Geburtshilfe und Frauenheilkunde, Table of Contents

CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2022; 82(01): 59-67
DOI: 10.1055/a-1608-1309

GebFra Science

Original Article

The Pretreatment Controlling Nutritional Status Score in Ovarian Cancer: Influence on Prognosis, Surgical Outcome, and Postoperative Complication Rate

Der Controlling Nutritional Status Score vor Beginn der Ovarialkarzinomtherapie: Bedeutung für Prognose, Operationserfolg und postoperative Komplikationsrate

Christine Bekos

¹Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

,

Christoph Grimm

¹Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

,

Lisa Gensthaler

¹Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

²Department of Surgery, Medical University of Vienna, Vienna, Austria

,

Thomas Bartl

¹Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

,

Alexander Reinthaller

¹Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

³Karl Landsteiner Institute for General Gynecology and Experimental Gynecologic Oncology, Vienna, Austria

,

Richard Schwameis

¹Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

,

Stephan Polterauer

¹Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

³Karl Landsteiner Institute for General Gynecology and Experimental Gynecologic Oncology, Vienna, Austria

› Author Affiliations

Abstract

Introduction The Controlling Nutritional (CONUT) Status score is an established predictor of impaired prognosis in patients with solid tumors. The aim of this study was to investigate the prognostic value of the CONUT score for overall survival and perioperative complication rates in patients with epithelial ovarian cancer.

Patients In this retrospective study we assessed the data of 337 consecutive patients with ovarian cancer. The CONUT score was associated with surgical outcome, postoperative complications and clinicopathological parameters. We used univariate log-rank test and multivariable Cox regression models to evaluate the association between pretreatment CONUT scores and survival.

Results A low CONUT score (0 – 2) was associated with an early FIGO stage (p = 0.004), complete tumor resection (p < 0.001), less neoadjuvant chemotherapy (p = 0.017) and other histologies than serous cystadenocarcinoma (p = 0.006). Postoperative complications were observed in 51.4% and 60.5% of patients with a CONUT score of 0 – 2 and a score > 2, respectively (p = 0.161). A shorter overall survival was observed in patients with a CONUT score > 2 compared to patients with a low CONUT score, with 5-year overall survival rates of 31.5% and 58.7%, respectively (p < 0.001). In multivariable analysis, both advanced age (p < 0.001) and FIGO stage (p < 0.001), residual disease (p < 0.001) and a high CONUT score (p = 0.048) were independently associated with unfavorable overall survival.

Conclusion Pretreatment CONUT score is an independent prognostic marker for overall survival and associated with successful surgery. Patients with a high CONUT score might benefit from pretreatment nutritional intervention.

Zusammenfassung

Einleitung Der Controlling Nutritional (CONUT) Status Score ist ein etablierter Prädiktor für eine eingeschränkte Prognose bei Patienten mit soliden Tumoren. Ziel dieser Studie war es, den prognostischen Wert des CONUT-Scores für das Gesamtüberleben und für perioperative Komplikationsraten bei Patientinnen mit epithelialem Ovarialkarzinom zu untersuchen.

Patientinnen In dieser retrospektiven Studie wurden die Daten von 337 konsekutiv aufgenommenen Patientinnen mit Ovarialkarzinom analysiert. Der CONUT-Score war mit dem Operationsergebnis, den postoperativen Komplikationen sowie den klinisch-pathologischen Parametern assoziiert. Wir verwendeten univariate Log-Rank-Tests sowie multivariable Cox-Regressionsmodelle, um die Assoziation zwischen dem CONUT-Score vor Beginn der Behandlung und das Überleben zu evaluieren.

Ergebnisse Ein niedriger CONUT-Score (0 – 2) war mit einem frühen FIGO-Stadium (p = 0,004), einer vollständigen Resektion des Tumors (p < 0,001), weniger neoadjuvanter Chemotherapie (p = 0,017) und Tumoren, die keine seröse Zystadenokarzinome waren (p = 0,006), assoziiert. Postoperative Komplikationen traten bei 51,4% bzw. 60,5% von Patientinnen mit einem CONUT-Score von 0 – 2 bzw. einem Score von > 2 auf (p = 0,161). Patientinnen mit einem CONUT-Score von > 2 hatten ein kürzeres Gesamtüberleben verglichen mit Patientinnen mit einem niedrigen CONUT-Score, mit einer 5-Jahres-Überlebensrate von 31,5% bzw. 58,7% für die jeweilige Gruppe (p < 0,001). Die multivariable Analyse ergab, dass fortgeschrittenes Alter (p < 0,001), FIGO-Stadium (p < 0,001), Resterkrankung (p < 0,001) und hoher CONUT-Score (p = 0,048) unabhängig voneinander mit ungünstigen Überlebensraten assoziiert waren.

Schlussfolgerungen Der CONUT-Score vor Beginn der Behandlung ist ein unabhängiger prognostischer Marker für das Gesamtüberleben und ist mit dem Operationserfolg assoziiert. Patientinnen mit einem hohen CONUT-Score könnten von einer Ernährungsintervention vor Beginn der Behandlung profitieren.

Key words

Key words

ovarian cancer - ovarian neoplasms - malabsorption syndromes - postoperative complications

Schlüsselwörter

Schlüsselwörter

Ovarialkarzinom - ovarielle Neoplasie - Malabsorptionssyndrome - postoperative Komplikationen

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