Controlling Nutritional Status Score Before Receiving Treatment as a Prognostic Indicator for Patients With Urothelial Cancer: An Exploration Evaluation Methods

Lei Peng; Chunxiao Du; Chunyang Meng; Jinze Li; Chengyu You; Xianhui Li; Pan Zhao; Dehong Cao; Yunxiang Li

doi:10.3389/fonc.2021.702908

Controlling Nutritional Status Score Before Receiving Treatment as a Prognostic Indicator for Patients With Urothelial Cancer: An Exploration Evaluation Methods

Front Oncol. 2021 Oct 13:11:702908. doi: 10.3389/fonc.2021.702908. eCollection 2021.

Authors

Lei Peng¹, Chunxiao Du², Chunyang Meng¹, Jinze Li³, Chengyu You¹, Xianhui Li¹, Pan Zhao¹, Dehong Cao^{3

4}, Yunxiang Li¹

Affiliations

¹ Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, China.
² Department of Clinical Pharmacy, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
³ Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
⁴ State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu, China.

Abstract

Introduction: This meta-analysis aims to assess whether the Controlling nutritional status (CONUT) score before treatment can be an independent predictor of the prognosis of patients with urothelial cancer (UC).

Methods: The system searches Web of Science, PubMed, MEDLINE, China National Knowledge Infrastructure (CNKI), and Cochrane Library, and the search time is up to April 2021. Use STATA 16.0 and Engauge Digitizer 4.1 software for data processing and statistical analysis.

Results: A total of 8 studies were included in this meta-analysis. The meta-analysis results show that compared with the low CONUT group, the high CONUT group has worse over survival (OS) [HR=1.58, 95%CI (1.34, 1.86), P=0.001], cancer-specific survival (CSS) [HR=2.03, 95%CI (1.25-3.29), P=0.04] and recurrence-free survival (RFS) [HR=1.97, 95%CI (1.15, 3.40), P=0.014]; for progression-free survival (PFS), or disease-free survival (DFS), the difference between the two groups was not statistically significant [HR=2.30, 95%CI (0.72, 7.32), P=0.158]. According to different carcinoma types, cut-off value, and region, subgroup analysis of OS was performed, and similar results were obtained.

Conclusions: Based on current evidence, this meta-analysis proves that the CONUT score of UC patients before treatment is an independent prognostic predictor. It performs well on OS, CSS, and RFS, but the conclusions on DFS/PFS need to be treated with caution.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021251890, identifier CRD42021251890.

Keywords: bladder cancer; controlling nutritional status; meta-analysis; prognostic factors; upper tract urothelial carcinoma; urothelial cancer.

Publication types

Systematic Review