The Controlling Nutritional Status (CONUT) Score and Prognosis in Malignant Tumors: A Systematic Review and Meta-Analysis

Abstract

Increasing evidences indicate that the controlling nutritional status (CONUT) score is associated with cancer prognosis. This study was conducted to investigate the prognostic significance of pretreatment CONUT score on patients with various malignant tumors. The correlation between CONUT score and clinical outcomes of tumor patients were studied by electronic literature retrieval. Pooled hazard ratios (HR), odds ratios (OR) and 95% confidence intervals (95% CI) were calculated to clarify the conclusion. Subgroup analysis were conducted in line with cancer type, cancer stage, treatment, sample size and cut-off value. A total of 62 studies involving 25224 patients were included in this study. Pooled analysis showed that higher CONUT scores were associated with shorter overall survival (HR 1.62, 95% CI 1.45–1.79, p < 0.001), cancer-specific survival (HR 1.80, 95% CI 1.48–2.13, p < 0.001), progress/recurrence-free survival (HR 1.54, 95% CI 1.23–1.85, p < 0.001) and disease-free survival (HR 1.56, 95% CI 1.39–1.74, p < 0.001). In addition, high CONUT score was correlated to higher incidence of postoperative complications (OR 1.64, 95% CI 1.38–1.95, p < 0.001) and mortality (OR 4.22, 95% CI 2.22–8.02, p < 0.001). Consequently, the pretreatment CONUT score is a valuable indicator to predict the clinical outcomes of patients with various malignant tumors.

Acknowledgments

We would like to acknowledge authors of original studies that were included in this study.

Authorship

JC and PS were responsible for conception, methodology and drafting of the manuscript. ZP and ZL contributed to the data extraction, analysis and interpretation. Software operation and drawing graph were conducted by LY, LW and JZ. QD was responsible for revising the draft, funding acquisition and supervision.

Data Availability Statement

The authors confirm that the data of this study are publicly available without restriction and available within the article and its supplementary materials.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by a Key Project of National Natural Science Foundation of China (Grant ID: 8177060452), Key Research and Development Project of Science and Technology Department of Sichuan Province (Grant ID: 2017SZ0067), and 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (Grant ID: ZY2016104).