{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T12:44:38Z","timestamp":1793882678473,"version":"4.7.0"},"reference-count":48,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fundamental Fund of Khon Kaen University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background: Preoperative inflammatory and nutrition-related markers\u2014including the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), prognostic nutritional index (PNI), and controlling nutritional status (CONUT) score\u2014have shown prognostic relevance in various malignancies. However, their comparative utility in predicting recurrence and survival across clinically relevant subgroups in patients with intrahepatic cholangiocarcinoma (iCCA) undergoing curative-intent resection remains unclear. Methods: This retrospective study included 213 patients with histologically confirmed iCCA who underwent curative-intent resection between 2015 and 2021. Preoperative NLR, LMR, PNI, and CONUT scores were calculated from laboratory data obtained within one week before resection. Clinicopathological variables, recurrence, and survival outcomes were analyzed using Cox regression and Kaplan\u2013Meier methods. Results: A preoperative NLR \u2265 2.4 was independently associated with poorer DFS (HR = 1.66, p = 0.025) and OS (HR = 1.94, p = 0.006). This effect remained significant in patients with R0 resection (DFS: HR = 1.66, p = 0.004; OS: HR = 2.11, p = 0.014) and in those who subsequently developed recurrence (OS: HR = 1.83, p = 0.004). The CONUT score was correlated with OS in both R0 and recurrent subgroups. Tumor morphology, consistent with prior reports, was identified as a postoperative pathological factor associated with worse prognosis. Conclusions: Preoperative NLR was associated with poorer DFS and OS in iCCA patients undergoing curative-intent resection. This association was consistently observed in subgroups with R0 resection and in those who developed recurrence. Meanwhile, the CONUT score showed limited independent significance only among patients with R0 resection who experienced recurrence.<\/jats:p>","DOI":"10.3390\/medsci14010023","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T10:53:50Z","timestamp":1767610430000},"page":"23","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Preoperative Prognostic Score for Patients with Intrahepatic Cholangiocarcinoma Undergoing Curative-Intent Resection"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0401-9812","authenticated-orcid":false,"given":"Jarin","family":"Chindaprasirt","sequence":"first","affiliation":[{"name":"Medical Oncology Program, Department of Medicine Srinagarind Hospital, Khon Kaen University, Khon Kaen 40002, Thailand"},{"name":"Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8094-3241","authenticated-orcid":false,"given":"Thanachai","family":"Sanlung","sequence":"additional","affiliation":[{"name":"Medical Oncology Program, Department of Medicine Srinagarind Hospital, Khon Kaen University, Khon Kaen 40002, Thailand"},{"name":"Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piyakarn","family":"Watcharenwong","sequence":"additional","affiliation":[{"name":"Medical Oncology Program, Department of Medicine Srinagarind Hospital, Khon Kaen University, Khon Kaen 40002, Thailand"},{"name":"Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasin","family":"Thanasukarn","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand"},{"name":"Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apiwat","family":"Jareanrat","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand"},{"name":"Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6689-2525","authenticated-orcid":false,"given":"Natcha","family":"Khuntikeo","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand"},{"name":"Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7850-2500","authenticated-orcid":false,"given":"Tharatip","family":"Srisuk","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand"},{"name":"Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakasit","family":"Sa-Ngiamwibool","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand"},{"name":"Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9185-4121","authenticated-orcid":false,"given":"Chaiwat","family":"Aphivatanasiri","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand"},{"name":"Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8572-5577","authenticated-orcid":false,"given":"Watcharin","family":"Loilome","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand"},{"name":"Systems Biosciences and Computational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piya","family":"Prajumwongs","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attapol","family":"Titapun","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand"},{"name":"Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1186\/s12957-024-03573-5","article-title":"Improving postoperative survival in cholangiocarcinoma: Development of surgical strategies with a screening program in the epidemic region","volume":"22","author":"Thanasukarn","year":"2024","journal-title":"World J. Surg. