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Preoperative controlling nutritional status (CONUT) score predicts long-term outcomes in patients with non-B non-C hepatocellular carcinoma after curative hepatic resection

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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.

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Data availability

The dataset analyzed for the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan

    Masashi Tsunematsu, Koichiro Haruki, Yuki Fujiwara, Kenei Furukawa, Shinji Onda, Michinori Matsumoto, Takeshi Gocho, Hiroaki Shiba & Katsuhiko Yanaga

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  1. Masashi Tsunematsu
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  2. Koichiro Haruki
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  3. Yuki Fujiwara
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  4. Kenei Furukawa
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  5. Shinji Onda
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  6. Michinori Matsumoto
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  7. Takeshi Gocho
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  8. Hiroaki Shiba
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  9. Katsuhiko Yanaga
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Contributions

MT, KH, SO, TG, HS, and KY contributed in the study conception and design; MT, KH, YF, KF, and MM provided data acquisition and statistical analysis; MT and KH participated in manuscript preparation; TG, HS, and KY contributed in manuscript revision. All authors have read and approved the manuscript for publication.

Corresponding author

Correspondence to Koichiro Haruki.

Ethics declarations

This retrospective cohort study was approved by the institutional review board at the Jikei University School of Medicine (#27-177).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This retrospective study meeting the ethical standards of the World Medical Association Declaration of Helsinki was approved by The Jikei University School of Medicine (#27-177).

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Written informed consent was obtained from the parents.

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Tsunematsu, M., Haruki, K., Fujiwara, Y. et al. Preoperative controlling nutritional status (CONUT) score predicts long-term outcomes in patients with non-B non-C hepatocellular carcinoma after curative hepatic resection. Langenbecks Arch Surg 406, 99–107 (2021). https://doi.org/10.1007/s00423-020-01987-9

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  • DOI: https://doi.org/10.1007/s00423-020-01987-9

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