The preoperative CONUT score combined with HRR can help assess the prognosis of patients with UTUC undergoing radical nephroureterectomy
10.3969/j.issn.1009-8291.2023.12.010
- VernacularTitle:术前CONUT评分联合HRR可帮助评估接受肾输尿管根治术UTUC患者的预后
- Author:
Xin XU
1
;
Yang XU
2
;
Rui CHEN
1
;
Renfu CHEN
3
Author Information
1. Department of Urology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000; Graduate School of Xuzhou Medical University, Xuzhou 221004
2. Department of Urology, Huzhou Hospital Affiliated to Zhejiang University School of Medicine, Huzhou 313099, China
3. Department of Urology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000
- Publication Type:Journal Article
- Keywords:
upper urinary tract urothelial carcinoma;
controlling nutritional status (CONUT) score;
hemoglobin to red cell distribution width (HRR);
radical nephroureterectomy
- From:
Journal of Modern Urology
2023;28(12):1053-1059
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To investigate the predictive value of preoperative controlled nutritional status (CONUT) score and ratio of hemoglobin to red cell distribution width (HRR) for survival of patients with upper urinary tract urothelial carcinoma (UTUC) after radical surgery. 【Methods】 A retrospective analysis was performed on 145 UTUC patients who underwent surgical treatment in the Affiliated Hospital of Xuzhou Medical University during May 2011 and Jun. 2017. Clinic opathologic data were collected, the best cut-off values of CONUT score and HRR were determined with receiver operating characteristic (ROC) curve, and the CONUT-HRR scoring system was established. The correlation between different CONUT-HRR scores and clinic opathological indicators of UTUC patients was compared. The application value of CONUT-HRR score in predicting the prognosis of UTUC patients was evaluated with Kaplan-Meier survival curve and Cox proportional risk regression model. 【Results】 The optimal cut-off values of preoperative CONUT score and HRR for predicting cancer specific survival (CSS) were 3 and 10.41, respectively. The patients were divided into three groups: CONUT-HRR 0 group (n=62, CONUT score <3 and HRR ≥10.41), CONUT-HRR 1 group (n=51, CONUT score <3 and HRR <10.41, or CONUT score ≥3 and HRR≥10.41), and CONUT-HRR 2 group (n=32, CONUT score ≥3 and HRR <10.41). CONUT-HRR score was correlated with age, surgical method, pathological T stage, lymph node metastasis and vascular invasion (all P<0.05). Kaplan-Meier survival curve results showed that the 5-year CSS of CONUT-HRR 0, 1 and 2 groups were 96.4%, 65.8% and 30.9%, respectively, with statistically significant differences (P<0.001). Cox regression model showed that CONUT-HRR score, pathological T stage, lymph node metastasis and vascular infiltration were independent factors of CSS. 【Conclusion】 Preoperative CONUT-HRR score can be used as a simple and reliable indicator to evaluate the prognosis of UTUC patients. Higher score indicates worse prognosis.