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1002\/jhbp.74","article-title":"Surgical management of perihilar cholangiocarcinoma: A Khon Kaen experience","volume":"21","author":"Khuntikeo","year":"2014","journal-title":"J. Hepatobiliary Pancreat. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Sripa, B., Kaewkes, S., Sithithaworn, P., Mairiang, E., Laha, T., Smout, M., Pairojkul, C., Bhudhisawasdi, V., Tesana, S., and Thinkamrop, B. (2007). Liver fluke induces cholangiocarcinoma. PLoS Med., 4.","DOI":"10.1371\/journal.pmed.0040201"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Treeprasertsuk, S., Poovorawan, K., Soonthornworasiri, N., Chaiteerakij, R., Thanapirom, K., Mairiang, P., Sawadpanich, K., Sonsiri, K., Mahachai, V., and Phaosawasdi, K. (2017). A significant cancer burden and high mortality of intrahepatic cholangiocarcinoma in Thailand: A nationwide database study. BMC Gastroenterol., 17.","DOI":"10.1186\/s12876-016-0565-6"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Khuntikeo, N., Chamadol, N., Yongvanit, P., Loilome, W., Namwat, N., Sithithaworn, P., Andrews, R.H., Petney, T.N., Promthet, S., and Thinkhamrop, K. (2015). Cohort profile: Cholangiocarcinoma screening and care program (CASCAP). BMC Cancer, 15.","DOI":"10.1186\/s12885-015-1475-7"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.jhep.2019.03.013","article-title":"Global trends in mortality from intrahepatic and extrahepatic cholangiocarcinoma","volume":"71","author":"Bertuccio","year":"2019","journal-title":"J. Hepatol."},{"key":"ref_7","first-page":"346","article-title":"Multidisciplinary management in the treatment of intrahepatic cholangiocarcinoma","volume":"73","author":"Ruff","year":"2023","journal-title":"CA Cancer J. Clin."},{"key":"ref_8","first-page":"198","article-title":"Advances in the treatment of intrahepatic cholangiocarcinoma: An overview of the current and future therapeutic landscape for clinicians","volume":"73","author":"Moris","year":"2023","journal-title":"CA Cancer J. Clin."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1001\/jamasurg.2020.1973","article-title":"Very Early Recurrence After Liver Resection for Intrahepatic Cholangiocarcinoma: Considering Alternative Treatment Approaches","volume":"155","author":"Tsilimigras","year":"2020","journal-title":"JAMA Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2549","DOI":"10.1245\/s10434-019-07353-4","article-title":"Recurrence Patterns and Timing Courses Following Curative-Intent Resection for Intrahepatic Cholangiocarcinoma","volume":"26","author":"Hu","year":"2019","journal-title":"Ann. Surg. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s12957-018-1540-1","article-title":"Specific risk factors contributing to early and late recurrences of intrahepatic cholangiocarcinoma after curative resection","volume":"17","author":"Wang","year":"2019","journal-title":"World J. Surg. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2582","DOI":"10.1038\/s41598-025-87124-2","article-title":"Discovery of novel serum peptide biomarkers for cholangiocarcinoma recurrence through MALDI-TOF MS and LC\u2013MS\/MS peptidome analysis","volume":"15","author":"Thanasukarn","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Yang, H., Wang, J., Li, Z., Yang, Y., Yang, L., Zhang, Y., Shi, Y., Cao, Y., Zhou, J., and Wang, Z. (2019). Risk Factors and Outcomes of Early Relapse After Curative Resection of Intrahepatic Cholangiocarcinoma. Front. Oncol., 9.","DOI":"10.3389\/fonc.2019.00854"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Bai, S., Shi, X., Dai, Y., Wang, H., Xia, Y., Liu, J., and Wang, K. (2024). The preoperative scoring system combining neutrophil\/lymphocyte ratio and CA19-9 predicts the long-term prognosis of intrahepatic cholangiocarcinoma patients undergoing curative liver resection. BMC Cancer, 24.","DOI":"10.1186\/s12885-024-12819-0"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"158","DOI":"10.14701\/ahbps.22-114","article-title":"Preoperative neutrophil-to-lymphocyte ratio is prognostic for early recurrence after curative intrahepatic cholangiocarcinoma resection","volume":"27","author":"Choi","year":"2023","journal-title":"Ann. Hepatobiliary Pancreat. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Matsuda, T., Umeda, Y., Matsuda, T., Endo, Y., Sato, D., Kojima, T., Sui, K., Inagaki, M., Ota, T., and Hioki, M. (2021). Preoperative prognostic nutritional index predicts postoperative infectious complications and oncological outcomes after hepatectomy in intrahepatic cholangiocarcinoma. BMC Cancer, 21.","DOI":"10.1186\/s12885-021-08424-0"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e20473","DOI":"10.1016\/j.heliyon.2023.e20473","article-title":"Preoperative controlling nutritional status (CONUT) score is an independent prognostic factor in cholangiocarcinoma patients treated with hepatectomy","volume":"9","author":"Titapun","year":"2023","journal-title":"Heliyon"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1002\/cam4.4935","article-title":"Prognostic utility of preoperative inflammatory markers in patients with intrahepatic cholangiocarcinoma after hepatic resection: A systematic review and meta-analysis","volume":"12","author":"Cui","year":"2023","journal-title":"Cancer Med."