The prognostic role of Controlling Nutritional Status (CONUT) scores in patients with gastrointestinal stromal tumors

Abstract Background: The Controlling Nutritional Status (CONUT) score is associated with the postoperative outcomes in various types of tumors. The relationship between the CONUT score and prognosis in patients with gastrointestinal stromal tumors (GISTs) needs to be clarified. Methods: Patients with completely resected primary GISTs in the absence of imatinib adjuvant therapy were included. Recurrence-free survival (RFS) was estimated with the Kaplan-Meier method and compared using log-rank test. Prognostic factors were compared using a Cox proportional hazards model. Results: A total of 455 patients were included. The median age was 57 years and 222 (48.8%) patients were male. The most common location was stomach (n= 219, 48.1%), the median tumor size was 4.5 cm (range 0.4-40.0) and the median mitotic index was 2/50 HPFs (range 0-200). Recurrence/metastasis developed in 92 (20.2%) patients. Patients were assigned to three groups: 219 (48.1%) were in normal nutrition group (CONUT=0-1), 196 (43.1%) were in light undernutrition group (CONUT=2-4) and 40 (8.8%) were in moderate-severe undernutrition group (CONUT≥5). Primary tumor site, tumor size, mitotic index, tumor rupture and CONUT score were independent prognostic factors for RFS using multivariate analysis (p<0.05). Conclusions: The CONUT score was an independent prognostic factor for patients with completely resected GIST.