Evaluation of Preoperative Nutritional and Immune Status Score for Predicting Individual Recurrence Risk Factors in Cervical Cancer

Abstract

Background: Nutritional and immune statuses are emerging as important predictors of cancer outcomes, particularly in cervical cancer, where recurrence risk stratification remains crucial. The Controlling Nutritional Status (CONUT) score integrates serum albumin, total cholesterol, and lymphocyte count to assess nutritional-immune function, potentially aiding prognostication. This study aimed to evaluate the association between preoperative CONUT score and individual recurrence risk factors in patients with early-stage cervical cancer undergoing primary surgery.

Methods: This cross-sectional observational study was conducted at the Department of Gynaecological Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from July 2022 to June 2023. A total of 116 patients with histologically confirmed early-stage cervical cancer who underwent radical hysterectomy with pelvic lymphadenectomy were enrolled. Preoperative laboratory data were used to calculate CONUT scores, which were then analyzed in relation to histopathological recurrence risk factors, including lymphovascular space invasion (LVSI), lymph node metastasis, parametrial invasion, and positive resection margins. Statistical significance was assessed using the chi-square test and relative risk analyses.

Results: Among participants, 44.8% had high CONUT scores (≥3). These patients showed higher, but not statistically significant, frequencies of LVSI, lymph node metastasis, and positive margins. However, the overall presence of recurrence risk factors was significantly higher in the high CONUT group (65.0% vs. 35.0%, p = 0.046), with a relative risk of 2.7 (95% CI: 0.9–7.4).

Conclusion: A high preoperative CONUT score is associated with an increased likelihood of recurrence, suggesting its potential utility in pre-surgical risk assessment.