Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?

Background/aim: The aim of the study was to evaluate the effect of Controlling Nutritional Status (CONUT) score on the prognosis in patients with diffuse large B-cell lymphoma (DLBCL). Materials and methods: The present study was a retrospective study. The CONUT score was calculated based on serum albumin, total cholesterol and lymphocyte levels. This study included a total of 266 patients, 131 (49.2%) were female and 135 (50.8%) were male. The median follow-up period was 51 months (range: 1–190). Results: The median age was 64 years. The cut off CONUT was 1.5. There was a significant difference between patients with high (≥ 2) or low (< 2) CONUT scores in terms of overall survival (OS) and progression-free survival (PFS). The 5-year OS and PFS in patients with high CONUT score was 52.1% and 49.7%. The 5-year OS and PFS in patients with low CONUT score was 79.8% and 75.6% (p < 0.001). In the multivariate analysis for OS, age ≥ 65 years (HR = 1.80, p = 0.028), Eastern Cooperative Oncology Group (ECOG) > 1 (HR = 2.04, p = 0.006), stage IIIA–IVB disease (HR = 2.75, p = 0.001) and the CONUT score (HR = 1.15, p = 0.003) were found statistically significant. In the multivariate analysis for PFS, age ≥ 65 years (HR = 2.02, p = 0.007), stage IIIA–IVB disease (HR = 2.42, p = 0.002) and the CONUT score (HR = 1.19, p = 0.001) were found to be significant parameters. Conclusion: High CONUT score reduces OS and PFS in DLBCL. CONUT score is an independent, strong prognostic index in patients with DLBCL. Key words: Lymphoma, Controlling Nutritional Status score, survival, prognosis

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Cioroianu AI, Stinga PI, Sticlaru L, Cioplea MD, Nichita L et al. Tumor microenvironment in diffuse large b-cell lymphoma: role and prognosis. Analytical Cellular Pathology (Amsterdam) 2019; 2019: 8586354. doi: 10.1155/2019/8586354.
2. Luan C, Wang F, Wei N, Chen B. Prognostic nutritional index and the prognosis of diffuse large b-cell lymphoma: a metaanalysis. Cancer Cell Int. 2020; 20: 455. doi:10.1186/s12935- 020-01535-x.
3. Yu W, Guo Q, Wang Z, Mao L, Wei J et al. Clinical significance of prognostic nutritional index for patients with diffuse large b-cell lymphoma. Nutr Cancer. 2019; 71 (4): 569-574. doi: 10.1080/01635581.2018.1540718.
4. Kato T, Yaku H, Morimoto T, Inuzuka Y, Tamaki Y et al. Association with controlling nutritional status (CONUT) score and in-hospital mortality and infection in acute heart failure. Sci Rep. 2020 Feb 24; 10 (1): 3320. doi: 10.1038/s41598-020- 60404-9.
5. Okamoto S, Ureshino H, Kidoguchi K, Kusaba K, Kizuka-Sano H et al. Clinical impact of the CONUT score in patients with multiple myeloma. Ann Hematol. 2020 Jan; 99 (1): 113-119. doi: 10.1007/s00277-019-03844-2.
6. Zhou H, Chao W, Cui L, Li M, Zou Y et al. Controlling nutritional status (CONUT) score as immune-nutritional predictor of outcomes in patients undergoing peritoneal dialysis. Clin Nutr. 2020 Aug; 39 (8): 2564-2570. doi: 10.1016/j. clnu.2019.11.018.
7. Kuroda D, Sawayama H, Kurashige J, Iwatsuki M, Eto T et al. Controlling nutritional status (CONUT) score is a prognostic marker for gastric cancer patients after curative resection. Gastric Cancer. 2018 Mar; 21 (2): 204-212. doi: 10.1007/ s10120-017-0744-3.
8. Ureshino H, Kusaba K, Kidoguchi K, Sano H, Nishioka A et al. Clinical impact of the CONUT score and mogamulizumab in adult t cell leukemia/lymphoma. Ann Hematol. 2019 Feb; 98 (2): 465-471. doi: 10.1007/s00277-018-3502-7.
9. Yamamoto M, Saito H, Uejima C, Tanio A, Tada Y et al. Prognostic value of combined tumor marker and controlling nutritional status (CONUT) score in colorectal cancer patients. Yonago Acta Med. 2019 Mar 28; 62 (1): 124-130. doi:10.33160/ yam.2019.03.017.
10. Kanemasa Y, Shimoyama T, Sasaki Y, Hishima T, Omuro Y. Geriatric nutritional risk index as a prognostic factor in patients with diffuse large b cell lymphoma. Ann Hematol. 2018 Jun; 97 (6): 999-1007. doi: 10.1007/s00277-018-3273-1.
