Impact of Controlling nutritional status (CONUT) in patients with unresectable advanced pancreatic cancer receiving multi-agent chemotherapy: A single center, retrospective cohort study

Abstract

Controlling nutritional status (CONUT) calculated using the serum albumin concentration, total lymphocyte count, and total cholesterol, was developed as a screening tool for the early detection of undernutrition. In addition, CONUT has been reported to be a prognostic predictor of various malignancies. AimTo investigate the impact of CONUT in patients with advanced pancreatic cancer (APC). MethodsBetween June 2014 and October 2020, 110 consecutive patients with APC who received multi-agent chemotherapy were retrospectively reviewed. Patients were classified into four categories (normal, 1; light, 2; moderate, 3; severe, 4) based on CONUT. Progression-free survival (PFS) and overall survival (OS) were evaluated. ResultsThirty-nine (35.4%), 63 (57.2%), and 8 (7.2%) patients had CONUT 1, 2, and 3, respectively, but no patients for CONUT 4. The baseline characteristics did not differ significantly between CONUT classifications. In the multivariate analyses, the presence of metastasis (hazard ratio [HR], 2.06; 95% confidence interval [CI], 1.22–3.52), CONUT 2 (HR, 2.15; 95% CI, 1.32–3.54), and CONUT 3 (HR, 9.18; 95% CI, 2.67–23.50) were independent risk factors for PFS. The presence of metastasis (HR, 1.76; 95% CI, 1.04–3.07), CONUT 2 (HR, 1.92; 95% CI, 1.16–3.24), and CONUT 3 (HR, 10.71; 95% CI, 3.87–27.63) were also independent risk factors for OS. A median OS in CONUT 1, 2, and 3 were 20, 14.5, and 3.5 months (CONUT 1 vs. CONUT 2, p = 0.02; CONUT 1 vs. CONUT 3, p < 0.01; CONUT 2 vs. CONUT 3, p < 0.01), respectively. ConclusionCONUT could be a predictor of prognosis for survival in patients with APC.