Using the Controlling Nutritional Status (CONUT) Score for Evaluating Patients with Early-Stage Hepatocellular Carcinoma After Radiofrequency Ablation: A Two-Center Retrospective Study

Cardiovasc Intervent Radiol. 2020 Sep;43(9):1294-1304. doi: 10.1007/s00270-020-02519-0. Epub 2020 May 20.

Abstract

Purpose: To estimate the prognostic significance of the controlling nutritional status (CONUT) in patients with BCLC stage A hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA).

Materials and methods: From January 2013 to December 2016, 325 patients with BCLC stage A HCC who underwent RFA at the National Cancer Center and First Hospital of Shanxi Medical University were retrospectively studied. The patients were divided into low (≤ 4) and high (≥ 5) CONUT scores for assessment of overall survival (OS) and recurrence-free survival (RFS). Several covariates, including age, sex, the diameter and number of lesions, lesion differentiation, Child-Pugh class, hepatitis B virus infection, along with blood levels of AFP, AST, ALT, γ-GT, and TBIL, were assessed using univariate and multivariate analyses.

Results: The mortality rate was 17.49% (46/263) and 35.48% (22/62) in the low and high CONUT groups, respectively, with the difference being statistically significant (P = 0.033). In addition, disease recurrence was significantly higher in the high CONUT group at 70.97%, as compared to the low CONUT group at 43.35% (P = 0.041). The predictive factors were used to build the nomogram to estimate 1-, 3- and 5-year OS and RFS rates.

Conclusions: CONUT scores were found to be associated with the prognosis of patients with early-stage HCC who underwent RFA. Higher CONUT scores were associated with poor survival outcomes.

Keywords: CONUT; Hepatocellular carcinoma; Overall survival; Radiofrequency ablation; Recurrence-free survival.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / diagnosis*
  • Carcinoma, Hepatocellular / surgery
  • Female
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / surgery
  • Male
  • Neoplasm Recurrence, Local
  • Neoplasm Staging*
  • Nutritional Status*
  • Postoperative Period
  • Prognosis
  • Radiofrequency Ablation / methods*
  • Retrospective Studies