Abstract 1240P
Background
Stage III NSCLC is a heterogeneous disease; in this context, surgery, chemoradiotherapy (CRT) or palliative approaches could be considered depending on tumor and patient’s characteristics. Thus, nutritional status plays an important role in treatment choice. We aim to determine the impact on survival of the CONUT score at baseline in patients with stage III NSCLC.
Methods
Patients diagnosed with stage III NSCLC from Jan.2010 to Dec.2015 in Hospital Universitario Doctor Peset (Valencia, Spain) were retrospectively reviewed. CONUT score was gathered at baseline. It includes albumin, cholesterol and lymphocyte levels, assigning 0-12 points depending on their value. Patients were classified in two groups: low vs. high CONUT score (cut-off point=4). Progression-free survival (PFS) and overall survival (OS) were estimated with Kaplan-Meier and log-rank test. Multivariate analysis was performed with Cox regression model.
Results
124 patients were included; median age was 65.5 years (range 39-83); 83.06% patients were male, 87.9% had ECOG 0-1 and 25.5% patients had a previous significant weight loss (≥5%). Predominant histologies were adenocarcinoma (39.5%) and squamous-cell carcinoma (58.1%). Most patients were treated with CRT (69.35%); surgery was performed in 16.13% cases; and 14.52% received palliative chemotherapy (CT). On the multivariate analysis, only the type of treatment and classification according to CONUT score had an impact on survival. Patients with CONUT≤4 had significant longer PFS and OS: 20.21 vs 12.09 months (p=.024) and 40.74 vs. 15.41 months (p=.003), respectively (Table). Table: 1240P
Multivariate analysis
| PFS | OS | |||
| HR (95% CI) | p value | HR (95% CI) | p value | |
| Age | 0.99 (0.96 – 1.02) | 0.534 | 0.99 (0.98 – 1.02) | 0.909 |
| ECOG | 1.27 (0.85 – 1.90) | 0.346 | 1.29 (0.86 – 1.96) | 0.216 |
| Significant weight loss (no vs. yes) | 0.88 (0.53 – 1.44) | 0.606 | 0.84 (0.51 – 1.41) | 0.519 |
| Type of treatment (surgery vs. CRT. vs. CT) | 3.26 (1.98 – 5.37) | <0.001 | 2.89 (1.79 – 4.66) | <0.001 |
| CONUT (low vs. high) | 1.86 (1.08 – 3.18) | 0.024 | 2.13 (1.29 – 3.53) | 0.003 |
Conclusions
Baseline CONUT score could be used as prognostic factor in stage III NSCLC patients, given its impact in survival irrespective of treatment approach. It is an inexpensive and reproducible marker and it could be evaluated in clinical trials.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Doctor Peset University Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.