Preoperative controlling nutritional status (CONUT) score predicts long-term outcomes in patients with non-B non-C hepat
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ORIGINAL ARTICLE
Preoperative controlling nutritional status (CONUT) score predicts long-term outcomes in patients with non-B non-C hepatocellular carcinoma after curative hepatic resection Masashi Tsunematsu 1 & Koichiro Haruki 1 & Yuki Fujiwara 1 & Kenei Furukawa 1 & Shinji Onda 1 & Michinori Matsumoto 1 & Takeshi Gocho 1 & Hiroaki Shiba 1 & Katsuhiko Yanaga 1 Received: 15 May 2020 / Accepted: 3 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The controlling nutritional status (CONUT) score has been reported to predict outcomes in patients with hepatocellular carcinoma (HCC). However, the prognostic significance of the CONUT score in patients with non-B non-C (NBNC) HCC remains to be established. Methods The study comprised 246 patients who had undergone elective hepatic resection for HCC between April 2003 and October 2017. We retrospectively investigated the relation between preoperative CONUT score as well as clinicopathological characteristics and disease-free survival (DFS) as well as overall survival (OS). Results In univariate analyses, CONUT score was associated with DFS and OS in patients with NBNC-HCC (p ≤ 0.01), while there was no significant association of CONUT score with DFS and OS in patients with HBV- and HCV-related HCC (p ≥ 0.1). Of the 111 patients with NBNC-HCC, 97 (87.4%) had CONUT score ≤ 3 (low CONUT score) and the other 14 (12.6%) had CONUT score ≥ 4 (high CONUT score). In the patients with NBNC-HCC, multivariate analysis identified age ≥ 65 years (p = 0.03), multiple tumors (p < 0.01), and high CONUT score (p = 0.03) as the independent and significant predictors of DFS, while multiple tumors (p = 0.01), microvascular invasion (p < 0.01), and high CONUT score (p = 0.01) were the independent and significant predictors of OS. Conclusions The CONUT score seems to be a reliable and independent predictor of both DFS and OS after hepatic resection for NBNC-HCC. Keywords CONUT score . Non-B non-C hepatocellular carcinoma . Hepatic resection . Prognostic factor . Overall survival . Disease-free survival
Introduction Hepatocellular carcinoma (HCC) is one of the most prevalent malignancies worldwide and the fourth leading cause of cancer-related deaths [1]. Although operative mortality and morbidity of hepatic resection have been reduced due to Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00423-020-01987-9) contains supplementary material, which is available to authorized users. * Koichiro Haruki [email protected] 1
Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
advances in perioperative management, instruments, and surgical techniques, the long-term outcome of HCC remains unsatisfactory due to the high incidence of recurrence [2, 3]. Therefore, assessment of prognostic predictors is important for the management of patients with HCC. Indeed, various staging systems and biomarkers of HCC that focus on tumor-related factors, liv
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