Preoperative cancer cachexia and short-term outcomes following surgery

Mason, Meredith C.; García, José Manuel Pérez; Sansgiry, Shubhada; Walder, Annette; Berger, David H.; Anaya, Daniel A.

doi:10.1016/j.jss.2016.06.076

Cited by 23 publications

(9 citation statements)

References 31 publications

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“…The inefficiency of energy metabolism exacerbates the issue further, rendering postoperative nutrition supplementation less effective. The relatively few studies examining short‐term postoperative morbidity and complications of cancer cachexia have similarly demonstrated poorer tolerance to tumor resection 43–45 …”

Section: Discussionmentioning

confidence: 99%

“…The relatively few studies examining short-term postoperative morbidity and complications of cancer cachexia have similarly demonstrated poorer tolerance to tumor resection. [43][44][45] The only definitive method to stop cancer cachexia progression is eradication of the malignancy. Even after ablation, the preoperative, detrimental effects linger and make full recovery difficult or even impossible.…”

Section: Discussionmentioning

confidence: 99%

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Postoperative consequences of cancer cachexia after head and neck free flap reconstruction

et al. 2022

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Background Cachexia is detrimental for patients with head and neck cancer (HNC). However, postoperative consequences of HNC cachexia remain unknown. Methods A 2014–2019 retrospective review was performed of adults undergoing aerodigestive HNC resection with free tissue reconstruction. Propensity score matching using inverse probability of treatment weighting (IPTW) of cachectic and control groups was employed to adjust for covariate imbalances followed by binary logistic regression on postoperative outcomes. Results Out of 252 total patients, 135 (53.6%) had cancer cachexia. The cohort was predominantly white (94.4%) males (65.1%) aged 61.5 ± 11.5 years with stage III–IV (84.1%) malignancy of the oral cavity (66.3%). After matching cohort pre‐ and intra‐operative covariates using IPTW, cancer cachexia remained a strong, significant predictor of serious National Surgical Quality Improvement Program (NSQIP) complications (OR [95%CI] = 3.84 [1.80–8.21]) and major Clavien‐Dindo complications (OR [95%CI] = 3.00 [1.18–7.60]). Conclusions Cancer cachexia is associated with worse HNC free flap reconstruction outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Postoperative consequences of cancer cachexia after head and neck free flap reconstruction

et al. 2022

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“…Similarly, Mason et al. ( 21 ) analyzed the short-term effect of cachexia on postoperative complications, and have reported that adverse events tended to occur in 64.3% of patients with cachexia, a rate that was significantly higher than that in those without cachexia. A study focusing on clinical impact of cachexia in patients with head and neck cancer undergoing chemoradiotherapy by Hayashi et al.…”

Section: Discussionmentioning

confidence: 99%

Predictors predisposing to orocutaneous fistula occurrence following free flap reconstruction

Yuan

et al. 2022

Front. Oncol.

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ObjectivesTo explore the possible risk factors of orocutaneous fistula (OCF) development in free flap reconstruction of the tongue/floor of the mouth (TFOM).MethodsData of patients who underwent free flap reconstruction of the TFOM were retrospectively analyzed. The association between clinicopathologic variables and OCF occurrence was analyzed using univariate and multivariate analyses.ResultsAltogether, 469 patients were enrolled. OCF occurred in 43 patients with a rate of 9.2%. The univariate analysis revealed the negative effects of smoking, preoperative albumin level, cachexia, T4 stage, neck dissection, entire resection of the floor of the mouth (FOM), segmental mandibulectomy, and surgical site infection on OCF occurrence. The multivariate analysis confirmed the independence of cachexia (p<0.001, 4.386[1.883–9.472]), tumor stage (p<0.001, 2.738[1.482–6.629]), entire FOM resection (p<0.001, 6.332[2.110–14.432]), and surgical site infection (p<0.001, 5.376[1.998–11.218]) in affecting the OCF development.ConclusionsOCF development following free flap reconstruction of the TFOM was relatively uncommon, but significantly associated with presence of cachexia, T4 stage, entire FOM resection, and surgical site infection.

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“…Cancer is one of the many chronic diseases associated with cachexia [ 1 ], a condition that leads to progressive dysfunction, high morbidity and mortality risk [ 2 ], and increased complications from cancer surgery [ 3 ]. In addition, it reduces the effectiveness of anti-cancer chemotherapy and increases chemotherapy toxicity [ 4 ], negatively affecting cancer patients’ quality of life (QoL) [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Nutritional Interventions to Improve Cachexia Outcomes in Cancer—A Systematic Review

et al. 2022

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Background and Objectives: The prevalence of cachexia has increased across all of the cancer types and accounts for up to 20% of cancer-related deaths. This paper is a systematic review of nutritional interventions aiming to improve cachexia outcomes in cancer, focusing on weight gain. Materials and Methods: A search in Medline and Elsevier databases for articles up until the 23 January 2022, was conducted. Results: Out of 5732 screened records, 26 publications were included in the final analysis. Four randomized clinical trials showed a significant body weight (BW) increase in patients treated with eicosapentaenoic acid (EPA), β-hydroxy-beta-methyl butyrate (β-HMB), arginine, and glutamine or marine phospholipids (MPL). An upward BW trend was observed in patients treated with L-carnitine, an Ethanwell/Ethanzyme (EE) regimen enriched with ω-3 fatty acids, micronutrients, probiotics, fish oil, a leucine-rich supplement, or total parental nutrition (TPN) with a high dose of a branched-chain amino acid (BCAA). Conclusions: Although clinical trials relating to large numbers of nutritional supplements present promising data, many trials provided negative results. Further studies investigating the underlying mechanisms of action of these nutritional supplements in cancer cachexia are needed. Early screening for cancer cachexia risk and nutritional intervention in cancer patients before aggravating weight loss may stabilize their weight, preventing cachexia syndrome. According to the GRADE methodology, no positive recommendation for these nutritional supplements may be expressed.

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Preoperative cancer cachexia and short-term outcomes following surgery

Cited by 23 publications

References 31 publications

Postoperative consequences of cancer cachexia after head and neck free flap reconstruction

Postoperative consequences of cancer cachexia after head and neck free flap reconstruction

Predictors predisposing to orocutaneous fistula occurrence following free flap reconstruction

Nutritional Interventions to Improve Cachexia Outcomes in Cancer—A Systematic Review

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