Prognostic value of combined tumor marker and controlling nutritional status (CONUT) score in colorectal cancer patients

Background Nutritional status is strongly associated with prognosis in cancer patients. Controlling Nutritional Status (CONUT) score is a nutritional marker based on serum albumin, cholesterol, and total lymphocyte count. We investigated the prognostic significance of a combination of the tumor marker carcinoembryonic antigen (CEA) and CONUT score (T-CONUT) in colorectal cancer (CRC) patients. Methods A total of 522 patients who underwent surgery for CRC at our hospital were retrospectively enrolled in this study. Results Patients were divided into groups based on the results of receiver operating characteristic (ROC) curve analysis as follows: CONUT^high (CONUT score ≥ 3) and CONUT^low (CONUT score < 3), and CEA^low (< 5 ng/mL) and CEA^high (≥ 5 ng/mL). The 5-year overall survival (OS) rates of patients in the CONUT^low and CONUT^high groups were 76.0% and 53.9%, respectively (P < 0.0001), and in the CEA^low and CEA^high groups were 80.7% and 47.6%, respectively (P < 0.0001). Regarding T-CONUT, the 5-year OS rates of patients with CEA^low/CONUT^low, CEA^low/CONUT^high, CEA^high/CONUT^low, and CEA^high/ CONUT^high were 84.7%, 69%, 55.3%, and 36.1%, respectively (P < 0.0001). Multivariate analysis identified T-CONUT score as an independent prognostic indicator in CRC patients. Conclusion T-CONUT may be a useful tool for predicting prognosis in CRC patients.