Impact of the controlling nutritional status (CONUT) score on the prognosis after curative resection of pancreatic adenocarcinoma

Abstract

Introduction: The controlling nutritional status (CONUT) score has been established as a useful tool to evaluate immune-nutritional status. This study aimed to retrospectively investigate the impact of the CONUT score on short- and long-term outcomes in patients undergoing pancreatectomy for pancreatic ductal adenocarcinoma (PDAC). Methods: Between April 2002 and April 2016, 344 consecutive patients who underwent curative resection of PDAC without neoadjuvant therapy were analysed. After the best predictive value of the CONUT score for survival was explored, predictors of overall survival (OS) were identified using Kaplan-Meier analyses, the log-rank test and Cox multivariable analysis. Correlations between the CONUT score and postoperative complications were analysed using the Mann-Whitney U test and Spearman`s rank correlation. Results: The median survival times of patients with high and low CONUT scores were 18.0 and 26.8 months, respectively. The high CONUT score group showed significantly lower OS than that of the low CONUT score group in the univariate analysis (P = 0.002). In contrast, no significant difference in recurrence-free survival was found (P = 0.43). The multivariate analysis demonstrated that a high CONUT score was an independent prognostic risk factor for OS (hazard ratio: 1.64, P = 0.003). The CONUT score showed no association with postoperative pancreatic fistula, the Clavien-Dindo grade or the postoperative hospital stay. Conclusion: The CONUT score, which is a measure of immune-nutritional status, was an independent prognostic risk factor for OS in patients with PDAC after pancreatectomy and was not associated with RFS or postoperative complications.