No abstract

Objective: The modified Glasgow Prognostic Score (mGPS) is an inflammation-based measure of malnutrition that reflects a state of cachexia in cancer patients. We evaluated mGPS as an index to predict surgical site infection (SSI) incidence in patients undergoing colorectal cancer surgery. Subjects and Methods:We retrospectively analyzed 351 patients who underwent colon cancer resection. Factors correlated with the incidence of SSIs were identified by logistic analysis and stepwise selection.Results: SSIs were observed in 32 patients, with an incidence of 9.1%. Univariate logistic analysis revealed mGPS (Score 2), laparotomy, resection of other organs, colostomy, excessive blood loss (>423 mL), long duration of surgery (>279 minutes), pulmonary dysfunction, prognostic nutritional index (PNI) ! 40, neutrophil lymphocyte ratio (NLR)(>4), and controlling nutritional status (CONUT) " 2 to be associated with an increased incidence of SSIs. Multivariate analysis with variables selected by the stepwise procedure also revealed mGPS (Score 2) (Odds ratio (OR)=3.55, 95% Confidence interval (CI) 1.30 9.56; p=0.01), colostomy (OR=6.56, 95%CI 1.60 31.38; p=0.01), excessive blood loss (OR=3.20, 95%CI1.23 8.42; p=0.02), and NLR (>4)(OR=3.24, 95%CI 1.31 8.17; p=0.01) to be independent risk factors.Conclusion: mGPS is an independent risk factor for SSIs. Our results suggest that cachexia before surgery in patients with colorectal cancer might predict the incidence of SSIs. (J Nippon Med Sch 2017; 84: 224 230)

Elderly individuals with poor physical and nutritional status tended to respond poorly to influenza vaccination. A low level of activities of daily living and a combination of being underweight and having had recent bodyweight loss are good indicators of a poor immune response.

Objective:We evaluated the preoperative patient status including nutrition, immunity, and inflammation as a predictive factor of remote infection (RI) in colorectal cancer surgery. Subjects and Methods:A total of 351 patients who underwent colorectal cancer resection were retrospectively analyzed. Factors correlated with RI incidence were identified by logistic analysis and stepwise selection.Results: RI occurred in 27 patients, with an incidence of 7.7%. In univariate logistic analysis, a significantly high incidence of RI was associated with excessive blood loss (>423 mL), long duration of surgery (>279 minutes), ileus, pulmonary dysfunction, performance status (PS)"1, American Society of Anesthesiologists (ASA) classification>2, prognostic nutritional index (PNI)!40, and controlling nutritional status (CONUT)"2 , modified Glasgow Prognostic Score (mGPS) (Score 2). In multivariate analysis, pulmonary dysfunction (odds ratio=2.83; 95% CI: 1.14 6.97; p=0.02) and PNI!40 (odds ratio=3.87; 95% CI: 1.45 10.31; p=0.006) were independent risk factors of RI incidence.Conclusion: RI is caused by poor nutrition, immune system dysfunction and pulmonary dysfunction. (J Nippon Med Sch 2018; 85: 208 214)

Pretreatment evaluation of the degree of CE correlated with the response to concomitant chemotherapy with BV.