Preoperative controlling nutritional status (CONUT) score as a novel immune-nutritional predictor of survival in non-metastatic clear cell renal cell carcinoma of 7cm on preoperative imaging

PurposeThis study aimed at investigating the prognostic value of Preoperative controlling nutritional status (CONUT) score in non-metastatic clear-cell renal cell carcinoma of 7cm on preoperative imaging.MethodsWe retrospectively included 1046 among 1637 patients who underwent radical or partial nephrectomy for solid renal masses 7cm (2005-2014) after excluding other pathology, conditions affecting CONUT score components, metastasis, regional lymphadenopathy, positive margin, and follow-up <12 months. We defined high and low CONUT according to cut-off of (2). Multivariate Cox-regression analysis was used to predict factors affecting recurrence and survival. Kaplan-Meier curve was used for survival analysis.ResultsThe median age and follow-up were 56years and 63 months, respectively. 41 patients had recurrence (3.9%). CONUT was a predictor for recurrence-free, cancer-specific, and overall survival (HR 3.09, P=0.003 and HR 4.66, P=0.004 and HR 2.81, P=0.003, respectively). A higher CONUT was significantly associated with worse 5years recurrence-free (88.2% vs. 97.1%), cancer-specific (96.2% vs. 98.8%) and overall (90.9% vs. 96.5%) survival (log-rank, P=<0.001, P=0.006 and P=<0.001, respectively).ConclusionsThe preoperative CONUT is an independent prognostic marker for survival after curative surgery for non-metastatic clear-cell renal cell carcinoma of 7cm on preoperative imaging.