Prognostic impact of the Controlling Nutritional Status score following curative nephrectomy for patients with renal cell carcinoma

We aimed to evaluate the prognostic significance of the preoperative Controlling Nutritional Status (CONUT) score in patients with renal cell carcinoma (RCC), and then compared its accuracy of the prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) as predictors of survival. We included 635 patients who underwent nephrectomy for RCC from January 2004 to July 2014. The X-tile program was used to determine the optimal cut-off values for CONUT score, PNI, NLR, and PLR. The median follow-up duration after surgery was 48.40 (29.30–80.10) months. The optimal cutoff values were 2 for CONUT score, 48 for PNI, 3.5 for NLR and 204.7 for PLR by X-tile program with cancer-specific survival (CSS) as end-point. Higher CONUT score, NLR and PLR, and lower PNI were statistically associated with worse OS and CSS in the univariate analysis. Multivariate analysis showed that higher CONUT score was an independent predictor for OS (HR = 3.012; 95% CI, 1.525–5.948; P = .001) and CSS (HR = 3.001; 95% CI, 1.290–6.984; P = .011), and CONUT score was superior to PNI, NLR, and PLR according to the HR. Therefore, preoperative CONUT score can be a strong independent predictor in RCC patients after nephrectomy.