Prognostic Utility of Controlling Nutritional Status Score in Patients With Oral Cavity Cancer

We evaluated the preoperative Controlling Nutritional Status (CONUT) score-comprising serum albumin, total cholesterol levels, and lymphocyte counts-as a prognostic marker in oral cavity squamous cell carcinoma (OCSCC).

The research involved 352 patients with OCSCC who underwent primary surgical treatment at Chang Gung Memorial Hospital between January 2009 and December 2018. Patients were categorized based on their nutritional risk as determined by the CONUT score: 259 patients (73.6%) had a CONUT score of 0-1 (indicating normal nutrition), while 93 patients (26.4%) had a CONUT score of ≥ 2 (indicating varying degrees of undernutrition). We examined the relationships between the CONUT score, clinicopathological characteristics, and survival outcomes.

Higher CONUT scores (≥ 2) were significantly associated with poorer 5-year overall survival (OS) and disease-free survival (DFS) (both p < 0.001). Multivariable analysis identified a CONUT score of ≥ 2 as an independent adverse prognostic factor for both OS and DFS, with hazard ratios of 1.963 and 2.026, respectively. The CONUT score remained a significant predictor of OS in subgroup analyses, and a nomogram incorporating the CONUT score provided reliable OS predictions, with a concordance index of 0.772.

The preoperative CONUT score holds potential as a prognostic marker for patients with OCSCC undergoing surgery. The CONUT score-based nomogram could serve as a valuable tool for predicting survival outcomes in OCSCC management.

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