Controlling nutritional status score in predicting International Society of Urological Pathology score upgrading and biochemical recurrence after radical prostatectomy

A new tool to predict mortality in Fournier's Gangrene: Controlling Nutritional Status (CONUT) score

PURPOSE

The aim of our study was to demonstrate the role of The Controlling Nutritional Status (CONUT) score in predicting mortality after Fournier's Gangrene (FG) debridement by comparing it with other scoring systems.

METHODS

Data of 193 patients who underwent debridement for FG between January 2013 and December 2024 were retrospectively analyzed. Survivor 156 patients (Group S) and 37 non-survivor patients (Group NS) were divided into two groups. Four scoring systems commonly used to predict mortality in FG and the CONUT score were compared by regression analyses. Cut-off values were determined for each scoring system and ROC curves were constructed.

RESULTS

Mortality rate was 19.2%. Total CONUT and other scoring systems were higher in Group NS (p < 0.001). In multivariate analyses, an increase in Total CONUT score predicted mortality (OR = 99.26; 95% CI 8.19-120.30: p < 0.001). The sensitivity, specificity, PPV, NPV and AUC values at the CONUT score ≥ 2.5 cut-off were 86%, 87%, 87%, 87%, 96% and 0.935 (95% CI: 0.88-0.98; p < 0.001), respectively.

CONCLUSION

The CONUT score predicts mortality in FG with high sensitivity and specificity. It is also easy and practical to calculate.

Prognostic and clinicopathological significance of the Controlling Nutritional Status (CONUT) score in patients with lymphoma: a meta-analysis

OBJECTIVES

The role of the Controlling Nutritional Status (CONUT) scores in predicting the prognosis of lymphoma cases has been extensively explored, with no consistent results. The present meta-analysis focused on accurately evaluating whether CONUT could be used to predict the prognosis of lymphoma cases and its clinicopathological value.

DESIGN

The present meta-analysis was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The prognostic significance of CONUT to overall survival (OS) and progression-free survival (PFS) in lymphoma was estimated by calculating pooled HRs with 95% CIs. The relationship between CONUT and clinicopathological characteristics was measured based on pooled ORs with 95% CIs.

DATA SOURCES

PubMed, Web of Science, Embase and Cochrane Library databases were comprehensively searched from inception through 24 March 2023.

STATISTICAL METHODS

Either a random-effects model or a fixed-effects model was selected depending on the level of heterogeneity among the included studies.

RESULTS

This meta-analysis enrolled seven articles, containing 2060 patients with lymphoma. According to the pooled analysis, a higher CONUT score significantly predicted poor OS (HR=1.94, 95% CI 1.46 to 2.57, p<0.001) as well as poorer PFS (HR=1.51, 95% CI 1.04 to 2.20, p=0.031). Furthermore, according to the combined analysis, a higher CONUT score was significantly associated with Ann Arbor stages III-IV (OR=3.75, 95% CI 2.96 to 4.75, p<0.001), an Eastern Cooperative Oncology Group performance status of 2-4 (OR=5.14, 95% CI 3.97 to 6.65, p<0.001), high-intermediate/high National Comprehensive Cancer Network International Prognostic Index (OR=8.05, 95% CI 5.11 to 12.66, p<0.001), B symptoms (OR=4.97, 95% CI 2.89 to 8.52, p<0.001), extranodal disease (OR=3.25, 95% CI 2.24 to 4.70, p<0.001), bone marrow involvement (OR=4.86, 95% CI 3.25 to 7.27, p<0.001) and elevated lactate dehydrogenase levels (OR=3.21, 95% CI 2.37 to 4.34, p<0.001).

CONCLUSIONS

According to our results, higher CONUT scores were significantly associated with poor OS and PFS in lymphoma.