Mijin Kim, Hee Kyung Kim, Chae A Kim, Meihua Jin, Min Ji Jeon, Ho-Cheol Kang, Dong Jun Lim, Eun Sook Kim, Byeong-Cheol Ahn, Won Gu Kim, Bo Hyun Kim
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引用次数: 0
Abstract
Purpose: Medullary thyroid cancer (MTC) is aggressive in nature compared with differentiated thyroid cancer, with a poor 10-year overall survival rate. Given the effect of the immune-inflammatory system on the survival of patients with cancer, the aim of this study was to investigate the prognostic significance of the preoperative Controlling Nutritional Status (CONUT) score in patients with MTC.
Methods: This multicenter, retrospective study included 221 patients with MTC who underwent thyroidectomy at four tertiary hospitals. The CONUT score was calculated for all patients using preoperative serum albumin and total cholesterol concentrations and lymphocyte counts. Patients were stratified into high and low CONUT score groups based on a cut-off score of 2.
Results: Overall, 164 (74%) and 57 (26%) patients were categorized into low and high CONUT score groups, respectively. There were no significant differences in the clinicopathological characteristics, including age, sex, primary tumor size, preoperative levels of calcitonin and carcinoembryonic antigen, and neck lymph node and distant metastasis between the two groups. The 10-year disease-specific survival rate in the high CONUT score group was significantly shorter than that in the low CONUT score group (85.7% vs. 97.3%; p < 0.001). Multivariate analysis revealed that a high CONUT score was an independent prognostic factor for disease-specific survival (p = 0.008).
Conclusion: The preoperative CONUT score appears to be an independent prognostic indicator in patients with surgically treated MTC, with a high score indicating a poorer prognosis. Our findings underscore the importance of preoperative nutritional and immunological assessments in MTC management.
目的：甲状腺髓样癌（MTC）与分化型甲状腺癌相比具有侵袭性，其10年总生存率较低。鉴于免疫炎症系统对癌症患者生存的影响，本研究的目的是探讨术前控制营养状态（CONUT）评分在MTC患者中的预后意义。方法：这项多中心、回顾性研究包括在四所三级医院行甲状腺切除术的221例MTC患者。使用术前血清白蛋白、总胆固醇浓度和淋巴细胞计数计算所有患者的CONUT评分。将患者分为CONUT评分高组和低组，分值为2分。结果：总体而言，164例（74%）和57例（26%）患者分别被分为低和高CONUT评分组。两组患者的年龄、性别、原发肿瘤大小、术前降钙素、癌胚抗原水平、颈部淋巴结及远处转移等临床病理特征均无显著差异。CONUT评分高组的10年疾病特异性生存率显著短于CONUT评分低组(85.7% vs 97.3%；结论：术前CONUT评分似乎是手术治疗MTC患者的独立预后指标，评分越高预后越差。我们的研究结果强调了术前营养和免疫评估在MTC治疗中的重要性。
期刊介绍：
Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology.
Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted.
Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
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