Controlling nutritional status score as a survival prognosticator in patients with head and neck cancer

This study aimed to evaluate the prognostic significance of the preoperative Controlling Nutritional Status (CONUT) score in head and neck squamous cell carcinoma (HNSCC).

Patients with HNSCC who underwent radical surgery between 2008 and 2017 were retrospectively analyzed and randomly divided into training and validation cohorts by 3:1 ratio. The CONUT score, based on serum albumin, total cholesterol, and lymphocyte count measured within 1 week before surgery, was used. Univariate and multivariate Cox regression identified survival-related variables, forming the basis for predictive models developed in the training cohort and validated in the validation cohort.

A total of 636 patients were enrolled in this study, including 477 patients in the training cohort and 159 patients in validation cohort. A CONUT cutoff value of 2 effectively stratified patients into two distinct prognostic groups with significant survival differences in both the training and validation cohorts. In the multivariate Cox model, a high CONUT score emerged as an independent negative prognosticator of overall survival (OS) and cancer specific survival (CSS) in both training and validation cohorts. The CONUT score-based nomograms accurately predicted OS (concordance index: 0.778 in training cohort and 0.709 in validation cohort) and CSS (concordance index: 0.830 in training cohort and 0.778 in validation cohort).

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