratio do not predict survival in resectable pancreatic cancer. HPB Off J Int Hepato Pancreato Biliary Assoc 20:398–404
Gao Y, Wang WJ, Zhi Q, Shen M, Jiang M, Bian X et al (2017) Neutrophil/lymphocyte ratio is a more sensitive systemic inflammatory response biomarker than platelet/lymphocyte ratio in the prognosis evaluation of unresectable pancreatic cancer. Oncotarget 8:88835–88844
pubmed: 29179480
pmcid: 5687650
de Ulibarri JI, Gonzalez-Madrono A, de Villar NG, Gonzalez P, Gonzalez B, Mancha A et al (2005) CONUT: a tool for controlling nutritional status. First validation in a hospital population. Nutr Hosp 20:38–45
Cabre M, Ferreiro C, Arus M, Roca M, Palomera E, Serra-Prat M (2015) Evaluation of CONUT for clinical malnutrition detection and short-term prognostic assessment in hospitalized elderly people. J Nutr Health Aging 19:729–733
pubmed: 26193855
Fukushima K, Ueno Y, Kawagishi N, Kondo Y, Inoue J, Kakazu E et al (2011) The nutritional index 'CONUT' is useful for predicting long-term prognosis of patients with end-stage liver diseases. Tohoku J Exp Med 224:215–219
pubmed: 21701127
Nakagomi A, Kohashi K, Morisawa T, Kosugi M, Endoh I, Kusama Y et al (2016) Nutritional status is associated with inflammation and predicts a poor outcome in patients with chronic heart failure. J Atherosc Thromb 23:713–727
Lee SH, Chung MJ, Kim B, Lee HS, Lee HJ, Heo JY et al (2017) The Significance of the prognostic nutritional index for all stages of pancreatic cancer. Nutr Cancer 69:512–519
pubmed: 27967240
Kato Y, Yamada S, Suenaga M, Takami H, Niwa Y, Hayashi M et al (2018) Impact of the controlling nutritional status score on the prognosis after curative resection of pancreatic ductal adenocarcinoma. Pancreas 47:823–829
pubmed: 29975352
Toyokawa G, Kozuma Y, Matsubara T, Haratake N, Takamori S, Akamine T et al (2017) Prognostic impact of controlling nutritional status score in resected lung squamous cell carcinoma. J Thorac Disease 9:2942–2951
Toyokawa T, Kubo N, Tamura T, Sakurai K, Amano R, Tanaka H et al (2016) The pretreatment controlling nutritional status (CONUT) score is an independent prognostic factor in patients with resectable thoracic esophageal squamous cell carcinoma: results from a retrospective study. BMC Cancer 16:722
pubmed: 27599460
pmcid: 5013653
Kuroda D, Sawayama H, Kurashige J, Iwatsuki M, Eto T, Tokunaga R et al (2018) Controlling nutritional status (CONUT) score is a prognostic marker for gastric cancer patients after curative resection. Gastric Cancer Off J Int Gastric Cancer Assoc Japan Gastric Cancer Assoc 21:204–212
Harimoto N, Yoshizumi T, Inokuchi S, Itoh S, Adachi E, Ikeda Y et al (2018) Prognostic significance of preoperative controlling nutritional status (CONUT) score in patients undergoing hepatic resection for hepatocellular carcinoma: a multi-institutional study. Ann Surg Oncol 25:3316–3323
pubmed: 30051372
Miyata T, Yamashita YI, Higashi T, Taki K, Izumi D, Kosumi K et al (2018) The prognostic impact of controlling nutritional status (CONUT) in intrahepatic cholangiocarcinoma following curative hepatectomy: a retrospective single institution study. World J Surg 42:1085–1091
pubmed: 28887635
Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD et al (2009) The Clavien–Dindo classification of surgical complications: 5-year experience. Ann Surg 250:187–196
pubmed: 19638912
Brierley JGM, Wittekind C (2017) UICC TNM classification of malignant tumours, 8th edn. Wiley, Chichester
Uesaka K, Boku N, Fukutomi A, Okamura Y, Konishi M, Matsumoto I et al (2016) Adjuvant chemotherapy of S-1 versus gemcitabine for resected pancreatic cancer: a phase 3, open-label, randomised, non-inferiority trial (JASPAC 01). Lancet 388:248–257
pubmed: 27265347
Harimoto N, Yoshizumi T, Inokuchi S, Itoh S, Adachi E, Ikeda Y et al (2018) Prognostic significance of preoperative controlling nutritional status (conut) score in patients undergoing hepatic resection for hepatocellular carcinoma: a multi-institutional study. Ann Surg Oncol 25:3316–3323
pubmed: 30051372
Yamamoto Y, Ashida R, Ohgi K, Sugiura T, Okamura Y, Ito T et al (2018) Combined antrectomy reduces the incidence of delayed gastric emptying after pancreatoduodenectomy. Dig Surg 35:121–130
pubmed: 28467983
McMillan DC, Elahi MM, Sattar N, Angerson WJ, Johnstone J, McArdle CS (2001) Measurement of the systemic inflammatory response predicts cancer-specific and non-cancer survival in patients with cancer. Nutr Cancer 41:64–69
