Prognostic Significance of Preoperative Controlling Nutritional Status (CONUT) Score in Patients Undergoing Hepatic Resection for Hepatocellular Carcinoma: A Multi-institutional Study

被引：116

作者：

Harimoto, Norifumi ^{[1
,2
]}

Yoshizumi, Tomoharu ^{[2
]}

Inokuchi, Shoichi ^{[2
]}

Itoh, Shinji ^{[2
]}

Adachi, Eisuke ^{[3
]}

Ikeda, Yasuharu ^{[4
]}

Uchiyama, Hideaki ^{[5
]}

Utsunomiya, Tohru ^{[6
]}

Kajiyama, Kiyoshi ^{[7
]}

Kimura, Koichi ^{[8
]}

Kishihara, Fumiaki ^{[9
]}

Sugimachi, Keishi ^{[10
]}

Tsujita, Eiji ^{[10
]}

Ninomiya, Mizuki ^{[11
]}

Fukuzawa, Kengo ^{[12
]}

Maeda, Takashi ^{[13
,14
]}

Shirabe, Ken ^{[1
]}

Maehara, Yoshihiko ^{[2
]}

机构：

[1] Gunma Univ, Grad Sch Med, Dept Hepatobiliary & Pancreat Surg, Maebashi, Gunma, Japan

[2] Kyushu Univ, Grad Sch Med Sci, Dept Surg & Sci, Fukuoka, Fukuoka, Japan

[3] Kyushu Univ, Dept Surg, Fukuoka, Fukuoka, Japan

[4] Fukuoka City Hosp, Dept Surg, Fukuoka, Fukuoka, Japan

[5] Saiseikai Fukuoka Gen Hosp, Dept Surg, Fukuoka, Fukuoka, Japan

[6] Oita Prefectural Hosp, Dept Surg, Oita, Japan

[7] Iizuka Hosp, Dept Surg, Fukuoka, Fukuoka, Japan

[8] Munakata Med Assoc Hosp, Dept Surg, Fukuoka, Fukuoka, Japan

[9] Steel Mem Yawata Hosp, Dept Surg Gastroenterol, Fukuoka, Fukuoka, Japan

[10] Natl Kyushu Canc Ctr, Dept Hepatobiliary Pancreat Surg, Fukuoka, Fukuoka, Japan

[11] Matsuyama Red Cross Hosp, Dept Surg, Matsuyama, Ehime, Japan

[12] Oita Red Cross Hosp, Dept Surg, Oita, Japan

[13] Hiroshima Red Cross Hosp, Dept Surg, Hiroshima, Japan

[14] Atom Bomb Survivors Hosp, Hiroshima, Japan

来源：

ANNALS OF SURGICAL ONCOLOGY | 2018年 / 25卷 / 11期

关键词：

CANCER PATIENTS; HEPATECTOMY; INFLAMMATION; EXPERIENCE; SURVIVAL; IMPACT;

D O I：

10.1245/s10434-018-6672-6

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The Controlling Nutritional Status (CONUT) score is an objective tool that is widely used to assess the nutritional status in patients, including those with cancer. The relationship between the CONUT score and prognosis in patients who have undergone hepatic resection has not been evaluated in a multi-institutional study. Data were retrospectively collected for 2461 consecutive patients with hepatocellular carcinoma (HCC) who had undergone hepatic resection with curative intent at 13 institutions between January 2004 and December 2015. Patients were assigned to two groups: preoperative CONUT scores 3 (low CONUT score) and 4 (high CONUT score). Clinicopathological characteristics, surgical outcomes, and long-term survival were compared using propensity score matching analysis. Of the 2461 patients, 540 (21.9%) had high ( 4) and 1921 (78.1%) had low ( 3) preoperative CONUT scores. Overall, a high CONUT score was significantly associated with older age, female sex, low body mass index, low serum albumin, high serum total bilirubin, low lymphocyte count, low serum cholesterol, shorter prothrombin time, higher indocyanine green retention test at 15 min, Child-Pugh B (vs. A), liver cirrhosis, minor resection, shorter operation time, massive blood loss, blood transfusion, and postoperative complications. After propensity score matching, a higher CONUT score was significantly associated with poor overall survival (OS) and recurrence-free survival (RFS) using multivariate analysis. This retrospective, multi-institutional analysis showed that, in patients who undergo curative hepatectomy for HCC, the preoperative CONUT score is predictive of worse OS and RFS, even after propensity score matching analysis.

引用

页码：3316 / 3323

页数：8

共 31 条

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