17 ноября, 2023

Bladder carcinoma: nutritional status predicts postoperative results

Erkenntnis

  • In patients with clinically localized  Bladder carcinoma is a poor nutritional status according to Controlling Nutritional Status (CONUT) score independently associated with poorer postoperative morbidity and mortality. 

Why this matters

  • CONUT is simple and cost-effective and can contribute to stratification and treatment decisions through preoperative patient evaluation.

Study design

  • Study of 347 patients with clinically localized bladder cancer who underwent radical cystectomy between 2005 and 2019. 
  • The CONUT score was defined as an algorithm that included serum albumin, total lymphocyte count, and cholesterol.
  • A threshold to distinguish between low and high CONUT score was determined by calculating the ROC (Receiver Operating Characteristic) curve.
  • Funding: none.

Key results

  • The area under the curve was 0.72, so the limit for the CONUT score was set to 3.
  • 32.3% of patients had a high CONUT score of ≥3.
  • A high CONUT score was associated with a significantly higher rate of complications of any grade (OR 3.58, P=0.001), serious complications (OR 2.56, P=0.003), and readmission to hospital within 30 days (OR 2.39, P=0.01).
  • The addition of the CONUT score to the reference models improved discrimination in predicting complications of any degree ( 4.0%, P=0.03) and serious complications ( 4.0%, P=0.04) as well as resumption within 30 days ( 5.0%, P=0.02).
  • A high COUT score was associated with significantly worse recurrence-free survival (HR 2.57; P<0.001), overall survival (HR 2.37; P<0.001) and cancer-specific survival (HR 3.52; P<0.001).

Restrictions

  • Retrospective design.
  • Smoking status was unknown.

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Source — https://www.univadis.de/viewarticle/blasenkarzinom-ernahrungszustand-sagt-postoperative-ergebnisse-vorher

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