Assessment of nutritional status in laparoscopic gastrectomy for gastric cancer

Son, Young-Gil; Kwon, In Gyu; Ryu, Seung Wan

doi:10.21037/tgh.2017.09.08

Cited by 22 publications

(19 citation statements)

References 34 publications

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“…Malnutrition is associated with increased morbidity and mortality, delayed outpatience, poor treatment tolerance, and shorter survival. 11 In our study; moderate/severe malnutrition is found to be associated with worse non-hematological chemotherapy toxicities and severe malnutrition was associated with shorter median OS. Number of the patients with moderate/severe malnutrition is found to be decreased after second chemotherapy and this can be explained by the recovery condition of the patients.…”

Section: Discussionmentioning

confidence: 47%

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Does nutritional status affect treatment tolerability, chemotherapy response and survival in metastatic gastric cancer patients? Results of a prospective multicenter study in Turkey

Karabulut

Doğan

Afşar

et al. 2021

J Oncol Pharm Pract

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Background The possible impact of malnutrition on the efficacy and tolerability of modern chemotherapy for metastatic gastic adenocarcinoma (mGC) patients is unclear. With this study, we aimed to represent the possible impact of malnutrition on the efficacy and tolerability of chemotherapy, and also on the overall survival of mGC patients. Methods In this prospective multicenter study, we collected demographic, oncological and nutritional data of our mGC patients. The nutritional status of patients were assessed with the Nutritional Risk Index (NRI), Body Mass Index (BMI) and weight loss percentage within 21-day period, between the chemotherapy cycles. All of these parameters along with toxicity assessment were evaluated after each courses of chemotherapy in order to determine inter-treatment weight loss. NRIs were calculated with a formula as follows; [1.519 × serum albumin level(g/L) + 41.7 × current weight/basic weight]. Patients were classified as having ‘no malnutrition’ (NRI > 97.5), ‘moderate malnutrition’ (97.5 ≥ NRI ≥ 83.5) or ‘severe malnutrition’ (NRI < 83.5). Drug-induced toxicities and treatment responses were evaluated via National Cancer Institute CTCAE version 4.0 and RECIST Criteria 1.1, respectively. Results One hundred and sixteen mGC patients were enrolled into the study. Median age was 60 years with range 32–83. Primary location of the tumor was antrum in 40% of the patients and of which 24% had undergone primary tumor resection. Ninety-eight percent of the patients had WHO performance status 0 or 1. Malnutrition was diagnosed in 67% of the patients and was severe in 31% of them. All patients received chemotherapy as first-line setting. Severe malnutrition was not associated with chemotherapy responses (p = 0.57). Moderate/severe malnutrition was associated with more cytopenia, nausea/vomiting, diarrhea, neuropathy, (p < 0.05 for all parameters). Moderate/severe malnutrition is associated with worser non-hematological toxicities (p = 0.038). Forty-one percent of patients died during the follow up period (Median: 138 days, range: 21–378). Malnutritional level was associated with significantly reduced overall survival. Severe malnutrition was associated with shorter median overall survival (74 days (95% CI, 20.7–111.0) vs. 237 (95% CI, 148.4-325.6) in none/moderate groups, p = 0.007). Conclusions In mGC patients, moderate/severe malnutrition is associated with worse non-hematological toxicities. Severe malnutrition is also associated with reduced overall survival.

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Section: Discussionmentioning

confidence: 47%

“…Malnutrition is associated with increased morbidity and mortality, delayed outpatience, poor treatment tolerance, and shorter survival. 11…”

Section: Discussionmentioning

confidence: 99%

Does nutritional status affect treatment tolerability, chemotherapy response and survival in metastatic gastric cancer patients? Results of a prospective multicenter study in Turkey

Karabulut

Doğan

Afşar

et al. 2021

J Oncol Pharm Pract

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“…Son et al, reported that appropriate nutritional therapy can significantly reduce patient’s postoperative complications. 20 …”

Section: Discussionmentioning

confidence: 99%

Effect of Pre-operative Nutritional Protocol Implementation on Postoperative Outcomes Following Gastrointestinal Surgeries: A Randomized Clinical Trial

