Can a blood-test score help predict survival after head and neck cancer surgery?

Details

This study evaluated whether the preoperative Controlling Nutritional Status (CONUT) score could help predict prognosis in head and neck squamous cell carcinoma (HNSCC).

Researchers retrospectively analyzed patients with HNSCC who underwent radical surgery between 2008 and 2017. Patients were randomly divided into training and validation cohorts in a 3:1 ratio. The study included 636 patients: 477 in the training cohort and 159 in the validation cohort.

The CONUT score was based on serum albumin, total cholesterol, and lymphocyte count measured within 1 week before surgery. Univariate and multivariate Cox regression identified variables related to survival. These variables formed the basis of predictive models developed in the training cohort and tested in the validation cohort.

A CONUT cutoff value of 2 separated patients into two prognostic groups with significant survival differences in both cohorts. In multivariate Cox models, a high CONUT score was an independent predictor of poorer overall survival (OS) and cancer-specific survival (CSS) in both the training and validation cohorts.

The CONUT score-based nomograms—prediction tools combining prognostic information—accurately predicted OS, with concordance indices of 0.778 in the training cohort and 0.709 in the validation cohort. For CSS, the concordance indices were 0.830 in the training cohort and 0.778 in the validation cohort.

The researchers concluded that the preoperative CONUT score is a useful prognostic marker for surgically treated HNSCC, enhancing nomogram-based risk models to identify high-risk patients and help guide treatment decisions.