Background: Preoperative nutritional status is considered to affect the short-term and long-term outcomes of cancer patients. The clinical value of the controlling nutritional status (CONUT) score in elderly patients undergoing gastrectomy for gastric cancer remains unknown.
Methods: This study reviewed 211 elderly patients aged 75 years or over who underwent curative resection for gastric cancer from 2000 to 2015. Patients were grouped according to the preoperative CONUT score into those with normal nutrition (75 patients), light malnutrition (100 patients) and moderate or severe malnutrition (36 patients). The predictive value of the CONUT score for postoperative morbidity and survival was assessed.
Results: Impaired nutrition was associated with cardiovascular disease (P = 0.012) and chronic kidney disease (P = 0.014), and worsened malnutrition was linked to advanced age (P = 0.004), decreased body mass index (P = 0.008) and advanced disease stage (P = 0.01). Multivariate analysis showed the CONUT score as an independent predictor of procedure-unrelated infectious morbidity (odds ratio, 2.36; 95% confidence interval [CI], 0.99-5.40; P = 0.046). Patients with a higher CONUT score had significantly shorter overall survival in both stage I and stage II/III gastric cancer (P = 0.044 and P = 0.007, respectively) and reduced cancer-specific survival in stage II/III (P = 0.003) The CONUT score was a strong predictors of overall survival (hazard ratio [HR], 2.12; 95% CI, 1.18-3.69; P = 0.012) and cancer-specific survival (HR, 3.75; 95% CI, 1.30-10.43; P = 0.015) independent of disease stage.
Conclusions: The preoperative CONUT score is a simple and promising predictor of postoperative procedure-unrelated infectious morbidity and prognosis in elderly gastric cancer patients.