Preoperative CONUT score predicts postoperative complications in stage I-III gastric cancer patients undergoing curative gastric resections.

Abstract

Objective: The controlling nutritional status (CONUT) score, calculated using serum albumin, total cholesterol, and lymphocyte count, is an effective predictor of post-operative complications (PC) following oncologic resections in gastrointestinal system cancers. This retrospective study aimed to investigate the impact of pre-operative CONUT scores on overall post-operative complications (OPC) in patients with stage I-III gastric cancer (GC) who underwent gastrectomy.

Material and methods: Patients who underwent curative gastric resection for GC between January 2013 and December 2024 were retrospectively analyzed. Patients with a preoperative CONUT score of 0-1 were classified as the normal CONUT group. In contrast, those with a score of 2 or higher were classified as the high CONUT group. Preoperative, intraoperative, and postoperative data were reviewed. Risk factors for the development of OPC were evaluated using univariate and multivariate analyses.

Results: In the high CONUT group, American Society of Anesthesiologists scores, neutrophil/lymphocyte ratio, lymphatic invasion rates, TNM stages, duration of intensive care unit stay, OPC rates, and comprehensive complication index values were significantly higher (p<0.05). Multivariate analysis revealed that advanced TNM stage [odds ratio (OR): 5.8, 95% confidence interval (CI): 1.4-24.6, p=0.016] and a high CONUT score (OR: 4.1, 95% CI: 1.3-13.0, p=0.014) were independent risk factors for the development of PC.

Conclusion: Pre-operative CONUT score may serve as a predictor of OPC following curative GC resections.