1.Value of controlling nutritional status score and related inflammatory indicators in predicting the prognosis of patients with clear cell renal cell carcinoma: a multicenter retrospective study
Fang XIE ; Chuanzong FENG ; Cheng ZHANG ; Xuejiao SHEN ; Jian ZHOU
Journal of Modern Urology 2024;29(5):406-411
【Objective】 To explore the value of controlling nutritional status (CONUT) score and related inflammatory indicators in predicting the prognosis of clear cell renal cell carcinoma (ccRCC) patients, to provide a reference for better clinical assessment and individualized treatment plan. 【Methods】 A retrospective study was conducted on 132 patients with ccRCC admitted to four comprehensive hospitals in Yibin during 2010 and 2018.Patients’ medical and follow-up records were collected, and receiver operating characteristic (ROC) curve was drawn to analyze the area under the curve (AUC) and optimal cut-off value of CONUT score and related indicators.Survival curve was plotted with Kaplan-Meier method, and the influencing factors of prognosis were analyzed with Log-rank test and Cox regression. 【Results】 During the follow-up of 62 (53, 71) months, 37 (28.03%) deaths occurred.The disease-specific survival (DSS) and progression-free survival (PFS) were 51 (41, 58) and 46 (35, 56) months, respectively.The 3-year and 5-year DSS and PFS were 84.09% and 71.97%, and 75.00% and 71.97%, respectively.The AUC of CONUT score, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR) were 0.980, 0.905, 0.899 and 0.884, respectively, with the optimal cut-off values of 3.50, 3.19, 89.07 and 3.56, respectively.Cox regression showed that CONUT score (HR=0.042, 95%CI:0.013—0.140) and PLR (HR=0.182, 95%CI:0.045—0.744) were associated with DSS; CONUT score (HR=0.029, 95%CI:0.010—0.086) and LMR (HR=2.984, 95%CI:1.227—7.258) were associated with PFS. 【Conclusion】 The prognosis of ccRCC patients is related to their nutritional, immune, and inflammatory status.CONUT score and inflammatory factors (PLR, LMR) may be important predictors of DSS and PFS.