In patients with a resected gastrointestinal stromal tumor (GIST), an elevated preoperative controlling nutritional status (CONUT) score has been shown to be a predictor of recurrence, researchers reported in the Journal of Surgical Oncology.

Patients with localized primary GISTs who were treated at the First Affiliated Hospital, Zhejiang University School of Medicine, in Hangzhou, Zhejiang, China, between January 2000 and December 2013 were enrolled in the study. A GIST diagnosis was based on a combination of histopathologic assessment and positive immunohistochemical staining for CD117 and DOG1 antibodies.

Study inclusion criteria were being aged 18 to 80 years, Eastern Cooperative Oncology Group performance status score of 0 to 2, and completely resected GIST. Preoperative CONUT scores were calculated according to peripheral lymphocyte counts, serum albumin concentrations, and total cholesterol concentrations.

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It is well known that recurrence/metastasis is common even following complete surgical resection in patients with GIST, with the 5-year recurrence-free survival (RFS) rate reported to be approximately 70%. Recognizing that CONUT score is associated with postsurgical outcomes among individuals with a variety of tumor types, the researchers sought to elucidate the prognostic role played by CONUT score in patients with GIST.

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All study participants were followed up every 3 to 6 months for the first 2 years, every 6 to 12 months for the next 3 years, then yearly thereafter.

A total of 455 patients who had not received imatinib adjuvant chemotherapy were enrolled in the study. The median follow-up time was 132.0 months (range, 7.0 to 253.0 months). Overall, 20.2% (92 of 455) of the participants experienced recurrence/metastases.

All participants were assigned to 1 of 3 treatment groups: (1) normal-nutrition group: n=219 (CONUT score of 0 to 1); (2) mild-malnutrition group: n=196 (CONUT score of 2 to 4); or (3) moderate-severe-malnutrition group: n=40 (CONUT score ≥5).

Per multivariate analysis, significant prognostic risk factors for shorter RFS included high CONUT score, nongastric primary tumor site, large tumor size, tumor rupture, and high mitotic index (P <.05 for all).

According to the investigators, “The clinical application of the CONUT score is simple and feasible, and might contribute to the individualized treatment of GIST patients.”


Yang W, Shou C, Yu J,  et al. Elevated preoperative controlling nutritional status (CONUT) scores as a predictor of postoperative recurrence in gastrointestinal stromal tumors. J Surg Oncol. Published online August 1, 2022. doi:10.1002/jso.27042