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. 2021 Jan 11:10:593452.
doi: 10.3389/fonc.2020.593452. eCollection 2020.

Controlling Nutritional Status (CONUT) Score as a New Indicator of Prognosis in Patients With Hilar Cholangiocarcinoma Is Superior to NLR and PNI: A Single-Center Retrospective Study

Ankang Wang  1   2 , Zhenxing He  1 , Peng Cong  1 , Yueyu Qu  1 , Tao Hu  1 , Yu Cai  1 , Bo Sun  2 , Hao Chen  2 , Wenguang Fu  2 , Yong Peng  1
Affiliations

Controlling Nutritional Status (CONUT) Score as a New Indicator of Prognosis in Patients With Hilar Cholangiocarcinoma Is Superior to NLR and PNI: A Single-Center Retrospective Study

Ankang Wang et al. Front Oncol. .

Abstract

Background: Currently, many nutritional indicators, including controlling nutritional status score (CONUT), can be used to assess a patient's nutritional status and have been reported as reliable predictors of multiple malignancies. However, the value of CONUT score in predicting postoperative outcomes in patients with hilar cholangiocarcinoma has not been explored. In this study, its predictive value will be discussed and compared with the known predictors the neutrophil lymphocyte ratio (NLR) and prognostic nutritional index (PNI).

Methods: Preoperative CONUT scores, PNI and NLR levels of 94 Hilar cholangiocarcinoma (HCCA) patients who underwent radical-intent resection of hepatobiliary surgery in our hospital from March 2010 to April 2019 were retrospectively collected and analyzed. They were grouped according to their optimal cutoff value and the prognostic effects of patients in each group were compared respectively.

Results: CONUThigh was more frequent in patients with Clavien-Dindo classification of ≥IIIa (P = 0.008) and Bile leakage presence (P = 0.011). Kaplan-Meier curves analyzing the relationship between CONUT, PNI, and NLR values and HCCA patient survival (including total survival (OS) and recurrence-free survival (RFS) showed significant differences between groups (P <0.001). Meanwhile, multi-factor analysis found that Degree of cure, PNI, NLR, and preoperative CONUT score were independent prognostic factors for OS and RFS. The predictive power of CONUT score was higher than that of NLR and PNI based on time-dependent receiver operating Characteristic (ROC) analysis and the net reclassification index (NRI) and integrated discriminatory index (IDI) values (P < 0.05).

Conclusion: CONUT score may be of some clinical reference value in evaluating postoperative prognosis of HCCA patients.

Keywords: controlling nutritional status score; hilar cholangiocarcinoma; neutrophil lymphocyte ratio; prognosis; prognostic nutritional index.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Enrollment and outcomes. HCCA, Hilar cholangiocarcinoma.
Figure 2
Figure 2
Overall survival curves for hilar cholangiocarcinoma patients according to PNI (A), NLR (B) and CONUT score (C). PNI, prognostic nutritional index; NLR, neutrophil lymphocyte ratio; CONUT, controlling nutritional status.
Figure 3
Figure 3
Recurrence-free survival curves for hilar cholangiocarcinoma patients according to PNI (A), NLR (B) and CONUT score (C). PNI, prognostic nutritional index; NLR, neutrophil lymphocyte ratio; CONUT, controlling nutritional status.
Figure 4
Figure 4
Time-dependent ROC curves of preoperative PNI, NLR and CONUT score for the prediction of hilar cholangiocarcinoma patients’ outcomes. (A) Overall survival. (B) Recurrence-free survival. PNI, prognostic nutritional index; NLR, neutrophil lymphocyte ratio; CONUT, controlling nutritional status; ROC, receiver operating characteristic; AUC, area under curve; CI, confidence interval.
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References

    1. DeOliveira ML, Cunningham SC, Cameron JL, Kamangar F, Winter JM, Lillemoe KD, et al. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg (2007) 245(5):755–62. 10.1097/01.sla.0000251366.62632.d3 - DOI - PMC - PubMed
    1. Soares KC, Kamel I, Cosgrove DP, Herman JM, Pawlik TM. Hilar cholangiocarcinoma: diagnosis, treatment options, and management. Hepatobiliary Surg Nutr (2014) 3(1):18–34. 10.3978/j.issn.2304-3881.2014.02.05 - DOI - PMC - PubMed
    1. Dumitrascu T, Chirita D, Ionescu M, Popescu I. Resection for hilar cholangiocarcinoma: analysis of prognostic factors and the impact of systemic inflammation on long-term outcome. J Gastrointest Surg (2013) 17(5):913–24. 10.1007/s11605-013-2144-2 - DOI - PubMed
    1. Saxena A, Chua TC, Chu FC, Morris DL. Improved outcomes after aggressive surgical resection of hilar cholangiocarcinoma: a critical analysis of recurrence and survival. Am J Surg (2011) 202(3):310–20. 10.1016/j.amjsurg.2010.08.041 - DOI - PubMed
    1. Molina V, Sampson J, Ferrer J, Diaz A, Ayuso JR, Sanchez-Cabus S, et al. Surgical treatment of perihilar cholangiocarcinoma: early results of en bloc portal vein resection. Langenbecks Arch Surg (2017) 402(1):95–104. 10.1007/s00423-016-1542-9 - DOI - PubMed

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