Background: Malnutrition is a frequent issue in esophageal cancer (EC). The Controlling Nutritional Status (CONUT) Score has been established as a prognostic indicator in EC patients who underwent surgery. We aimed to investigate the role of the CONUT Score in EC patients treated with chemoradiotherapy (CRT). Methods: The trial included 101 non-metastatic EC patients. Receiver operating characteristic (ROC) curve analyses were used to determine cut-off values for the CONUT Score and other indices. Cox regression analyses were performed to determine prognostic markers. Results: Of 101 patients, 59.4% (n = 60) and 40.6% (n = 41) of patients were treated with CRT alone and CRT plus surgery, respectively. ROC curve analyses determined an optimal cut-off for CONUT Score in overall survival (OS), which was 3.5 (AUC = 0.63, CI 95%: 0.51-0.76, P = 0.05). The sensitivity and specificity of CONUT were 66% and 61%, respectively. Low CONUT (≤3.5) patients had significantly longer median OS than high CONUT (>3.5) patients (57.1 vs. 23 months; P = 0.009). Multivariate regression analysis revealed a CONUT Score hazard ratio (HR) of 1.96 for OS (CI 95%: 1.03-3.75, P = 0.04). Conclusion: The CONUT Score might be a useful prognostic tool in EC patients treated with CRT. Appropriate nutritional support might provide a better prognosis, which underlines the importance of multidisciplinary assessment of malnutrition in EC patients.

The objective of this study was to explore the possible association between low skeletal muscle mass (SMM)—assessed by computed tomography (CT) and ultrasound (US)—and hematologic toxicity in cancer patients. A prospective cohort study was conducted in cancer patients who received anthracycline-based chemotherapy between 2018 and 2020 and who had baseline abdominal CT including L3 level for measuring SMM. Regional muscle measurements were carried out using US. A total of 65 patients (14 males, 51 females) were included. ROC (receiver operating characteristic) analysis identified threshold values of 18.0 mm [AUC (area under the curve) = 0.765] for females and 20.0 mm (AUC = 0.813) for males, predicting severe neutropenia. Using these cut-offs, females with low rectus femoris (RF) thickness (<18.0 mm) had a significantly higher incidence of grade ≥3 neutropenia (50.0% vs. 10.8%, p = 0.005), and males with low RF values (<20.0 mm) had a higher incidence (80.0% vs. 22.2%, p = 0.063). A regression analysis, irrespective of age, gender, and body mass index, revealed that only low RF muscle thickness increased the risk of grade 3–4 neutropenia by 9.210 times (95% CI = 2.401–35.326, p = 0.001). Utilizing US to measure RF muscle thickness aids in identifying cancer patients at an elevated risk of developing neutropenia. Needless to say, US can serve as a convenient and easily accessible tool for assessing low SMM, providing repeat point-of-care evaluations in clinical practice.

The purpose of this study was to identify the frequency of chemotherapy-induced amenorrhea and associated factors thereof in premenopausal female patients diagnosed with colon cancer. Premenopausal female patients under the age of 50 years who were diagnosed with stages I, II, and III colon cancer were included. A questionnaire surveying personal history including menarche, comorbidities, drugs, other clinical features, and menstrual history during and after completion of chemotherapy was filled by the patients during outpatient visits. Patients who received pelvic radiotherapy were excluded from the study. A total of 60 patients were included in the study. Eleven patients had been treated with surgery alone, and 49 patients had received adjuvant chemotherapy with either fluorouracil (5-FU) alone (n=22) or 5-FU+oxaliplatin (n=27). The frequency of persistent amenorrhea 1 year after receiving chemotherapy was 20% in the whole group, 18% in patients who had received adjuvant chemotherapy with 5-FU alone, and 22% in patients who had received chemotherapy with 5-FU+oxaliplatin. Frequency of persistent amenorrhea was 3.5% in patients under the age of 44 years and 42.8% in patients aged 44 years and older. Multivariate analysis showed that age of 44 years and older (hazard ratio: 29.3; 95% confidence interval: 2.8–309.2, P=0.005) and menarche age of 14 years and older (hazard ratio: 7.6; 95% confidence interval: 1.2–49, P=0.076) were significantly associated with increased risk of persistent amenorrhea. In this study, we found that the frequency of persistent amenorrhea was 20% in patients who received 5-FU monotherapy or oxaliplatin-based adjuvant chemotherapy protocols in colon cancer treatment. Older age and later menarche were the factors that increased the risk of persistent amenorrhea 1 year after chemotherapy.