Survival impact of perioperative changes in prognostic nutritional index levels after esophagectomy
| Autor: | Wataru Soneda, Ryoma Haneda, Hirotoshi Kikuchi, Tomohiro Matsumoto, Kinji Kamiya, Sanshiro Kawata, Yoshihiro Hiramatsu, Hiroya Takeuchi, Junko Honke, Yoshifumi Morita |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Esophageal Neoplasms medicine.medical_treatment Esophageal cancer Gastroenterology Internal medicine medicine Humans Stage (cooking) Pathological Retrospective Studies business.industry Hazard ratio Prognostic nutritional index Perioperative medicine.disease Prognosis Confidence interval Esophagectomy Nutrition Assessment Cardiothoracic surgery Esophageal Squamous Cell Carcinoma business |
| Zdroj: | Esophagus : official journal of the Japan Esophageal Society. 19(2) |
| ISSN: | 1612-9067 |
| Popis: | Background The correlation between perioperative changes in nutritional status during esophagectomy and prognosis remains unclear. This study aimed to evaluate the impact of changes in prognostic nutritional index levels during the perioperative period on esophageal cancer patient survivals. Methods From January 2009 to May 2019, 158 patients with esophageal squamous cell carcinoma were enrolled. From the time-dependent ROC analysis, the cutoff values of preoperative and postoperative prognostic nutritional index levels were 46.9 and 40.9. Patients were divided into preoperative-high group (Group H) and preoperative-low group (Group L). Then, patients in Group L were divided into preoperative-low and postoperative-high group (Group L–H) and preoperative-low and postoperative-low group (Group L–L). Long-term outcomes and prognostic factors were evaluated. Results Patients in Group L had significantly worse overall survival than those in Group H (p = 0.001). Patients in Group L–L had significantly worse overall survival than those in Group L–H (p = 0.023). However, there was no significant difference in overall survival between Groups H and L–H (p = 0.224). In multivariable analysis, advanced pathological stage (hazard ratio 10.947, 95% confidence interval 2.590–46.268, p = 0.001) and Group L–L (hazard ratio 2.171, 95% confidence interval 1.249–3.775, p = 0.006) were independent predictors of poor overall survival. Conclusions Patients in Group L–H had a good prognosis, similar to those in Group H. This result indicated that increasing the postoperative prognostic nutritional index level sufficiently using various intensive perioperative support methods could improve prognosis after esophagectomy in patients with poor preoperative nutritional status. |
| Databáze: | OpenAIRE |
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