Background/Objectives: Anaplastic thyroid cancer (ATC) is an aggressive thyroid cancer subtype with a poor prognosis. The Controlling Nutritional Status (CONUT) score, reflecting both immune and nutritional status, is a prognostic marker in several malignancies; however, its utility in ATC has not been established. We aimed to evaluate the predictive value of the pretreatment CONUT score in ATC and compare its prognostic utility with that of other nutritional indices, including the Prognostic Nutritional Index (PNI) and Geriatric Nutritional Risk Index (GNRI).Methods: We retrospectively reviewed clinical characteristics, laboratory parameters, and survival outcomes of 156 patients with ATC at our institution between January 2004 and May 2024. Based on survival analysis, patients were categorized into low- and high-risk groups based on each nutritional index (CONUT score, PNI, GNRI) using optimal cut-off values. One-year survival differences were evaluated using Kaplan–Meier curves and log-rank test. Independent predictors of 1-year mortality were identified using multivariable Cox proportional hazards regression.Results: Optimal thresholds were 3, 42, and 102 for the CONUT score, PNI, and GNRI, respectively. Patients with CONUT scores ≥ 3 exhibited significantly higher 1-year mortality, compared with those with scores < 3. Multivariable analysis revealed that CONUT score ≥ 3, PNI ≤ 42, and GNRI ≤ 102 were independently associated with increased 1-year mortality risk. Incorporation of CONUT score ≥ 3 into the baseline prediction model significantly enhanced its discriminatory performance.Conclusions: These findings underscore the prognostic value of pretreatment immuno-nutritional assessment and support the integration of the CONUT score into early risk stratification strategies for patients with ATC.
背景/目的：间变性甲状腺癌（ATC）是一种侵袭性强、预后不良的甲状腺癌亚型。控制营养状态（CONUT）评分作为反映机体免疫与营养状况的综合指标，已在多种恶性肿瘤中被证实具有预后预测价值，但其在ATC中的应用尚未明确。本研究旨在评估治疗前CONUT评分对ATC的预测价值，并比较其与预后营养指数（PNI）及老年营养风险指数（GNRI）等其他营养评估工具的预后判断效能。 方法：回顾性分析2004年1月至2024年5月期间我院收治的156例ATC患者的临床特征、实验室参数及生存结局。通过生存分析确定各营养指标（CONUT评分、PNI、GNRI）的最佳截断值，并据此将患者分为低危组与高危组。采用Kaplan-Meier曲线与对数秩检验比较组间1年生存差异，通过多变量Cox比例风险回归模型分析1年死亡率的独立预测因素。 结果：CONUT评分、PNI和GNRI的最佳截断值分别为3、42和102。CONUT评分≥3的患者1年死亡率显著高于评分<3的患者。多变量分析显示，CONUT评分≥3、PNI≤42及GNRI≤102均为1年死亡率增加的独立危险因素。将CONUT评分≥3纳入基线预测模型后，模型的区分能力得到显著提升。 结论：本研究结果证实了治疗前免疫营养评估在ATC预后判断中的重要价值，支持将CONUT评分整合至ATC患者的早期风险分层策略中。
肿瘤(癌症)患者之家