2021

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Introduction: A significant proportion of patients undergoing major gastrointestinal operations suffer from malnutrition. Although the benefit of postoperative nutritional support is well established, the effects of energy intake during pre-operative period is less reported. The present study was designed to test the effect of structured pre-operative nutritional therapy on the postoperative recovery of patients undergoing major gastrointestinal operations. Methods: A randomized clinical trial was conducted among 80 patients of the surgical gastroenterology department of a tertiary care center in south India. A simple random sampling method was used. The nutritional status of all participants was assessed by subjective global assessment (SGA). While control group received standard energy intake nutrition, the experimental group received calculated nutrition with an extra 50 g of soy protein for seven days pre operatively. Data were analysed using SPSS version 20. Results: The median day of removal of abdominal drainage tube was 3 (0-5) compared to 5 (2.5-7.5) in the control group. In the intervention group, the median time for the appearance of bowel sounds and starting of enteral feeding was 1.1 (0.5) days and 2 (1-2) days, while in the control group, it was 1.6 (0.9) days, 3 (1-4) days, respectively which was significant at P<0.05. Similarly, the mean (SD) postoperative serum albumin on third day was 3.6 (0.4) g/dL vs 3.4 (0.4) g/dL experimental and in the control group. Conclusion: Preoperative nutrition protocol improved the patients’ clinical outcomes in terms of post-operative serum albumin, the timing of bowel sounds, and early initiation of enteral feeds.

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“…Causes of poor outcomes are late diagnosis, pre-operative malnutrition and impaired immune system being one of the most important causes. Even eighty-five percent of patients undergoing surgery for gastric cancer are malnourished [7]. It is a result of tumour-related cachexia and decreased food intake due to anorexia.…”

Section: Introductionmentioning

confidence: 99%

Impact of preoperative immunonutrition on thrombocyte phagocytic activity and early postoperative outcomes in invasive gastric cancer patients.

Kamocki

Matowicka

Jurczuk

et al. 2020

Preprint

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Background:The aim was to determine the phagocytic activity of thrombocytes in patients with gastric cancer and to assess the effect of oral and parenteral preoperative glutamine-based immunonutrition on nutritional status, thrombocyte phagocytic activity and early postoperative outcomes. Methods:Patients suffer from invasive gastric cancer had been treated with preoperative immunonutrition with glutamine and they were compared to patients without nutritional treatment. Nutritional status, percentage of weight loss and BMI were assessed. Levels of total protein, albumin, cholesterol, triglycerides, platelets and their phagocytic ability were measured twice. Postsurgical complications were assessed via Claven-Dindo classification. Results:Group I-20 patients with an oral glutamine, Group II-38 patients received an intravenous glutamine. Group III-25 patients did not receive preoperative immunonutrition. 47% patients Group I, 54% patients Group II and 33% patients Group III were malnourished. In Group I, percentage of phagocytizing platelet (%PhP) was 1.1 pre- and 1.2 postoperatively. Phagocytic index (PhI) was 1.0 and 1.1. In Group II, %PhP was 1.1 and 1.2. PhI was 1.0 and 1.1. In Group III %PhP was 1.0 and1.2. PhI was 1.0 and 1.1. An increase in triglyceride level was observed in both immunonutrition groups. There was a fall in total protein, albumin level in Group II. In Group III there was a decline in total protein, albumin and cholesterol level. Total platelet count, and PhI was increased in both immunonutrition groups. There was also a rise in %PhP in Group II. In Group III there was no change in blood plateles level, %PhP and PhI. Complications rate was 53% in Group I, 29 % in Group II, 40% in Group III. Conclusions:In invasive gastric cancer, laboratory nutritional parameters are significantly reduced, causing malnutrition in 45.7% of patients. Oral glutamine supplementation inhibited the postoperative decline in protein metabolism parameters, however, this did not affect the reduction of the percentage of postoperative complications. Glutamine used preoperatively significantly reduced the percentage of serious surgical complications, regardless of the way it was supplemented. Patients with invasive gastric cancer have a significant decrease in platelet phagocytic activity. Immunonutrition based on intravenous form of glutamine allows to improve the phagocytic activity of platelets.

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Assessment of nutritional status in laparoscopic gastrectomy for gastric cancer

Cited by 22 publications

References 34 publications

Does nutritional status affect treatment tolerability, chemotherapy response and survival in metastatic gastric cancer patients? Results of a prospective multicenter study in Turkey

Does nutritional status affect treatment tolerability, chemotherapy response and survival in metastatic gastric cancer patients? Results of a prospective multicenter study in Turkey

Effect of Pre-operative Nutritional Protocol Implementation on Postoperative Outcomes Following Gastrointestinal Surgeries: A Randomized Clinical Trial

Impact of preoperative immunonutrition on thrombocyte phagocytic activity and early postoperative outcomes in invasive gastric cancer patients.

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