Preoperative controlling nutritional status (CONUT) score as a novel immune-nutritional predictor of survival in non-metastatic clear cell renal cell carcinoma of ≤ 7 cm on preoperative imaging.

Abstract

PURPOSE:

This study aimed at investigating the prognostic value of Preoperative controlling nutritional status (CONUT) score in non-metastatic clear-cell renal cell carcinoma of ≤ 7 cm on preoperative imaging.

METHODS:

We retrospectively included 1046 among 1637 patients who underwent radical or partial nephrectomy for solid renal masses ≤ 7 cm (2005-2014) after excluding other pathology, conditions affecting CONUT score components, metastasis, regional lymphadenopathy, positive margin, and follow-up < 12 months. We defined high and low CONUT according to cut-off of (2). Multivariate Cox-regression analysis was used to predict factors affecting recurrence and survival. Kaplan-Meier curve was used for survival analysis.

RESULTS:

The median age and follow-up were 56 years and 63 months, respectively. 41 patients had recurrence (3.9%). CONUT was a predictor for recurrence-free, cancer-specific, and overall survival (HR 3.09, P = 0.003 and HR 4.66, P = 0.004 and HR 2.81, P = 0.003, respectively). A higher CONUT was significantly associated with worse 5 years recurrence-free (88.2% vs. 97.1%), cancer-specific (96.2% vs. 98.8%) and overall (90.9% vs. 96.5%) survival (log-rank, P = < 0.001, P = 0.006 and P = < 0.001, respectively).

CONCLUSIONS:

The preoperative CONUT is an independent prognostic marker for survival after curative surgery for non-metastatic clear-cell renal cell carcinoma of ≤ 7 cm on preoperative imaging.

• Authors: Ahmed Elghiaty, Jongchan Kim, Won Sik Jang, Jee Soo Park, Ji Eun Heo, Koon Ho Rha, Young Deuk Choi, Won Sik Ham
• Journal: Journal of cancer research and clinical oncology (J Cancer Res Clin Oncol) Vol. 145 Issue 4 Pg. 957-965 (Apr 2019) ISSN: 1432-1335 [Electronic] Germany
• PMID: 30758671 (Publication Type: Journal Article)

Chemical References

• Serum Albumin
• Cholesterol

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Renal Cell (blood, immunology, mortality, surgery)
• Cholesterol (blood)
• Disease-Free Survival
• Female
• Humans
• Kaplan-Meier Estimate
• Kidney Neoplasms (blood, immunology, mortality, surgery)
• Lymphocyte Count
• Male
• Middle Aged
• Nephrectomy
• Nutritional Status
• Predictive Value of Tests
• Preoperative Period
• Retrospective Studies
• Serum Albumin (metabolism)