Controlling Nutritional Status (CONUT) score as a prognostic marker for gastrointestinal stromal tumours

Impact of Nutritional Changes on the Prognosis in Pancreatic Cancer Patients Underwent Curative Surgery After Neoadjuvant Chemotherapy

BACKGROUND

Pancreatic cancer is a highly aggressive malignancy with a poor prognosis. Neoadjuvant chemotherapy (NAC) is increasingly used to improve survival in patients with pancreatic cancer; however, it often results in nutritional deterioration, which may negatively impact patient outcomes. Therefore, this study aimed to assess the effect of changes in nutritional status on the long-term outcomes of patients with pancreatic cancer who underwent curative surgery after NAC.

METHODS

This retrospective single-center study included 148 patients with pancreatic cancer who underwent curative surgery after NAC between 2010 and 2020. The Controlled Nutritional Status (CONUT) score was used to determine the nutritional status of the patients. Patients were categorized into worsened, maintained, and improved groups based on the changes in their CONUT scores before and after NAC. We compared differences in overall survival (OS) and disease-free survival (DFS) between the groups.

RESULTS

The worsened nutritional status group exhibited the shortest median OS (28 months) compared to the maintained and improved groups (39 and 66 months, respectively; p = 0.01). Additionally, the worsened group demonstrated the shortest DFS compared to the other two groups (13, 22, and 39 months, respectively; p = 0.02). Multivariate analysis identified nutritional deterioration as an independent prognostic factor for OS (hazard ratios (HR), 2.11; 95% confidence intervals (CI), 1.31-3.40; p < 0.01).

CONCLUSIONS

Nutritional deterioration after NAC is a significant prognostic factor of poor survival outcomes in patients with pancreatic cancer. These findings indicate that serial nutritional assessments and treatment during NAC are crucial for improving patient outcomes.

Prognostic and clinicopathological value of the controlling nutritional status (CONUT) score in patients with head and neck cancer: a meta-analysis

BACKGROUND

The efficiency of controlling nutritional status (CONUT) score in detecting the prognosis of head and neck cancer (HNC) patients has been investigated in some works, but no consistent findings are obtained. Therefore, this work focused on evaluating the precise prognostic role of CONUT for HNC patients through meta-analysis.

METHODS

The effect of CONUT on predicting the prognosis of HNC patients was evaluated through calculating combined hazard ratios (HRs) as well as 95% confidence intervals (CIs). The correlations of CONUT with clinicopathological features of HNC patients were investigated through combined odds ratios (ORs) and 95%CIs. This study used the random-effects model in the case of significant heterogeneity; or else, we selected the fixed-effects model.

RESULTS

There were eight articles involving 1,478 patients enrolled for the current meta-analysis. We adopted the fixed-effects model for OS and DFS analysis because of the non-significant heterogeneity. As demonstrated by our combined findings, high CONUT score could significantly predict the poor overall survival (OS) (HR = 1.94, 95%CI = 1.55-2.44, p < 0.001) and disease-free survival (DFS) (HR = 1.93, 95%CI = 1.45-2.56, p < 0.001) of HNC. In addition, higher CONUT score was significantly connected to T3-T4 stage (OR = 3.21, 95%CI = 1.94-5.31, p < 0.001) and N1-N3 stage (OR = 3.10, 95%CI = 1.74-5.53, p < 0.001).

CONCLUSION

According to findings in the present meta-analysis, high CONUT score significantly predicted the prognosis of OS and DFS for HNC patients. Higher CONUT score was also correlated to larger tumor size and LN metastasis in HNC. Due to it is a cost-effective and easily available parameter, CONUT could serve as promising prognostic biomarker for HNC.

Prognostic and clinicopathological role of prognostic nutritional index (PNI) in endometrial cancer: A meta-analysis

Background

The effect of prognostic nutritional index (PNI) on predicting prognosis of endometrial cancer (EC) patients has been widely analyzed, but no consistent findings are obtained. We therefore performed a meta-analysis for determining accurate role of PNI in predicting EC prognosis.

Methods

We comprehensively searched PubMed, Web of Science, Embase, Cochrane Library, and CNKI databases from inception till January 5, 2024. Correlation between PNI and survival outcomes in EC was evaluated by pooled hazard ratios (HRs) and 95 % confidence intervals (CIs).

Results

There were altogether eight articles involving 3,164 patients enrolled into this meta-analysis. According to our pooled results, low PNI significantly predicted the dismal overall survival (OS) (HR = 1.72, 95%CI = 1.33-2.22, p < 0.001) and inferior progression-free survival (PFS)/disease-free survival (DFS)/recurrence-free survival (RFS) (HR = 2.49, 95%CI = 1.62-3.84, p < 0.001) for EC patients. Furthermore, as revealed by our pooled results, a decreased PNI was significantly connected to FIGO stage III-IV (OR = 2.06, 95%CI = 1.42-2.99, p < 0.001), tumor grade of G3 (OR = 1.68, 95%CI = 1.32-2.14, p < 0.001), presence of lymphovascular space invasion (LVSI) (OR = 1.72, 95%CI = 1.14-2.61, p = 0.010), and presence of myometrial invasion (MMI) (OR = 2.04, 95%CI = 1.51-2.77, p < 0.001) in EC.

Conclusion

According to our meta-analysis results, the decreased PNI is markedly related to poor OS and inferior PFS/DFS/RFS of EC patients. Additionally, decreased PNI was indicative of features implying tumor progression and development in EC.

Clinical characteristics and prognostic analysis of postoperative recurrence or metastasis of low-risk gastrointestinal stromal tumors

BACKGROUND

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract. This study aimed to investigate the clinical characteristics and prognosis of postoperative recurrence or metastasis in patients with low-risk stromal tumors, in order to take individualized postoperative management and treatment for patients with low-risk GISTs with relatively high recurrence.

METHODS

We retrospectively analyzed the clinicopathological and follow-up data of patients with GISTs who underwent surgical resection in Nanjing Drum Tower Hospital from March 2010 to December 2021. A total of 282 patients with low-risk GISTs were included, none of whom were treated with imatinib. Univariate and multivariate Cox analysis and survival curves were used to explore the relationship between clinical features and recurrence or metastasis in patients with low-risk GISTs.

RESULTS

Of the 282 patients with low-risk GISTs who met inclusion criteria, 14 (4.96%) had recurrence or metastasis. There was a correlation between tumor size, primary site, resection type, Ki67 index, neutrophil lymphocyte ratio (NLR) and CD34 expression and postoperative recurrence or metastasis of GISTs (P < 0.05). Subsequently, multifactorial analysis showed that tumor primary site, tumor size, and Ki67 index were independent risk factors affecting postoperative recurrent or metastasis in patients with low-risk GISTs (P < 0.05). Ultimately, According to Kaplan-Meier analysis, non-gastric primary tumors, larger tumors, and high Ki67 index were significantly associated with poor progression-free survival ( PFS ).

CONCLUSIONS

Tumor location, tumor size and Ki-67 were independent risk factors for postoperative recurrence and metastasis in patients with low-risk GISTs. Based on the 2008 modified NIH recurrence risk grading system, combined with the above three factors, it can be used to evaluate the prognosis of patients with low-risk GISTs and provide personalized postoperative review and follow-up management recommendations.