Original Article


Prognostic impact of controlling nutritional status score in resected lung squamous cell carcinoma

Gouji Toyokawa, Yuka Kozuma, Taichi Matsubara, Naoki Haratake, Shinkichi Takamori, Takaki Akamine, Kazuki Takada, Masakazu Katsura, Mototsugu Shimokawa, Fumihiro Shoji, Tatsuro Okamoto, Yoshihiko Maehara

Abstract

Background: The preoperative immune-nutritional status has been shown to predict the postoperative prognosis in various types of cancer; however, the prognostic significance of the controlling nutritional status (CONUT) score in resected lung squamous cell carcinoma (SCC) has yet to be elucidated.
Methods: A total of 108 patients with resected lung SCC were analyzed for their clinicopathological factors, including the CONUT score, which can be calculated from the serum albumin, total cholesterol, and total peripheral lymphocyte count. The patients were divided into two groups: CONUT low (0 or 1) or high (≥2).
Results: Among 108 patients, 76 (70.4%) were CONUT low, while 32 (29.6%) were CONUT high. No significant association between the CONUT score and the clinicopathological factors was found. Patients with CONUT high exhibited significantly shorter disease-free and overall survivals (DFS and OS) than those with CONUT low (P=0.016 and P=0.006, respectively). Multivariate analyses showed that the CONUT score [hazard ratio (HR): 1.902, 95% confidence interval (CI): 1.045–3.373, P=0.036], age (HR: 2.286, 95% CI: 1.246–4.304, P=0.007), pathological stage (HR: 2.527, 95% CI: 1.391–4.644, P=0.002), and lymphatic invasion (HR: 2.321, 95% CI: 1.110–4.493, P=0.027) were independent prognostic factors for the DFS. Furthermore, in a multivariate analysis, the CONUT score (HR: 1.909, 95% CI: 0.902–3.860, P=0.081), age (HR: 2.455, 95% CI: 1.208–5.178, P=0.013), pathological stage (HR: 2.488, 95% CI: 1.201–5.306, P=0.014), and lymphatic invasion (HR: 3.409, 95% CI: 1.532–7.240, P=0.004) were shown to be independent prognostic factors for the OS.
Conclusions: The current study showed that the CONUT score was an independent prognostic factor for the DFS and OS in patients with resected lung SCC.

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