Abstract

BACKGROUND:

The controlling nutritional status (CONUT) score is an objective indicator of general condition from the aspect of nutritional status, calculated from serum albumin, total cholesterol, and total lymphocyte count. The CONUT score is also considered to reflect the degree of tumor-derived chronic inflammation and the host immune status in patients with advanced cancer.

OBJECTIVE:

To examine the prognostic role of the CONUT score in patients with advanced urothelial carcinoma (aUC) treated with first-line platinum-based chemotherapy.

METHODS:

Associations of the CONUT score with clinical parameters and overall survival (OS) were investigated retrospectively in 147 patients with aUC receiving first-line platinum-based chemotherapy at a single cancer center from February 2003 to April 2019.

RESULTS:

The median (range) CONUT score was 1 (0– 7). A higher CONUT score was associated with lower hemoglobin (P < 0.001) and higher C-reactive protein levels (P = 0.023) but not with chemotherapy response (P = 0.432). The median OS for patients with CONUT scores 0– 1, 2– 3, and ≥4 were 23.3, 14.9, and 9.4 months, respectively (P < 0.001). In the multivariable analysis, a higher CONUT score was independently associated with shorter OS (scores 2– 3 vs 0– 1, HR 1.58, P = 0.048; scores ≥4 vs 0– 1, HR 2.63, P = 0.008) along with poorer performance status (HR 4.79, P < 0.001), primary tumor site of the upper urinary tract (HR 1.70, P = 0.016), higher LDH (HR 3.85, P = 0.036), higher alkaline phosphatase (HR 3.06, P = 0.028), and non-responders to chemotherapy (HR 2.07, P < 0.001).

CONCLUSIONS:

The CONUT score is a prognostic biomarker in patients with aUC receiving first-line platinum-based chemotherapy.

中文翻译：

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营养控制状态（CONUT）评分是一线铂类化学疗法治疗晚期尿路上皮癌患者的预后生物标志物

摘要

背景：

从营养状况来看，控制营养状况（CONUT）评分是一般状况的客观指标，可以通过血清白蛋白，总胆固醇和总淋巴细胞计数来计算。CONUT分数也被认为反映了晚期癌症患者的肿瘤源性慢性炎症程度和宿主免疫状态。

目的：

目的检查CONUT评分对一线铂类化学疗法治疗的晚期尿路上皮癌（aUC）患者的预后作用。

方法：

从2003年2月至2019年4月，在单一癌症中心对147例接受一线铂类化学疗法的aUC患者进行了CONUT评分与临床参数和总生存期（OS）的关联性研究。

结果：

CONUT得分的中位数（范围）为1（0–7）。较高的CONUT评分与较低的血红蛋白（P  <0.001）和较高的C反应蛋白水平（P  = 0.023）相关，而与化疗反应无关（P  = 0.432）。CONUT评分为0–1、2–3和≥4的患者的OS的中位数分别为23.3、14.9和9.4个月（P  <0.001）。在多变量分析中，较高的CONUT得分与较短的OS独立相关（得分2-3与0-1，HR 1.58，P  = 0.048；得分≥4与0-1，HR 2.63，P  = 0.008）以及较差表现状态（HR 4.79，P  <0.001），上尿路原发肿瘤部位（HR 1.70，P = 0.016），较高的LDH（HR 3.85，P  = 0.036），较高的碱性磷酸酶（HR 3.06，P  = 0.028）和对化疗无反应（HR 2.07，P  <0.001）。

结论：

CONUT评分是接受一线铂类化疗的aUC患者的预后生物标志物。