pubmed: 12094630
Wu N, Chen G, Hu H, Pang L, Chen Z (2015) Low pretherapeutic serum albumin as a risk factor for poor outcome in esophageal squamous cell carcinomas. Nutr Cancer 67:481–485
pubmed: 25706773
Cengiz O, Kocer B, Surmeli S, Santicky MJ, Soran A (2006) Are pretreatment serum albumin and cholesterol levels prognostic tools in patients with colorectal carcinoma? Med Sci Monit Int Med J Exp Clin Res 12:Cr240–CR247
Onate-Ocana LF, Aiello-Crocifoglio V, Gallardo-Rincon D, Herrera-Goepfert R, Brom-Valladares R, Carrillo JF et al (2007) Serum albumin as a significant prognostic factor for patients with gastric carcinoma. Ann Surg Oncol 14:381–389
pubmed: 17160496
Peters SJ, Vanhaecke T, Papeleu P, Rogiers V, Haagsman HP, van Norren K (2010) Co-culture of primary rat hepatocytes with rat liver epithelial cells enhances interleukin-6-induced acute-phase protein response. Cell Tissue Res 340:451–457
pubmed: 20411395
pmcid: 2882052
Honda H, Qureshi AR, Heimburger O, Barany P, Wang K, Pecoits-Filho R et al (2006) Serum albumin, C-reactive protein, interleukin 6, and fetuin a as predictors of malnutrition, cardiovascular disease, and mortality in patients with ESRD. Am J Kidney Dis 47:139–148
pubmed: 16377395
Hendifar A, Osipov A, Khanuja J, Nissen N, Naziri J, Yang W et al (2016) Influence of body mass index and albumin on perioperative morbidity and clinical outcomes in resected pancreatic adenocarcinoma. PLoS ONE 11:e0152172
pubmed: 27015568
pmcid: 4807776
Okuyama H, Ichikawa Y, Sun Y, Hamazaki T, Lands WE (2007) Cancer and all-cause mortalities are lower in the higher total cholesterol groups among general populations. World Rev Nutr Diet 96:37–54
pubmed: 17167279
Li JR, Zhang Y, Zheng JL (2015) Decreased pretreatment serum cholesterol level is related with poor prognosis in resectable non-small cell lung cancer. Int J Clin Exp Pathol 8:11877–11883
pubmed: 26617943
pmcid: 4637759
Wang J, Wang WJ, Zhai L, Zhang DF (2015) Association of cholesterol with risk of pancreatic cancer: a meta-analysis. World J Gastroenterol 21:3711–3719
pubmed: 25834340
pmcid: 4375597
Kang R, Li P, Wang T, Li X, Wei Z, Zhang Z et al (2016) Apolipoprotein E epsilon 2 allele and low serum cholesterol as risk factors for gastric cancer in a Chinese Han population. Sci Rep 6:19930
pubmed: 26817942
pmcid: 4730152
Niendorf A, Nagele H, Gerding D, Meyer-Pannwitt U, Gebhardt A (1995) Increased LDL receptor mRNA expression in colon cancer is correlated with a rise in plasma cholesterol levels after curative surgery. Int J Cancer 61:461–464
pubmed: 7759150
Calleros L, Lasa M, Toro MJ, Chiloeches A (2006) Low cell cholesterol levels increase NFkappaB activity through a p38 MAPK-dependent mechanism. Cell Signal 18:2292–2301
pubmed: 16806824
Hughes DA, Townsend PJ, Haslam PL (1992) Enhancement of the antigen-presenting function of monocytes by cholesterol: possible relevance to inflammatory mechanisms in extrinsic allergic alveolitis and atherosclerosis. Clin Exp Immunol 87:279–286
pubmed: 1370928
pmcid: 1554263
Muldoon MF, Marsland A, Flory JD, Rabin BS, Whiteside TL, Manuck SB (1997) Immune system differences in men with hypo- or hypercholesterolemia. Clin Immunol Immunopathol 84:145–149
pubmed: 9245545
Coussens LM, Werb Z (2002) Inflammation and cancer. Nature 420:860–867
pubmed: 12490959
pmcid: 2803035
Mantovani A, Allavena P, Sica A, Balkwill F (2008) Cancer-related inflammation. Nature 454:436–444
pubmed: 18650914
Chiba T, Ohtani H, Mizoi T, Naito Y, Sato E, Nagura H et al (2004) Intraepithelial CD8+ T-cell-count becomes a prognostic factor after a longer follow-up period in human colorectal carcinoma: possible association with suppression of micrometastasis. Br J Cancer 91:1711–1717
pubmed: 15494715
pmcid: 2410024
Liang L, Zhu J, Jia H, Huang L, Li D, Li Q et al (2016) Predictive value of pretreatment lymphocyte count in stage II colorectal cancer and in high-risk patients treated with adjuvant chemotherapy. Oncotarget 7:1014–1028
pubmed: 26510910
Zhang J, Wang YF, Wu B, Zhong ZX, Wang KX, Yang LQ et al (2017) Intraepithelial attack rather than intratumorally infiltration of CD8+T lymphocytes is a favorable prognostic indicator in pancreatic ductal adenocarcinoma. Curr Mol Med 17:689–698
pubmed: 29521231
pmcid: 6416191