Postoperative outcome after oesophagectomy for cancer: Nutritional status is the missing ring in the current prognostic scores

Filip, Bogdan; Scarpa, Marco; Cavallin, Francesco; Cagol, Matteo; Alfieri, Rita; Saadeh, Luca Maria; Ancona, Ermanno; Castoro, Carlo

doi:10.1016/j.ejso.2015.02.014

Cited by 61 publications

(29 citation statements)

References 29 publications

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“…Esophagectomized patients with a high Prognostic Nutritional Index-a tool which includes serum albumin and absolute peripheral lymphocyte count-had a higher prevalence of postoperative complications [24]. These results are in accordance with later studies, indicating that nutritional status preoperatively, expressed as PNI, was significantly related with the occurrence of severe complications and was a predictive factor for long-term survival [25,26]. Nevertheless, Han-Geurts et al showed that PNI was not associated with postoperative infectious complications in patients who underwent esophageal resection for malignancy [27].…”

Section: Methods Of Nutritional Assessment and Impact On Clinical Outsupporting

confidence: 80%

Nutritional Management of Esophageal Cancer Patients

Schizas¹,

Lidoriki²,

Moris³

et al. 2017

Esophageal Abnormalities

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Esophageal cancer is associated with malnutrition in the vast majority of patients. This phenomenon is partly attributed to the disease process itself, the location of the tumor and other factors, such as dysphagia which is often accentuated due to chemotherapy/ radiotherapy treatment or surgical intervention. The poor nutritional status of these patients is often related to the presence of cancer cachexia, altered metabolism, and tissue wasting. Malnutrition in this patient population affects quality of life, worsens patient's tolerance to chemotherapy and accounts for lower survival. Nutritional management of these patients includes both proper nutritional assessment and support and might prevent, to a certain extent, the manifestation of malnutrition-related consequences. The purpose of this article is to review the current literature in order to focus on the etiology and diagnosis of malnutrition in esophageal cancer patients, emphasizing also on the optimal nutritional support during multimodality treatment.

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Section: Methods Of Nutritional Assessment and Impact On Clinical Outsupporting

confidence: 80%

Nutritional Management of Esophageal Cancer Patients

Schizas¹,

Lidoriki²,

Moris³

et al. 2017

Esophageal Abnormalities

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“…We believe that potentially useful factors that have been reported in other studies, such as the systemic immune-inflammatory index [29] or the nutritional prognosis index [30], should be included.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Predictive Mortality Scores in Esophagectomy with Three-Field Lymph Node Dissection in Patients with Esophageal Cancer

Mora¹,

Nakajima²,

Okada³

et al. 2018

Dig Surg

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Background/Aim: Esophagectomy is still the best therapeutic option for curing resectable esophageal cancer (EC). Radical surgical resection with three-field lymphadenectomy (3FLD) is a potentially curative treatment option. We compared the predictive accuracy of 5 different scores in patients with EC who underwent 3FLD. Methods: Five years’ worth of medical records in a single institution were analyzed (January 2010 to January 2015) from 311 patients who underwent esophagectomy for EC. We selected 191 in whom 3FLD was performed. Mortality was calculated based on 5 predictive scores. Outcomes measures were intraoperative mortality, 30-day mortality, and 1- and 2-year mortality after surgery. Results: Intraoperative mortality and 30-day mortality after surgery was 0%; 1 and 2-year mortality were 19.8 and 31.4%, respectively. The area under the curve showed poor discriminatory power for all 5 scores (<0.7). In one-way analysis of variance, for 1 year mortality, Portsmouth-Physiological and Operative Severity Score for mortality (P-Possum) was significant (p = 0.0424); in a multivariable analysis for 2-year mortality, P-Possum (p < 0.0001) remained significant. Conclusion: There is no accurate prognosis score for esophagectomy in patients who undergo high-risk procedures like 3FLD. New scores are needed to predict the mortality after 3FLD with good discriminatory power. Independent factors affect survival and may function as the baseline for obtaining a new accurate mortality score.

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“…Thus, the assessment of nutritional status should be included in the determination of surgical risk 27 .…”

Section: ■ Discussionmentioning

confidence: 99%

Combination of preoperative pulmonary and nutritional preparation for esophagectomy

et al. 2018

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Purpose: To compare pulmonary and nutritional parameters before and after inspiratory muscle training (IMT) and enteral feeding support in patients with esophageal disease undergoing preoperative outpatient follow-up. Methods: Thirty patients with a mean age of 55.83 years, 16 men and 14 women, were included. Pulmonary assessment consisted of the measurement of MIP, MEP, and spirometry. Anthropometric measurements and laboratory tests were performed for nutritional assessment. After preoperative evaluation, inspiratory muscle training and enteral nutrition support were started. A p<0.05 was considered statistically significant. Results: After an outpatient follow-up period of 4 weeks, a significant increase in MIP (-62.20 ± 25.78 to -81.53 ± 23.09), MEP (73.4 ± 31.95 to 90.33 ± 28.39), and FVC (94.86 ± 16.77 to 98.56 ± 17.44) was observed. Regarding the anthropometric variables, a significant increase was also observed in BMI (20.18 ± 5.04 to 20.40 ± 4.69), arm circumference (23.38 ± 3.28 to 25.08 ± 4.55), arm muscle circumference (21.48 ± 3.00 to 22.07 ± 3.36), and triceps skinfold thickness (5.62 ± 2.68 to 8.33 ± 6.59). Conclusion: Pulmonary and nutritional preparation can improve respiratory muscle strength, FVC and anthropometric parameters. However, further studies are needed to confirm the effectiveness of this preoperative preparation.

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Postoperative outcome after oesophagectomy for cancer: Nutritional status is the missing ring in the current prognostic scores

Cited by 61 publications

References 29 publications

Nutritional Management of Esophageal Cancer Patients

Nutritional Management of Esophageal Cancer Patients

Comparative Study of Predictive Mortality Scores in Esophagectomy with Three-Field Lymph Node Dissection in Patients with Esophageal Cancer

Combination of preoperative pulmonary and nutritional preparation for esophagectomy

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