The prognostic value of preoperative controlling nutritional status score in non-metastatic renal cell carcinoma treated with surgery: a retrospective single-institution study
Authors Song H, Xu B, Luo C, Zhang Z, Ma B, Jin J, Zhang Q
Received 21 March 2019
Accepted for publication 25 July 2019
Published 9 August 2019 Volume 2019:11 Pages 7567—7575
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Nicola Ludin
Peer reviewer comments 2
Editor who approved publication: Dr Beicheng Sun
Haifeng Song,1–3,* Ben Xu,1–3,* Cheng Luo,1–3 Zhenan Zhang,1–3 Binglei Ma,1–3 Jie Jin,1–3 Qian Zhang1–3
1Department of Urology, Peking University First Hospital, Beijing 100034, People’s Republic of China; 2Institute of Urology, Peking University, Beijing 100034, People’s Republic of China; 3National Research Center for Genitourinary Oncology, Beijing 100034, People’s Republic of China
*These authors contributed equally to this work
Purpose: This study aimed to investigate the significance of the controlling nutritional status (CONUT) score as a predictor for survival outcomes for non-metastatic renal cell carcinoma (RCC) patients.
Methods: We retrospectively reviewed 325 patients who received surgical treatment for renal cell carcinoma between 2010 and 2012 at Peking University First Hospital. Patients were divided into two groups according to the optimal cut-off value of CONUT score. Kaplan–Meier method and log-rank test were used for survival analysis according to different CONUT groups. Cox proportional hazards regression models were performed to assess the prognostic value of clinicopathological parameters for overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS) respectively.
Results: The optimal cut-off value of CONUT score was 3. High CONUT score significantly correlated to higher tumor grade (P<0.001), later pathological T stage (P<0.001) and tumor necrosis (P<0.001). Patients with higher CONUT score had worse OS (HR 5.34, 95% CI 2.29–12.46, P<0.001), CSS (HR 5.51, 95% CI 2.12–14.33, P<0.001) and DFS (HR 4.23, 95% CI 2.16–8.29, P<0.001). In multivariable analysis, high CONUT score was an independent risk factor for OS, CSS and DFS (OS: HR=3.36, 95% CI 1.73–6.56, P<0.001; CSS: HR=3.34, 95% CI 1.59–6.98, P=0.001; DFS: HR=1.85, ]95% CI 1.07–3.21, P=0.029)
Conclusion: Preoperative CONUT score was an independent prognostic factor for OS, CSS and DFS in non-metastatic RCC patients treated with surgery.
Keywords: CONUT score, renal cell carcinoma, surgery, survival, biomarker
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