ABSTRACT
AIM: The aim of our study was to assess the predictive value of controlling nutritional status (CONUT) score for the prognosis of prostate cancer. METHODS: A total of 257 patients' characteristics, prostate-specific antigen (PSA) values, biopsy, and pathological specimen features were all recorded. The CONUT score was calculated for each patient from three blood parameters: total lymphocyte count (TLC), serum albumin, and cholesterol concentrations. Spearman's correlation coefficient was used to assess the correlation between the total CONUT score and the variables including age, body mass index, prostate volume, PSA, biopsy and pathological specimen features, and PSA-recurrence free survival (PSA-RFS) time. The Kaplan-Meier method and log-rank test were used for PSA-RFS analysis. Regression analyses were performed to assess the association between clinicopathological factors, the International Society of Urological Pathology (ISUP) upgrading, and biochemical recurrence (BCR). RESULTS: Statistically significant differences were determined in pathologic ISUP grade, and total tumor volume between low and high CONUT score groups. Additionally, the high CONUT score group had a significantly higher BCR rate and lower PSA-RFS when compared with the low CONUT score group. A strong positive correlation between total CONUT score and pathologic ISUP grade and a moderate negative correlation between total CONUT score and PSA-RFS was determined. In multivariate analysis, a total CONUT score ≥2 had a statistically significant association with ISUP upgrading (odds ratio [OR] = 3.05) and BCR (3.52). CONCLUSION: Preoperative CONUT score is an independent predictive factor for ISUP score upgrading and BCR in patients who undergo radical prostatectomy.
ABSTRACT
PURPOSE: Our aim was to investigate the predictive value of Controlling Nutritional Status (CONUT) score and Prognostic Nutritional Index (PNI) for systemic inflammatory response syndrome (SIRS)/sepsis after percutaneous nephrolithotomy (PNL). METHODS: Demographic and clinical data of 422 patients who underwent PNL were evaluated. The CONUT score was calculated from lymphocyte count, serum albumin, and cholesterol, while the PNI was calculated using lymphocyte count and serum albumin. Spearman's correlation coefficient was used to evaluate the relationship between nutritional scores and systemic inflammation markers. Logistic regression analysis was performed to determine the risk factors for SIRS/sepsis development after PNL. RESULTS: Patients with SIRS/sepsis had a significantly higher preoperative CONUT score and lower PNI compared with the SIRS/sepsis (-) group. A positive significant correlation between CONUT score and CRP (rho = 0.75), CONUT score and procalcitonin (rho = 0.36), and CONUT score and WBC (rho = 0.23) were determined. Additionally, a negative significant correlation was shown between PNI and procalcitonin (rho = - 0.30) and PNI and CRP (rho = - 0.64). The ROC curve analysis showed that the cut-off values for the CONUT score and PNI were 4 (AUC = 0.827) and 42 (AUC = 0.734), respectively. Age, stone size, history of pyelonephritis, residual stone, presence of infection stone, CONUT score ≥ 4, and PNI ≤ 42 were found to be independent predictors for postoperative SIRS/sepsis in multivariate analysis. CONCLUSION: Our results demonstrated that preoperative CONUT score and PNI are potential predictive factors for SIRS/sepsis development after PNL. Therefore, patients with CONUT score ≥ 4 and PNI ≤ 42 are suggested to be closely monitoring due to the risk of post-PNL SIRS/sepsis.
