The prognostic value of preoperative controlling nutritional status score in non-metastatic renal cell carcinoma treated with surgery: a retrospective single-institution study

Figures & data

Table 1 Assessment of nutrition status by controlling nutritional status (CONUT) scoring system

Parameter	Undernutrition degree
	None	Light	Moderate	Severe
Serum albumin (g/dL)	≥3.50	3.00–3.49	2.50–2.99	<2.50
Score	0	2	4	6
Total lymphocyte (/mm^3)	≥1600	1200–1599	800–1199	<800
Score	0	1	2	3
Total cholesterol (mg/dL)	≥180	140–179	100–139	<100
Score	0	1	2	3

Note: CONUT score=serum albumin score+total lymphocyte count score+total cholesterol score.

Figure 1 ROC curve for CONUT score.

Abbreviations: ROC, receiver operating characteristic; CONUT score, controlling nutritional status score.

Table 2 Clinicopathological characteristics of the 325 patients according to different controlling nutritional status (CONUT) groups

Factors	Total (n=328)	CONUT<3 (n=255)	CONUT≥3 (n=70)	P-value*
Age (years)
≤65	240	193	47
>65	85	62	23	P=0.198
Gender
Male	231	177	54	P=0.265
Female	94	78	16
Diabetes
Yes	46	35	11
No	279	220	59	P=0.819
Hypertension
Yes	128	105	23
No	197	150	47	P=0.261
Tumor grade
G1-2	275	226	49
G3-4	50	29	21	P<0.001
Pathological T stage
pT1-2	247	212	35
pT3-4	78	43	35	P<0.001
Necrosis
Yes	95	62	33
No	230	193	37	P<0.001
Histology
Clear cell	292	232	60
Non-clear cell	33	23	10	P=0.285

Notes: *Chi-square test. Bold values indicates statistical significance in univariate and multivariate analysis which had been detailed in the "Results" section.

Table 3 Univariate and multivariate analyses of clinicopathological parameters to predict CSS, DFS and OS in patients with non-metastatic RCC

Factors	OS				CSS				DFS
	Univariate		Multivariate		Univariate		Multivariate		Univariate		Multivariate
	HR (95% CI)	P-value	HR (95% CI)	P-value	HR (95% CI)	P-value	HR (95% CI)	P-value	HR (95% CI)	P-value	HR (95% CI)	P-value
Age
≤65	1.00 (ref)				1.00 (ref)				1.00 (ref)
>65	1.47 (0.72–3.03)	0.249			0.85 (0.38–1.91)	0.710			0.87 (0.49–1.56)	0.654
Gender
Male	1.00 (ref)				1.00 (ref)				1.00 (ref)
Female	0.73 (0.37–1.46)	0.404			0.84 (0.39–1.83)	0.679			0.74 (0.42–1.29)	0.319
Pathological T stage
T1-T2	1.00 (ref)		1.00 (ref)		1.00 (ref)		1.00 (ref)		1.00 (ref)		1.00 (ref)
T3-T4	7.69 (3.34–17.66)	<0.001	3.89 (1.76–8.57)	0.001	7.91 (3.08–20.32)	<0.001	3.05 (1.26–7.37)	0.014	9.05 (4.61–17.74)	<0.001	3.97 (2.05–7.72)	<0.001
Tumor grade
G1-G2	1.00 (ref)		1.00 (ref)		1.00 (ref)		1.00 (ref)		1.00 (ref)		1.00 (ref)
G3-G4	6.18 (2.37–16.14)	<0.001	2.48 (1.19–5.21)	0.016	8.98 (3.03–26.62)	<0.001	4.07 (1.76–9.43)	0.001	8.04 (3.59–18.03)	<0.001	2.34 (1.23–4.44)	0.010
Histology
Clear cell	1.00 (ref)				1.00 (ref)				1.00 (ref)
Non-clear cell	0.99 (0.35–2.78)	0.986			1.28 (0.40–4.04)	0.648			0.93 (0.41–2.09)	0.857
CONUT score
<3	1.00 (ref)		1.00 (ref)		1.00 (ref)		1.00 (ref)		1.00 (ref)		1.00 (ref)
≥3	5.34 (2.29–12.46)	<0.001	3.36 (1.73–6.56)	<0.001	5.51 (2.12–14.33)	<0.001	3.34 (1.59–6.98)	0.001	4.23 (2.16–8.29)	<0.001	1.85 (1.07–3.21)	0.029
Diabetes
No	1.00 (ref)		1.00 (ref)		1.00 (ref)				1.00 (ref)
Yes	1.93 (0.77–4.83)	0.079	2.24 (1.06–4.720)	0.035	1.88 (0.67–5.28)	0.135			1.45 (0.69–3.05)	0.259
Hypertension
No	1.00(ref)				1.00 (ref)				1.00 (ref)
Yes	1.04(0.55–1.98)	0.897			0.94 (0.46–1.93)	0.866			0.91 (0.54–1.53)	0.736
Necrosis
No	1.00 (ref)				1.00 (ref)				1.00 (ref)		1.00 (ref)
Yes	4.45 (2.14–9.23)	<0.001			5.73 (2.51–13.04)	<0.001			5.82 (3.22–10.52)	<0.001	2.07 (1.08–4.02)	0.030

Notes: Bold values indicate statistical significance in univariate and multivariate analysis which had been detailed in the "Results" section.

Abbreviations: RCC, renal cell carcinoma; OS, overall survival; CSS, cancer-specific survival; DFS, disease-free survival; HR, hazard ratio; CONUT, controlling nutritional status.

Figure 2 Kaplan–Meier survival curves for non-metastatic RCC patients treated with surgery. Survival curves set at cut-off value 2 for OS (A), CSS (B) and DFS (C).

Abbreviations: RCC, renal cell carcinoma; OS, overall survival; CSS, cancer-specific survival; DFS, disease-free survival; CONUT, controlling nutritional status.