1. Confounding objective measures: albumin and lymphocytes used in CONUT are heavily influenced by the profound inflammatory response from the tumor itself, not purely nutritional status. 2. Complexity: the etiology of malnutrition in PC is multifactorial (malabsorption, inflammation, anorexia), making it difficult for any single tool to capture fully. The gene discussed is ALB; the disease is pachyonychia congenita.