Prognostic Effect of Preoperative Controlling Nutritional Status Score in Patients with Locally Advanced Rectal Cancer: A Two-Center, Retrospective Study

ThisstudyaimedtoidentifytheprognosisrelevanttotheControllingNutritionalStatus(CONUT) scoreinlocallyadvancedrectalcancerpatientswhoweretreatedwithneoadjuvantchemoradiotherapybeforeradicalsurgery. Methods: Fromaretrospectivedatabaseof568patientsundergoingradicalsurgeryforrectalcancerattwoChineseinstitutionsbetween2012and2022, datafor300patientswithlocallyadvancedrectalcancerwereidentified. TheoptimalcutoffvaluefortheCONUTscoreinpredictingoverallsurvival(OS) wasdeterminedusingXtilesoftware. TheassociationsoftheCONUTscorewiththerecurrentmetastasisandclinicopathologicparameterswereanalyzed. TheCONUTscore'sabilitytopredictOSwasalsocomparedwithotherprognosticmarkers. UnivariateandmultivariateCoxregressionanalysisforOSwasperformed. SubgroupanalysiswasconductedtoevaluatefurthertheCONUTscore'spredictingvalue. Results: TheoptimalCONUTscorecutoffvaluewasdeterminedas5accordingtoX-tile. PatientsweredividedintoCONUThigh(CONUTscore < 5) andCONUT-low(CONUTscore< 5) groups. CONUTscoreissignificantlycorrelatedwithhemoglobin, globulin, andplatelets. Time-dependentreceiveroperatingcharacteristicoftheCONUTscorepredictingOSoutperformedallcommonprognosticmarkers. MultivariateCoxregressionanalysisidentifiedCONUTscoreasanindependentprognosticfactorforOS(hazardratio= 5.701; 95% CI, 2.336-13.914; P< 0.001). Inthesubgroupsofage, sex, carcinoembryonicantigen, ypTNM, andtumorresponsestatus, significantstatisticaldifferencescanbeobservedbetweenCONUT-highand-low. . Conclusions: ThepresentstudyfindsthatthepreoperativeCONUTscoremaybeausefulprognosticindicatorinclinicalscenarios.