Preoperative controlling nutritional status on the prognosis of postoperative gastric cancer patients： a Meta-analysis

Objective To evaluate the prognostic value of controlling nutritional status score (CONUT) in patients undergoing gastrectomy for gastric cancer. Methods CNKI, Wanfang, China Biomedical Literature Library, VIP, PubMed, Web of Science, Cochrane Library, and Embase databases were electronically searched for collecting relevant studies on the application of preoperative CONUT scores to the prognosis of gastric cancer patients after surgery. The search period was from database establishment to April 20, 2023. After screening literature, extracting data, and assessing quality assessment, Meta-analysis was performed using the RevMan 5.3 and Stata 15.0 software. Results A total of 17 studies involving 9 233 patients were included. The results of Meta-analysis showed that, compared with the low CONUT group, patients in the high CONUT group had poorer overall survival ［HR=1.70, 95%CI(1.54,1.87), P＜0.01］, tumor specific survival ［HR=2.55, 95%CI (1.23,5.27), P=0.01］, and progression free survival ［HR=1.53, 95%CI(1.29,1.82), P＜0.01］. The CONUT score was significantly correlated with complications ［OR=2.10, 95%CI (1.53,2.90), P＜0.01］, nerve infiltration ［OR=1.54, 95%CI(1.02,2.32), P=0.04］, mortality ［OR=2.24, 95%CI (1.25,4.01), P＜0.01］, T3/4 ［OR=2.06, 95%CI (1.73,2.46), P＜0.01］, N2/3 ［OR=1.76, 95%CI (1.51,2.05), P＜0.01］, Stage Ⅲ ［OR=1.62, 95%CI (1.39,1.90), P＜0.01］, but not with tumor differentiation ［OR=0.88, 95%CI (0.75,1.04), P=0.13］. Conclusion Preoperative CONUT score is an independent prognostic indicator of gastric cancer patiem associated with clinicopathological parameters of gastric cancer.