Preoperative controlling nutritional status as an optimal prognostic nutritional index to predict the outcome for colorectal cancer

Table 1 Definition of the controlling nutritional status

	CONUT
	Low		High
Serum albumin (g/dL)	3.5-4.5	3.0-3.49	2.5-2.99	< 2.5
ALB score	1	2	4	6
Total lymphocyte (count/mm3)	≥ 1600	1200-1599	800-1199	< 800
TLC score	0	1	2	3
Total cholesterol (mg/dL)	> 180	140-180	100-139	< 100
T-cho score	0	1	2	3
CONUT total score	0-1	2-4	5-8	9-12
Assessment	Normal	Light	Moderate	Severe

CONUT: Controlling nutritional status; ALB: Albumin; TLC: Total lymphocyte count; T-cho: Total cholesterol.

Table 2 Clinicopathological characteristics of 217 patients with colorectal cancer after surgery

Variable	All (217)	The CONUT score		P value
		CONUT low (189)	CONUT high (28)
Age (yr)	58.4 ± 12.7	58.4 ± 12.4	58.9 ± 15.1	0.842
Male sex, n (%)	125 (57.6)	113 (59.8)	12 (42.9)	0.091
BMI (kg/m2)	22.9 ± 3.2	23.1 ± 3.1	21.5 ± 3.9	0.015
Tumor site, n (%)				0.787
Colon	122 (56.2)	105 (55.6)	17 (60.7)
Rectum	95 (43.8)	84 (44.4)	11 (39.3)
Comorbidities, yes, n (%)	69(31.8)	60(31.7)	9(32.1)	0.966
Sarcopenia, yes, n (%)	49 (22.6)	32 (16.9)	17 (60.7)	< 0.01
WBC (× 109/L)	5.84 ± 1.92	5.92 ± 1.92	5.27 ± 1.86	0.093
Platelet (× 109/L)	218 ± 85	222 ± 89	191 ± 46	0.068
Hemoglobin (g/L)	122.5 ± 24.6	125.6 ± 23.2	101.6 ± 24.1	< 0.01
Albumin (g/L)	41.3 ± 4.4	42.1 ± 3.7	35.7 ± 4.5	< 0.01
Lymphocyte (× 109/L)	1.6 ± 0.7	1.7 ± 0.6	0.9 ± 0.3	< 0.01
Cholesterol (mg/dL)	166.6 ± 41.5	173.0 ± 39.2	123.7 ± 30.0	< 0.01
CRP (mg/L)	8.9 ± 20.3	7.5 ± 19.7	18.5 ± 21.9	0.007
CEA (ng/ml)	5.9 ± 10.1	5.9 ± 10.5	6.6 ± 7.1	0.706
CA199 (U/ml)	25.5 ± 55.4	25.7 ± 56.8	24.5 ± 45.6	0.920
Postoperative complications, yes, n (%)	34 (15.7)	26 (13.8)	8 (28.6)	0.044
TNM stage, n (%)				0.044
Ⅰ	36 (6.6)	35 (18.5)	1 (3.6)
Ⅱ	91 (1.9)	74 (39.2)	17 (60.7)
Ⅲ	90 (41.5)	80 (42.3)	10 (35.7)

CONUT: Controlling nutritional status; BMI: Body mass index; WBC: White blood cell; CEA: Carcinoembryonic antigen; CA199: Carbohydrate antigen199; CRP: C-reactive protein.

Table 3 Uni- and multi-variate analyses of factors associated with 3-year overall survival in patients with colorectal cancer

Variable		Univariate analysis			Multivariate analysis
		HR	95%CI	P value	HR	95%CI	P value
Age (yr)	≥ 65/< 65	1.815	0.738-4.468	0.194
Sex	Female/male	1.577	0.641-3.881	0.321
BMI (kg/m2)	≥ 24/ < 24	0.202	0.047-0.873	0.032	0.506	0.103-2.474	0.400
Tumor site	Colon/rectum	0.931	0.374-2.314	0.877
Comorbidities	Yes/no	2.557	0.745-8.777	0.136
Sarcopenia	Yes/no	8.012	3.151-20.372	< 0.01	3.640	1.182-11.207	0.024
WBC (× 109/L)	≥ 10/< 10	1.228	0.164-9.202	0.841
Platelet (× 109/L)	≥ 300/< 300	0.798	0.184-3.454	0.763
Hemoglobin (g/L)	≥ 90/< 90	0.367	0.132-1.019	0.054	0.696	0.234-2.071	0.515
CRP (mg/L)	> 10/≤ 10	1.647	0.381-7.130	0.504
CEA (ng/mL)	≥ 3.4/< 3.4	2.319	0.881-6.101	0.088	1.970	0.708-5.480	0.194
CA199 (U/mL)	≥ 37/< 37	1.903	0.254-14.257	0.531
Postoperative complications	Yes/no	1.028	0.300-3.529	0.965
TNM stage	Ⅲ/Ⅰ,Ⅱ	4.167	1.501-11.571	0.006	4.396	1.534-12.598	0.006
CONUT score	≥ 5/≤ 4	5.939	2.386-14.785	< 0.01	3.920	1.330-11.547	0.013

95%CI: 95% confidence interval; HR: Hazard ratio; BMI: Body mass index; WBC: White blood cell; CEA: Carcinoembryonic antigen; CA199: Carbohydrate antigen 199; CONUT: Controlling nutritional status; CRP: C-reactive protein.

Table 4 Uni- and multi-variate analyses of factors associated with 3-year replase-free survival rates in patients with colorectal cancer

Variable		Univariate analysis			Multivariate analysis
		HR	95%CI	P value	HR	95%CI	P value
Age (yr)	≥ 65/< 65	1.625	0.781-3.380	0.194
Sex	Female/male	1.503	0.724-3.118	0.274
BMI (kg/m2)	≥ 24/ < 24	0.354	0.135-0.928	0.035	0.792	0.269-2.337	0.673
Tumor site	Colon/rectum	0.986	0.469-2.074	0.970
Comorbidities	Yes/no	1.462	0.624-3.428	0.382
Sarcopenia	Yes/no	6.795	3.240-14.250	< 0.01	4.122	1.678-10.125	0.002
WBC (× 109/L)	≥ 10/< 10	1.728	0.410-7.283	0.490
Platelet (× 109/L)	≥ 300/< 300	1.294	0.392-4.276	0.673
Hemoglobin (g/L)	≥ 90/< 90	0.492	0.199-1.214	0.124
CRP (mg/L)	> 10/≤ 10	1.625	0.491-5.382	0.427
CEA (ng/mL)	≥ 3.4/< 3.4	2.356	1.072-5.177	0.033	2.220	0.989-4.984	0.053
CA199 (U/mL)	≥ 37/< 37	1.483	0.352-6.243	0.591
Postoperative complications	Yes/no	1.028	0.300-3.529	0.965
TNM stage	Ⅲ/Ⅰ,Ⅱ	3.477	1.581-7.650	0.002	3.603	1.612-8.053	0.002
CONUT score	≥ 5/≤ 4	4.724	2.177-10.254	< 0.01	2.992	1.241-7.212	0.015

95%CI: 95% confidence interval; HR: Hazard ratio; BMI: Body mass index; WBC: White blood cell; CEA: Carcinoembryonic antigen; CA199: Carbohydrate antigen 199; CONUT: Controlling nutritional status; CRP: C-reactive protein.