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Prognostic significance of the controlling nutritional status (CONUT) score in epithelial ovarian cancer
  1. Yong Li1,
  2. Can Zhang1,
  3. Rui Ji1,
  4. Hong Lu1,
  5. Weiling Zhang1,
  6. Ling-Ling Li1,
  7. Rong Liu1,
  8. Hongyan Qian2 and
  9. Aiqin He1
  1. 1 Department of Gynecological Oncology, Tumor Hospital Affiliated to Nantong University, Nantong, Jiangsu, China
  2. 2 Cancer Research Center Nantong, Tumor Hospital Affiliated to Nantong University, Nantong, Jiangsu, China
  1. Correspondence to Dr Aiqin He; HAQ0118{at}; Dr Hongyan Qian; qhy672041647{at}


Purpose The controlling nutritional status (CONUT) score is a nutritional indicator that serves as a prognostic factor for many malignancies. This study aimed to investigate the prognostic significance of pre-treatment CONUT scores in patients with epithelial ovarian cancer.

Methods We evaluated newly diagnosed patients with epithelial ovarian cancer who were treated at the Nantong Tumor Hospital, between January 2013 and April 2016. Pre-treatment CONUT scores were calculated using serum albumin levels, total lymphocyte counts, and cholesterol levels. The optimal CONUT score cut-off was determined via receiver operating characteristic curve and Youden’s index. The difference in survival rates between the high-CONUT score group and the low-CONUT score group was analyzed using Kaplan-Meier curves and the log-rank test. Univariate and multivariate Cox proportional hazard regression models were used to identify prognostic factors influencing survival in these patients.

Results In total, 206 patients were included. The optimal cut-off value for the CONUT score was 3. The high-CONUT score group (score ≥3) had higher International Federation of Gynecology and Obstetrics (FIGO) stages, medium-large amounts of ascitic fluid, higher CA125 levels, and more chemoresistance than those with a low-CONUT score (score <3). The low-CONUT score group had longer median overall survival (64.8 vs 32.3 months, respectively; p<0.001) and longer median progression-free survival (32.3 vs 18.8 months, respectively; p=0.002) than those in the high-CONUT score group. Multivariate analysis showed that the CONUT score was an independent prognostic factor for overall survival.

Conclusions The CONUT score predicts the prognosis of epithelial ovarian cancer and is thus helpful for individualizing treatment and improving survival in these patients.

  • ovarian neoplasms

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  • YL and CZ contributed equally.

  • Correction notice Since this article was first published online, Nantong Tumor University has been updated to Tumor Hospital Affifiliated to Nantong University.

  • Contributors YL and CZ contributed equally to this work, designed the study, developed the methodology, collected the data, performed the analysis, and wrote the manuscript in consultation with RJ, HL, WZ, L-LL and RL.

  • Funding Nantong government provided financial support in the form of the project in Nantong Health and Family Planning Commission of Jiangsu (WKZL2018088). Nantong Tumor Hospital provided financial support in the form of the project in Nantong University (2019LY032).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Ethics Committee of the Nantong Tumor Hospital (2019-A004) and was conducted in accordance with relevant guidelines and regulations.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available.