The value of preoperative controlling nutritional status score in evaluating short-term and long-term outcomes of patients with colorectal cancer following surgical resection

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Background: This study aimed to explore the value of controlling nutritional status (CONUT) score in assessing short-term and long-term outcomes of colorectal cancer (CRC) patients, and construct CONUT-based nomograms to predict risk of postoperative comorbidities and survival.Methods: We retrospectively enrolled 512 patients from 2012 to 2014.Patients were categorized into low-CONUT and high-CONUT groups.Logistic regression analysis was used to determine characteristics influencing postoperative comorbidities.Kaplan-Meier survival curve and Cox proportional hazards analysis were used to determine characteristics affecting prognosis.The receiver operating characteristic was used to compare ability of the CONUT score with other immune-nutritional indicators to predict prognosis.Results: Logistic regression analysis suggested that high CONUT score was an independent risk factor affecting postoperative comorbidities (odds ratio, 1.792; 95% confidence interval [CI], 1.113-2.886;P = 0.016).Patients with low-CONUT score had longer disease-free survival (DFS) (P < 0.001) and overall survival (OS) (P < 0.001) compared to those with high-CONUT score, especially at the early stage.CONUT score was an independent factor affecting both DFS (hazard ratio [HR], 1.820; 95% CI, 1.204-2.752;P = 0.005) and OS (HR, 1.815; 95% CI, 1.180-2.792;P = 0.007).The area under the curve of CONUT score was higher than for other immune-nutritional indicators.The CONUT-based nomograms had good predictive capability.Conclusions: CONUT score is a strong independent predictor of postoperative comorbidities and long-term outcomes in CRC patients, and might be a better prognostic factor than other immune-nutritional indicators.The CONUT-based nomograms are conducive to the individualized formulation of follow-up strategies and treatment plans.