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Qi, S., Ma, Z., Shen, L., Wang, J., Zhou, L., Tian, B., Liu, C., Chen, K., and Cheng, W. (2024). Application of preoperative NLR-based prognostic model in predicting prognosis of intrahepatic cholangiocarcinoma following radical surgery. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1492358"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1111\/his.13975","article-title":"The 2019 WHO classification of tumours of the digestive system","volume":"76","author":"Nagtegaal","year":"2020","journal-title":"Histopathology"},{"key":"ref_21","unstructured":"Amin, M.B., Edge, S.B., Greene, F.L., Byrd, D.R., Brookland, R.K., Washington, M.K., Gershenwald, J.E., Compton, C.C., Hess, K.R., and Sullivan, D.C. (2017). AJCC Cancer Staging Manual, Springer."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1944","DOI":"10.1016\/j.hpb.2022.06.004","article-title":"Modification of the AJCC\/UICC 8th edition staging system for intrahepatic cholangiocarcinoma: Proposal for an alternative staging system from cholangiocarcinoma-prevalent Northeast Thailand","volume":"24","author":"Aphivatanasiri","year":"2022","journal-title":"HPB"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1002\/jso.20329","article-title":"Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer","volume":"91","author":"Walsh","year":"2005","journal-title":"J. Surg. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.amjsurg.2007.12.057","article-title":"Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma","volume":"197","author":"Smith","year":"2009","journal-title":"Am. J. Surg."},{"key":"ref_25","first-page":"1001","article-title":"Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients","volume":"85","author":"Onodera","year":"1984","journal-title":"Nihon Geka Gakkai Zasshi"},{"key":"ref_26","first-page":"38","article-title":"CONUT: A tool for controlling nutritional status. First validation in a hospital population","volume":"20","author":"Gonzalez","year":"2005","journal-title":"Nutr. Hosp."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.4143\/crt.2024.1187","article-title":"Preoperative Prediction Model for Early Recurrence of Intrahepatic Cholangiocarcinoma after Surgical Resection: Development and External Validation Study","volume":"57","author":"Kim","year":"2025","journal-title":"Cancer Res. Treat."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Jang, H.J., Kim, D.H., Choi, S.H., Rhee, H., Cho, E.-S., Yeom, S.-K., Park, S., Lee, S.S., and Park, M.-S. (2025). Preoperative Prediction of Microvascular Invasion in Intrahepatic Cholangiocarcinoma and Its Prognostic Implications: A Multicenter Study. Liver Cancer, ahead of print.","DOI":"10.1159\/000547071"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Mazaki, J., Katsumata, K., Kasahara, K., Tago, T., Wada, T., Kuwabara, H., Enomoto, M., Ishizaki, T., Nagakawa, Y., and Tsuchida, A. (2020). Neutrophil-to-lymphocyte ratio is a prognostic factor for colon cancer: A propensity score analysis. BMC Cancer, 20.","DOI":"10.1186\/s12885-020-07429-5"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"69","DOI":"10.2147\/JIR.S391932","article-title":"Fashionable, but What is Their Real Clinical Usefulness? NLR, LMR, and PLR as a Promising Indicator in Colorectal Cancer Prognosis: A Systematic Review","volume":"16","author":"Misiewicz","year":"2023","journal-title":"J. Inflamm. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"106959","DOI":"10.1016\/j.ijsu.2022.106959","article-title":"Prognostic value of neutrophil-to-lymphocyte ratio in colorectal cancer liver metastasis: A meta-analysis of results from multivariate analysis","volume":"107","author":"Lin","year":"2022","journal-title":"Int. J. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1186\/s12957-015-0670-y","article-title":"Preoperative neutrophil-to-lymphocyte ratio predicts recurrence of patients with single-nodule small hepatocellular carcinoma following curative resection: A retrospective report","volume":"13","author":"Liao","year":"2015","journal-title":"World J. Surg. