P-045 - The pretreatment Controlling Nutritional Status (CONUT) score as an independent prognostic factor in patients with clinical Stage I-III esophageal s...

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Oesophageal Cancer
Supportive Care
Presenter T. Toyokawa
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors T. Toyokawa, N. Kubo, M. Shibutani, K. Sakurai, H. Nagahara, H. Tanaka, K. Muguruma, H. Ohtani, M. Yashiro, K. Maeda, M. Ohira, K. Hirakawa
  • Osaka City University Graduate School of Medicine, Osaka/JP

Abstract

Introduction

Although the significance of the preoperative immune-nutritional status has been reported to correlate with morbidity and survival in various cancers, there have been no reports on the relationship between the Controlling Nutritional Status (CONUT) score and the clinical outcomes after curative surgery for esophageal cancer. We examined the impact of the CONUT score on short-term and long-term outcomes in patients with clinical Stage I-III thoracic esophageal squamous cell carcinoma (ESCC).

Methods

Consecutive patients who underwent curative esophagectomy with three-field lymphadenectomy for clinical Stage I-III thoracic ESCC at the Osaka City University Hospital between January 2000 and December 2014 were retrospectively reviewed. The CONUT score was estimated based on the serum albumin concentration, the total peripheral lymphocyte count and total cholesterol concentration. Survival rates were calculated by the Kaplan-Meier method, and survival curves were compared with the log-rank test. A Cox proportional hazards model was used to investigate the prognostic significance.

Results

In total, 157 patients were included in this study. A total of 11 (7.0%) and 146 (93.0%) were assigned to high and low CONUT groups, respectively. High-CONUT group was associated with only BMI (≤21.0). With regard to short-term outcome, the CONUT score was not associated with the incidence of critical complications such as anastomotic leakage and pneumonia. The median follow-up period was 53 months (1-172 months). The 5-year relapse free and overall survivals (RFS, OS) were 45.5% and 40.9% in high-CONUT group, and 65.1% and 71.8% in low-CONUT group, respectively (P = 0.008 in RFS, P < 0.001 in OS). In multivariate analysis, performance status (PS), the CONUT score and clinical Stage were independent prognostic factors for RFS, while PS, American Society of Anesthesiologists Physical Status, the CONUT score and clinical Stage were independent prognostic factors for OS.

Conclusion

Our findings showed that the CONUT score is a significant predictor of survival in patients with clinical Stage I-III thoracic ESCC but not of short-term outcome. The CONUT score is easily measurable immunonutritional biomarker and may be a useful indicator for pretreatment nutritional management.