Prognostic role of the controlling nutritional status (CONUT) score in patients with biliary tract cancer: a meta-analysis

Abstract

Background

Previous reports have not reached consistent results regarding the prognostic significance of the controlling nutritional status (CONUT) score in biliary tract cancer (BTC). Therefore, the present meta-analysis was conducted to investigate the precise role of the CONUT score in predicting the prognosis of BTC.

Methods

Electronic platforms including Web of Science, PubMed, Cochrane Library, and Embase were comprehensively searched up to May 2, 2023. We also determined combined hazard ratios (HRs) and 95% confidence intervals (CIs) to estimate the role of the CONUT score in predicting the prognosis of patients with BTC.

Results

Ten studies involving 1,441 patients were included in the present study. Nine studies treated patients with surgical resection, and one study used percutaneous transhepatic biliary stenting (PTBS) plus 125I seed intracavitary irradiation. Based on the combined data, a higher CONUT score significantly predicted dismal overall survival (OS) (HR = 1.94, 95%CI = 1.41–2.66, p < 0.001), inferior recurrence-free survival (RFS) (HR = 1.79, 95%CI = 1.48–2.17, p < 0.001) in BTC, and low differentiation (OR = 1.57, 95%CI = 1.15–2.14, p = 0.004). Nonetheless, the CONUT score was not related to sex, lymph node metastasis, microvascular invasion, perineural invasion, distant metastasis, TNM stage, or tumor number in patients with BTC.

Conclusion

Higher CONUT scores significantly predicted worse OS and RFS in patients with BTC. Moreover, BTC patients with high CONUT scores tended to have poor tumor differentiation. The CONUT score could help clinicians stratify high-risk patients with BTC and devise individualized treatment plans.

KEY MESSAGES

1. As far as we know, this study is the first to analyze whether pretreatment CONUT is significant for predicting the prognosis of BTC.

2. A high CONUT significantly predicted worse OS and RFS in BTC patients.

3. CONUT could help clinicians stratify high-risk BTC patients and devise individualized treatment plans.

Keywords:

• CONUT
• biliary tract cancer
• meta-analysis
• evidence-based medicine
• prognosis

Acknowledgments

We would like to thank Editage (www.editage.com) for English language editing.

Authors’ contributions

HJ and ZW design the project; HZ and ZW searched databases and performed literature screen; HZ and ZW extracted and analyzed the data, analysis; HZ and ZW evaluated the quality of included literature; HZ contributed to writing the manuscript. Final draft was approved by all the authors. All authors contributed to the article and approved the submitted version.

Disclosure statement

The authors declare that there is no conflict of interest.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.