11. Park S, Han B, Cho JW, Woo SY, Kim S et al. Effect of nutritional status on survival outcome of diffuse large b-cell lymphoma patients treated with rituximab-CHOP. Nutr Cancer. 2014; 66 (2): 225-33. doi: 10.1080/01635581.2014.867065.
12. Gooden MJ, de Bock GH, Leffers N, Daemen T, Nijman HW. The prognostic influence of tumour-infiltrating lymphocytes in cancer: a systematic review with meta-analysis. Br J Cancer. 2011 Jun 28; 105 (1): 93-103. doi: 10.1038/bjc.2011.189.
13. Tokunaga R, Sakamoto Y, Nakagawa S, Ohuchi M, Izumi D et al. CONUT: a novel independent predictive score for colorectal cancer patients undergoing potentially curative resection. Int J Colorectal Dis. 2017 Jan; 32 (1): 99-106. doi: 10.1007/s00384- 016-2668-5.
14. Liu X, Zhang D, Lin E, Chen Y, Li W et al. Preoperative controlling nutritional status (CONUT) score as a predictor of long-term outcome after curative resection followed by adjuvant chemotherapy in stage II-III gastric Cancer. BMC Cancer. 2018 Jun 28; 18 (1): 699. doi: 10.1186/s12885-018- 4616-y.
15. Toyokawa T, Kubo N, Tamura T, Sakurai K, Amano R et al. The pretreatment controlling nutritional status (CONUT) score is an independent prognostic factor in patients with resectable thoracic esophageal squamous cell carcinoma: results from a retrospective study. BMC Cancer. 2016 Sep 6; 16 (1): 722. doi: 10.1186/s12885-016-2696-0.
16. Ahiko Y, Shida D, Horie T, Tanabe T, Takamizawa Y et al. Controlling nutritional status (CONUT) score as a preoperative risk assessment index for older patients with colorectal cancer. BMC Cancer. 2019 Nov 6; 19 (1): 946. doi: 10.1186/s12885- 019-6218-8.
17. Harimoto N, Yoshizumi T, Inokuchi S, Itoh S, Adachi E et al. Prognostic significance of preoperative controlling nutritional status (CONUT) score in patients undergoing hepatic resection for hepatocellular carcinoma: a multi-institutional study. Ann Surg Oncol. 2018 Oct; 25 (11): 3316-3323. doi: 10.1245/ s10434-018-6672-6.
18. Miyata T, Yamashita YI, Higashi T, Taki K, Izumi D et al. The prognostic impact of controlling nutritional status (CONUT) in intrahepatic cholangiocarcinoma following curative hepatectomy: a retrospective single institution study. World J Surg. 2018 Apr; 42 (4): 1085-1091. doi: 10.1007/s00268-017- 4214-1.
19. Takamori S, Toyokawa G, Taguchi K, Edagawa M, Shimamatsu S et al. The controlling nutritional status score is a significant independent predictor of poor prognosis in patients with malignant pleural mesothelioma. Clin Lung Cancer. 2017 Jul; 18 (4): e303-e313. doi: 10.1016/j.cllc.2017.01.008.
20. Nagata A, Kanemasa Y, Sasaki Y, Nakamura S, Okuya T et al. Clinical impact of controlling nutritional status score on the prognosis of patients with diffuse large b-cell lymphoma. Hematol Oncol. 2020 Aug; 38 (3): 309-317. doi: 10.1002/ hon.2732.
21. Matsukawa T, Suto K, Kanaya M, Izumiyama K, Minauchi K et al.Validation and comparison of prognostic values of GNRI, PNI, and CONUT in newly diagnosed diffuse large b cell lymphoma. Ann Hematol. 2020 Dec; 99 (12): 2859-2868. doi: 10.1007/s00277-020-04262-5.

