Abstract
The present study aimed to determine the correlation between controlling nutritional status (CONUT) and prognosis in resected breast cancer patients. Totally, 861 breast cancer patients with surgical resection in West China Hospital of Sichuan University between 2007 and 2010 were included. The relationship between CONUT and various clinicopathological factors as well as prognosis was evaluated. The results showed that the optimal cutoff value for CONUT to predict the 5-year survival was 3 and CONUT had a higher area under the ROC curve (AUC) for 5-year disease free survival (DFS) and overall survival (OS) prediction compared with the neutrophil lymphocyte ratio (NLR) and prognostic nutritional index (PNI). High CONUT was significantly correlated with older age, lymph node involvement, advanced T-stage, and surgery type. In the multivariate analysis, CONUT-high patients had worse DFS and OS, when compared with CONUT-low patients. In conclusion, preoperative CONUT is a useful marker for predicting long term outcomes in breast cancer patients after curative resection.
Highlights
Breast cancer is one of the most commonly diagnosed malignancies in women worldwide[1]
The prognostic accuracies of controlling nutritional status (CONUT), prognostic nutritional index (PNI) and neutrophilocyte-to-lymphocyte ratio (NLR) were explored by the area under the receiver operating characteristic (ROC) curve (AUC) of the ROC curve for predicting the 5-year disease free survival (DFS) and overall survival (OS) (Fig. 1A,B)
The AUCs of CONUT, NLR and PNI for DFS were 0.622, 0.590, and 0.581, respectively, while the AUCs of CONUT, NLR and PNI for OS were 0.621, 0.579, and 0.577, respectively
Summary
Breast cancer is one of the most commonly diagnosed malignancies in women worldwide[1]. Previous studies have reported that preoperative nutritional status, including albumin, is related with the prognosis in several malignancies[4,6]. The prognostic nutritional index (PNI), which consists of serum albumin concentration and total lymphocyte count, is used to assess the perioperative immunonutritional status and surgical risk for patients[5]. It is corroborated to be a prognostic factor in various tumors, including breast cancer[17,18,19,20,21] Based on these findings, a more comprehensive scoring system, controlling nutritional status (CONUT), consisting of serum albumin, cholesterol levels and lymphocyte count in peripheral blood, is yet to be proposed to assess patient nutritional status. We firstly attempted to assess the prognostic significance of CONUT in breast cancer patients who received curative resection based on a large study
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