Using the Controlling Nutritional Status (CONUT) Score for Evaluating Patients with Early-Stage Hepatocellular Carcinoma After Radiofrequency Ablation: A Two-Center Retrospective Study

Purpose: To estimate the prognostic significance of the controlling nutritional status (CONUT) in patients with BCLC stage A hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA). Materials and Methods: From January 2013 to December 2016, 325 patients with BCLC stage A HCC who underwent RFA at the National Cancer Center and First Hospital of Shanxi Medical University were retrospectively studied. The patients were divided into low (≤ 4) and high (≥ 5) CONUT scores for assessment of overall survival (OS) and recurrence-free survival (RFS). Several covariates, including age, sex, the diameter and number of lesions, lesion differentiation, Child–Pugh class, hepatitis B virus infection, along with blood levels of AFP, AST, ALT, γ-GT, and TBIL, were assessed using univariate and multivariate analyses. Results: The mortality rate was 17.49% (46/263) and 35.48% (22/62) in the low and high CONUT groups, respectively, with the difference being statistically significant (P = 0.033). In addition, disease recurrence was significantly higher in the high CONUT group at 70.97%, as compared to the low CONUT group at 43.35% (P = 0.041). The predictive factors were used to build the nomogram to estimate 1-, 3- and 5-year OS and RFS rates. Conclusions: CONUT scores were found to be associated with the prognosis of patients with early-stage HCC who underwent RFA. Higher CONUT scores were associated with poor survival outcomes.