APA	Akgun Cagliyan G, Hacioglu S, ÜNVER KOLUMAN B, ilkkilic k, nar r, Baser M, bozdemir a, SENOL H, ŞEN TÜRK N, Erol V, YILDIRIM O, Cagliyan O, Güler N (2021). Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?. , 2112 - 2119. 10.3906/sag-2101-406
Chicago	Akgun Cagliyan Gulsum,Hacioglu Sibel,ÜNVER KOLUMAN BAŞAK,ilkkilic kadir,nar rukiye,Baser Mehmet Nuri,bozdemir aslı,SENOL HANDE,ŞEN TÜRK Nilay,Erol Veysel,YILDIRIM ONURCAN,Cagliyan Omer,Güler Nil Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?. (2021): 2112 - 2119. 10.3906/sag-2101-406
MLA	Akgun Cagliyan Gulsum,Hacioglu Sibel,ÜNVER KOLUMAN BAŞAK,ilkkilic kadir,nar rukiye,Baser Mehmet Nuri,bozdemir aslı,SENOL HANDE,ŞEN TÜRK Nilay,Erol Veysel,YILDIRIM ONURCAN,Cagliyan Omer,Güler Nil Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?. , 2021, ss.2112 - 2119. 10.3906/sag-2101-406
AMA	Akgun Cagliyan G,Hacioglu S,ÜNVER KOLUMAN B,ilkkilic k,nar r,Baser M,bozdemir a,SENOL H,ŞEN TÜRK N,Erol V,YILDIRIM O,Cagliyan O,Güler N Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?. . 2021; 2112 - 2119. 10.3906/sag-2101-406
Vancouver	Akgun Cagliyan G,Hacioglu S,ÜNVER KOLUMAN B,ilkkilic k,nar r,Baser M,bozdemir a,SENOL H,ŞEN TÜRK N,Erol V,YILDIRIM O,Cagliyan O,Güler N Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?. . 2021; 2112 - 2119. 10.3906/sag-2101-406
IEEE	Akgun Cagliyan G,Hacioglu S,ÜNVER KOLUMAN B,ilkkilic k,nar r,Baser M,bozdemir a,SENOL H,ŞEN TÜRK N,Erol V,YILDIRIM O,Cagliyan O,Güler N "Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?." , ss.2112 - 2119, 2021. 10.3906/sag-2101-406
ISNAD	Akgun Cagliyan, Gulsum vd. "Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?". (2021), 2112-2119. https://doi.org/10.3906/sag-2101-406

APA	Akgun Cagliyan G, Hacioglu S, ÜNVER KOLUMAN B, ilkkilic k, nar r, Baser M, bozdemir a, SENOL H, ŞEN TÜRK N, Erol V, YILDIRIM O, Cagliyan O, Güler N (2021). Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?. Turkish Journal of Medical Sciences, 51(4), 2112 - 2119. 10.3906/sag-2101-406
Chicago	Akgun Cagliyan Gulsum,Hacioglu Sibel,ÜNVER KOLUMAN BAŞAK,ilkkilic kadir,nar rukiye,Baser Mehmet Nuri,bozdemir aslı,SENOL HANDE,ŞEN TÜRK Nilay,Erol Veysel,YILDIRIM ONURCAN,Cagliyan Omer,Güler Nil Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?. Turkish Journal of Medical Sciences 51, no.4 (2021): 2112 - 2119. 10.3906/sag-2101-406
MLA	Akgun Cagliyan Gulsum,Hacioglu Sibel,ÜNVER KOLUMAN BAŞAK,ilkkilic kadir,nar rukiye,Baser Mehmet Nuri,bozdemir aslı,SENOL HANDE,ŞEN TÜRK Nilay,Erol Veysel,YILDIRIM ONURCAN,Cagliyan Omer,Güler Nil Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?. Turkish Journal of Medical Sciences, vol.51, no.4, 2021, ss.2112 - 2119. 10.3906/sag-2101-406
AMA	Akgun Cagliyan G,Hacioglu S,ÜNVER KOLUMAN B,ilkkilic k,nar r,Baser M,bozdemir a,SENOL H,ŞEN TÜRK N,Erol V,YILDIRIM O,Cagliyan O,Güler N Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?. Turkish Journal of Medical Sciences. 2021; 51(4): 2112 - 2119. 10.3906/sag-2101-406
Vancouver	Akgun Cagliyan G,Hacioglu S,ÜNVER KOLUMAN B,ilkkilic k,nar r,Baser M,bozdemir a,SENOL H,ŞEN TÜRK N,Erol V,YILDIRIM O,Cagliyan O,Güler N Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?. Turkish Journal of Medical Sciences. 2021; 51(4): 2112 - 2119. 10.3906/sag-2101-406
IEEE	Akgun Cagliyan G,Hacioglu S,ÜNVER KOLUMAN B,ilkkilic k,nar r,Baser M,bozdemir a,SENOL H,ŞEN TÜRK N,Erol V,YILDIRIM O,Cagliyan O,Güler N "Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?." Turkish Journal of Medical Sciences, 51, ss.2112 - 2119, 2021. 10.3906/sag-2101-406
ISNAD	Akgun Cagliyan, Gulsum vd. "Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?". Turkish Journal of Medical Sciences 51/4 (2021), 2112-2119. https://doi.org/10.3906/sag-2101-406