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"17","DOI":"10.2147\/JHC.S86792","article-title":"Pretreatment neutrophil-lymphocyte ratio: Useful prognostic biomarker in hepatocellular carcinoma","volume":"5","author":"Najjar","year":"2018","journal-title":"J. Hepatocell. Carcinoma"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3122","DOI":"10.3748\/wjg.v23.i17.3122","article-title":"Prognostic value of the neutrophil-to-lymphocyte ratio for hepatocellular carcinoma patients with portal\/hepatic vein tumor thrombosis","volume":"23","author":"Li","year":"2017","journal-title":"World J. Gastroenterol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1007\/s00268-008-9552-6","article-title":"Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative resection for hepatocellular carcinoma","volume":"32","author":"Gomez","year":"2008","journal-title":"World J. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Peng, J., Chen, H., Chen, Z., Tan, J., Wu, F., and Li, X. (2025). Prognostic value of neutrophil-to-lymphocyte ratio in patients with hepatocellular carcinoma receiving curative therapies: A systematic review and meta-analysis. BMC Cancer, 25.","DOI":"10.1186\/s12885-025-13972-w"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.21037\/tcr-20-3237","article-title":"Neutrophil-to-lymphocyte ratio predicts prognosis of patients with hepatocellular carcinoma: A systematic review and meta-analysis","volume":"10","author":"Lin","year":"2021","journal-title":"Transl. Cancer Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1038\/nri3024","article-title":"Neutrophils in the activation and regulation of innate and adaptive immunity","volume":"11","author":"Mantovani","year":"2011","journal-title":"Nat. Rev. Immunol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Fridlender, Z.G., Sun, J., Mishalian, I., Singhal, S., Cheng, G., Kapoor, V., Horng, W., Fridlender, G., Bayuh, R., and Worthen, G.S. (2012). Transcriptomic analysis comparing tumor-associated neutrophils with granulocytic myeloid-derived suppressor cells and normal neutrophils. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0031524"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.clim.2016.11.009","article-title":"Neutrophil infiltration mediated by CXCL5 accumulation in the laryngeal squamous cell carcinoma microenvironment: A mechanism by which tumour cells escape immune surveillance","volume":"175","author":"Zhang","year":"2017","journal-title":"Clin. Immunol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1038\/s41598-024-84890-3","article-title":"Pretreatment neutrophil-to-lymphocyte ratio is associated with immunotherapy efficacy in patients with advanced cancer: A systematic review and meta-analysis","volume":"15","author":"Su","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1038\/bjc.2011.189","article-title":"The prognostic influence of tumour-infiltrating lymphocytes in cancer: A systematic review with meta-analysis","volume":"105","author":"Gooden","year":"2011","journal-title":"Br. J. Cancer"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Tan, X., Wang, Y., Yu, Y., Zheng, R., Li, J., Chen, S., Xie, Q., Guo, S., Zhang, C., and Deng, X. (2025). Neutrophil-to-lymphocyte ratio predicts a poor prognosis for penile cancer with an immunosuppressive tumor microenvironment. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1568825"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1002\/bjs.10676","article-title":"Early versus late recurrence of intrahepatic cholangiocarcinoma after resection with curative intent","volume":"105","author":"Zhang","year":"2018","journal-title":"Br. J. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2261461","DOI":"10.1080\/07853890.2023.2261461","article-title":"Prognostic role of the controlling nutritional status (CONUT) score in patients with biliary tract cancer: A meta-analysis","volume":"55","author":"Jiang","year":"2023","journal-title":"Ann. Med."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Takagi, K., Domagala, P., Polak, W.G., Buettner, S., Wijnhoven, B.P.L., and Ijzermans, J.N.M. (2019). Prognostic significance of the controlling nutritional status (CONUT) score in patients undergoing gastrectomy for gastric cancer: A systematic review and meta-analysis. BMC Surg., 19.","DOI":"10.1186\/s12893-019-0593-6"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1159\/000500233","article-title":"The Controlling Nutritional Status Score and Postoperative Complication Risk in Gastrointestinal and Hepatopancreatobiliary Surgical Oncology: A Systematic Review and Meta-Analysis","volume":"74","author":"Takagi","year":"2019","journal-title":"Ann. Nutr. Metab."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2353","DOI":"10.1007\/s00268-017-3985-8","article-title":"Preoperative Controlling Nutritional Status (CONUT) Score for Assessment of Prognosis Following Hepatectomy for Hepatocellular Carcinoma","volume":"41","author":"Takagi","year":"2017","journal-title":"World J. Surg."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/1\/23\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T11:09:34Z","timestamp":1767611374000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/1\/23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["medsci14010023"],"URL":"https:\/\/doi.org\/10.3390\/medsci14010023","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,5]]}}}