Abstract
BackgroundAn emerging prediction tool, the Controlling Nutritional Status (CONUT) score, has shown good assessment ability of postoperative outcomes in cancer patients. This study evaluated the role of the preoperative CONUT score regarding the short-term outcomes of gastric cancer (GC) after laparoscopic gastrectomy.MethodsThree hundred and nine GC patients undergoing laparoscopic gastrectomy from January 2016 to June 2019 were analysed, retrospectively. The patients were divided into two groups according to the CONUT optimal cut-off value. Clinical characteristics and postoperative complications in the two groups were analysed and evaluated. Risk factors for complications were identified by univariate and multivariate analyses.ResultsA total of 309 patients underwent laparoscopic gastrectomy; 91 (29.4%) patients experienced postoperative complications. The preoperative CONUT score showed a good predictive ability for postoperative complications (area under the curve (AUC) = 0.718, Youden index = 0.343) compared with other indices, with an optimal cut-off value of 2.5. Patients with high CONUT score had a significantly higher incidence of overall complications (P < 0.001). Age, haemoglobin, C-reactive protein, red blood cell levels, CONUT scores, surgical procedure type, T1, T4, N0 and N3 pathological TNM classification, and pathological stages of I and III were associated with postoperative complications (P < 0.05). Furthermore, the preoperative CONUT score was identified as an independent risk predictor of postoperative complications (P = 0.012; OR = 2.433; 95% CI, 1.218-4.862) after multivariate analysis.ConclusionsThe preoperative CONUT score is a practical nutritional assessment for predicting short-term outcomes in GC patients after laparoscopy-assisted gastrectomy.
Highlights
As a major public health issue globally, gastric cancer (GC) is the third leading cause of cancer-related death [1]
Receiver operating characteristic (ROC) curve of the Controlling Nutritional Status (CONUT) score, prognostic nutritional index (PNI), ALB and platelet-to-lymphocyte ratio (PLR) In total, 309 patients were enrolled in this study
The demarcated values of the CONUT score that correlated with outcomes differed from those in previous studies [8, 14,15,16,17,18,19]
Summary
As a major public health issue globally, gastric cancer (GC) is the third leading cause of cancer-related death [1]. Despite recent progress in the diagnosis and treatment of GC, patient prognosis remains poor. Patients with GC may have to endure unpleasant symptoms, such as early satiety, anorexia and dysphagia, caused by obstruction due to the tumour mass and chronic anaemia due to malignant ulcers. These factors result in progressive weight loss, compromised immunity and malnutrition [4]. The Controlling Nutritional Status (CONUT) score, has shown good assessment ability of postoperative outcomes in cancer patients. This study evaluated the role of the preoperative CONUT score regarding the short-term outcomes of gastric cancer (GC) after laparoscopic gastrectomy
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