Using the Controlling Nutritional Status (CONUT) Score for Evaluating Patients with Early-Stage Hepatocellular Carcinoma
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CLINICAL INVESTIGATION
INTERVENTIONAL ONCOLOGY
Using the Controlling Nutritional Status (CONUT) Score for Evaluating Patients with Early-Stage Hepatocellular Carcinoma After Radiofrequency Ablation: A Two-Center Retrospective Study Yi Chen1,2 • Chao Zhao2 • Yi Yang1 • Yu-Jing Xin1 • Ya-Nan Wang1 Xiao Li1 • Xiang Zhou1 • Dui-Ping Feng2
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Received: 14 February 2020 / Accepted: 5 May 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Purpose To estimate the prognostic significance of the controlling nutritional status (CONUT) in patients with BCLC stage A hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA). Materials and Methods From January 2013 to December 2016, 325 patients with BCLC stage A HCC who underwent RFA at the National Cancer Center and First Hospital of Shanxi Medical University were retrospectively studied. The patients were divided into low (B 4) and high (C 5) CONUT scores for assessment of overall survival (OS) and recurrence-free survival (RFS). Several covariates, including age, sex, the diameter and number of lesions, lesion differentiation, Child–Pugh class, hepatitis B virus infection, along with blood levels of AFP, AST, ALT, cGT, and TBIL, were assessed using univariate and multivariate analyses. Results The mortality rate was 17.49% (46/263) and 35.48% (22/62) in the low and high CONUT groups, respectively, with the difference being statistically significant (P = 0.033). In addition, disease recurrence was significantly higher in the high CONUT group at 70.97%, as & Xiang Zhou [email protected] & Dui-Ping Feng [email protected] 1
Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
2
Department of Interventional Radiology, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
compared to the low CONUT group at 43.35% (P = 0.041). The predictive factors were used to build the nomogram to estimate 1-, 3- and 5-year OS and RFS rates. Conclusions CONUT scores were found to be associated with the prognosis of patients with early-stage HCC who underwent RFA. Higher CONUT scores were associated with poor survival outcomes. Keywords Hepatocellular carcinoma Radiofrequency ablation CONUT Overall survival Recurrence-free survival
Introduction Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide [1]. The etiology of HCC is widespread, with hepatitis B and C viruses (HBV or HCV) and alcohol abuse being the most common cause of the disease [1]. HCC therapies are numerous and may include surgical resection, liver transplantation, thermal ablation, cryoablation, transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), radiation therapy, percutaneous ethanol injections (PEI), and systemic therapies like
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