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The present study aimed to investigate the prognostic significance of the preoperative controlling nutritional status (CONUT) score in patients with resectable advanced hypopharyngeal cancer. Patients were divided into the high‐CONUT score group (≥3) and the low‐CONUT score group (≤2) according to ROC analysis. The CONUT score was associated with body mass index (p = 0.047), monocyte, pharyngocutaneous fistula, flap repairment, tumor (T) classification, node (N) classification, a subsite of tumor, and negative pathologic factors. Tumor, node, metastasis (TNM) stage, negative pathologic factors, adjuvant radiotherapy, postoperative chemoradiotherapy, and CONUT score were independent prognostic factors for survival. Patients with a higher CONUT score had worse overall survival (OS) and disease‐free survival. The area under the curve of the CONUT score (0.799) to predict 5‐year OS was greater than those of the Preoperative Nutritional Index (0.769), platelet‐to‐lymphocyte ratio (0.643), neutrophil‐to‐lymphocyte ratio (0.565), and lymphocyte‐to‐monocyte ratio (0.577). The CONUT score is a prognostic marker for resectable advanced hypopharyngeal cancer patients.
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