Good nutrition was found to be a prognostic factor for patients with malignant pleural mesothelioma (MPM). Determining the controlling nutritional status (CONUT) score as a measure of nutrition could help predict and improve MPM patients’ treatment response.
While nutritional status has been shown to be associated with prognosis in patients with gastric, intestinal, and lung cancer, less was known about its association with the prognosis of MPM patients.
CONUT is a new screening tool for early detection of poor nutrition, and consists of evaluating total albumin and cholesterol levels and lymphocyte counts. This nutritional index gives a realistic view not only of the biochemical status of a patient, but also of the immunological response possibilies. CONUT was previously reported to be an independent prognostic factor for gastric and intestinal cancer patients.
Researchers evaluated the CONUT index of 83 patients diagnosed with MPM during a 10-year period at the Kyushu Cancer Center in Fukuoka, Japan. The patients had a median age of 59, and 79.5 percent were male.
The authors found that nearly 63 percent of the patients had a low CONUT score, indicative of normal nutritional status. This group of patients had a better overall survival and progression-free survival rates than those with a high CONUT score. This was independent of whether patients had received surgical treatment or chemotherapy alone.
“CONUT score was useful for predicting the prognosis independently from the treatment modality,” the researchers wrote.
Clinical stage and the CONUT score were found to be independent predictive factors for overall survival and disease-free progression in MPM patients. High CONUT score and clinical stage 3 or 4 were identified as risk factors for MPM patients.
Compared to other prognostic factors, such as PD-L1 or BAP-1 expression, CONUT scores can be easily determined with a blood sample alone, without the need for additional sampling.
“The CONUT score, which is readily available, may be helpful in selecting patients with MPM who will benefit from chemotherapy or multidisciplinary therapy,” the team wrote.