Universität zu Köln

Mueller, Lukas, Hahn, Felix, Maehringer-Kunz, Aline, Stoehr, Fabian, Gairing, Simon J., Foerster, Friedrich, Weinmann, Arndt ORCID: 0000-0003-1198-1716, Galle, Peter R., Mittler, Jens, Pinto dos Santos, Daniel, Pitton, Michael B., Dueber, Christoph and Kloeckner, Roman (2021). Immunonutritive Scoring in Patients With Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization: Prognostic Nutritional Index or Controlling Nutritional Status Score? Front. Oncol., 11. LAUSANNE: FRONTIERS MEDIA SA. ISSN 2234-943X

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Abstract

Objectives The Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) score are immunonutritive scoring systems with proven predictive ability in various cancer entities, including hepatocellular carcinoma (HCC). We performed the first evaluation of the CONUT score for patients undergoing transarterial chemoembolization (TACE) and compared CONUT and PNI in the ability to predict median overall survival (OS). Methods Between 2010 and 2020, we retrospectively identified 237 treatment-naive patients with HCC who underwent initial TACE at our institution. Both scores include the albumin level and total lymphocyte count. The CONUT additionally includes the cholesterol level. Both scores were compared in univariate and multivariate regression analyses taking into account established risk factors. In a second step, a subgroup analysis was performed on BCLC stage B patients, for whom TACE is the recommended first-line treatment. Results A high CONUT score and low PNI were associated with impaired median OS (8.7 vs. 22.3 months, pvs. 20.1 months, p<0.001, respectively). In multivariate analysis, only the PNI remained an independent prognostic predictor (p=0.003), whereas the CONUT score lost its predictive ability (p=0.201). In the subgroup of recommended TACE candidates, both CONUT and PNI were able to stratify patients according to their median OS (6.6 vs. 17.9 months, pvs. 22.0 months, p<0.001, respectively). Again, in the multivariate analysis, only the PNI remained an independent prognostic factor (p=0.012). Conclusion Both scores were able to stratify patients according to their median OS, but only the PNI remained an independent prognostic factor. Therefore, PNI should be preferred when evaluating the nutritional status of patients undergoing TACE.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mueller, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hahn, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Maehringer-Kunz, Aline UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoehr, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Gairing, Simon J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Foerster, Friedrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Weinmann, Arndt UNSPECIFIED orcid.org/0000-0003-1198-1716 UNSPECIFIED Galle, Peter R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mittler, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Pinto dos Santos, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Pitton, Michael B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dueber, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Kloeckner, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-571282
DOI:	10.3389/fonc.2021.696183
Journal or Publication Title:	Front. Oncol.
Volume:	11
Date:	2021
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	2234-943X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STATUS CONUT SCORE; INFLAMMATION; SURVIVAL; SUBCLASSIFICATION; EPIDEMIOLOGY; SARCOPENIA; PROPOSAL; PREDICT; CANCER Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57128