Prognostic significance of perioperative nutritional parameters in patients with gastric cancer

Oh, Sangwook; Choi, Min-Gew; Seo, Jeong‐Meen; An, Ji Yeong; Lee, Jun Ho; Sohn, Tae Sung; Bae, Jae Moon; Kim, Sung Hoon

doi:10.1016/j.clnu.2018.02.015

Cited by 56 publications

(60 citation statements)

References 18 publications

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“…Recently, a number of studies have reported that the presence of a systemic inflammatory response and malnutrition is associated with poor prognosis in various malignancies. It has also been shown that systemic inflammation-based prognostic scores, such as the prognostic nutritional index (PNI) and Glasgow prognostic score (GPS), have independent prognostic value regardless of tumor stage in various malignancies, including non-small cell lung cancer (NSCLC) 7 – 11 .…”

Section: Introductionmentioning

confidence: 99%

Prediction of postoperative pulmonary complications using preoperative controlling nutritional status (CONUT) score in patients with resectable non-small cell lung cancer

Lee

et al. 2020

Sci Rep

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Postoperative pulmonary complications (PPCs) significantly impact surgical outcome. We investigated the predictive ability of controlling nutritional status (conUt) for ppc after lung resection in patients with non-small cell lung cancer (NSCLC). We retrospectively reviewed data of 922 patients with NSCLC who underwent complete resection from January 2016-December 2017. We analyzed the frequency and characteristics of ppcs and compared receiver operating characteristic (Roc) curves of various prognostic models to predict PPCs. A CONUT score higher than 1 was considered as a high CONUT score. Total incidence of PPCs was 8.6% (n = 79). The proportion of pneumonia was significantly larger in the high conUt group (P < 0.05). The CONUT consistently had a higher area under curve (AUC) value (0.64) than other prognostic models (prognostic nutritional index (PNI): AUC = 0.61, Glasgow prognostic score (GPS): AUC = 0.57, and assessment of respiratory risk in surgical patients in Catalonia (ARISCAT): AUC = 0.54). Multivariate analysis identified underweight [Odds ratio (OR) = 4.57, P = 0.002] and high CONUT score (OR = 1.91, P = 0.009) as independent PPCs prognostic factors. One-year mortality rate for high CONUT score was significantly higher (hazard ratio = 7.97; 95% confidence interval, 1.78-35.59). Preoperative CONUT score is an independent predictor of PPCs and 1-year mortality in patients with resectable NSCLC. Postoperative complication (PPC) is critically important for patient outcomes, and is associated with mortality, morbidity, and length of stay in both thoracic and non-thoracic surgical patients 1. Although the definition of PPCs varies in the literature, it generally includes prolonged air leak, pneumothorax, atelectasis, pleural effusion, respiratory infections, broncho-pleural fistula, and acute respiratory distress syndrome (ARDS) 2. In patients undergoing thoracic surgery in particular, the incidence of PPCs is reported to be between 3 and 49%, with mortality ranges ranging 2-12% 3. Therefore, careful preoperative evaluation is needed to predict PPCs, and this is a common concern among thoracic surgeons, pulmonologists, and anesthesiologists. Various PPCs prediction models have been previously developed; these include the assessment of respiratory risk in surgical patients in Catalonia (ARISCAT) model, Gupta risk calculators, and the respiratory failure risk index suggested by Arozullah et al. 2,4-6. However, these models require diverse preoperative parameters, which bring questionable clinical usefulness of those. Moreover, detailed nutritional status is not reflected in any of these models.

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Section: Introductionmentioning

confidence: 99%

Prediction of postoperative pulmonary complications using preoperative controlling nutritional status (CONUT) score in patients with resectable non-small cell lung cancer

Lee

et al. 2020

Sci Rep

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“…Therefore, the Alb concentration is not only a nutritional indicator but also an indicator of the inflammatory response. A growing body of evidence suggests that hypoalbuminemia is associated with poor survival in several primary malignancies, including GC [50][51]. In addition, several common inflammation-based prognostic scores, including NLR, PLR, GPS, and CONUT score, have prognostic value in patients with multiple types of malignant solid tumors [52][53][54][55][56].…”

Section: Discussionmentioning

confidence: 99%

Combining the Platelet-to-Albumin Ratio with Serum and Pathologic Variables to Establish a Risk Assessment Model for Lymph Node Metastasis of Gastric Cancer and Evaluation of Its Predictive Value

Huang

Xia

et al. 2019

Preprint

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Background The preoperative platelet count and serum tumor markers have been shown to correlate with the lymph node metastasis (LNM) of gastric cancer (GC).The aim of this study was to establish a risk assessment model that incorporated the platelet-to-albumin ratio (PAR) for LNM of GC and to evaluate its clinical significance. Methods The clinical data of 314 patients with GC diagnosed by postoperative pathology were collected in our hospital. According to whether there was LNM in the pathological specimens of the operation, the patients were divided into the group without LNM and the group with LNM. Univariate analysis and multivariate logistic regression were used to analyze the relevant factors affecting LNM of GC and to identify independent risk factors for LNM of GC. The random forest algorithm was used to extract the important risk factors of LNM in GC. A nomogram model of the risk assessment of LNM of GC was constructed by the “rms” package of R software. The receiver operating characteristic (ROC) curve was used to evaluate the accuracy, sensitivity and specificity of the model for predicting LNM of GC. Results Univariate analysis showed that the factors associated with LNM of GC were sex (P=0.015), smoking (P=0.027), lesion size (P=0.000), pathological type (P=0.001), differentiation degree (P=0.000), infiltration depth (P=0.000), PAR (P=0.005), carbohydrate antigen (CA) 19-9 (P=0.017), CA125 (P=0.000) and CA72-4 (P=0.005). Multivariate logistic regression showed that lesion size [odds ratio (OR): 1.322; P = 0.000], differentiation degree (OR: 0.582; P = 0.001), and depth of invasion (OR: 1.734; P = 0.000) were independent risk factors for LNM in GC. The risk assessment model of LNM in GC was established according to the ranking of variables shown by the random forest algorithm. The C statistic of the model evaluation was 0.827, the sensitivity was77.2%, and the specificity was 74.8%. Conclusion Lesion diameter larger than 2.65 cm, poor differentiation and deep infiltration were high-risk factors for LNM in GC. The nomogram model constructed by PAR, lesion size, infiltration depth, CA125, CA19-9, CA72-4, and differentiation degree, can well predict the risk of LNM in GC.

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“…Third, whether PNI is an optimal measure for evaluating nutritional status in patients undergoing gastrectomy remains to be fully addressed. Various perioperative nutritional and inflammatory parameters have been identified as useful predictors of poor OS in patients with GC [46], such that further studies designed to determine the optimal measures for evaluating perioperative nutritional status in patients with GC are warranted. Finally, this was a single-institution, retrospective study.…”

Section: Variablesmentioning

confidence: 99%

Pre- and post-operative low prognostic nutritional index influences survival in older patients with gastric carcinoma

Sugawara

Aikou

Yajima

et al. 2020

Journal of Geriatric Oncology

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Prognostic significance of perioperative nutritional parameters in patients with gastric cancer

Cited by 56 publications

References 18 publications

Prediction of postoperative pulmonary complications using preoperative controlling nutritional status (CONUT) score in patients with resectable non-small cell lung cancer

Prediction of postoperative pulmonary complications using preoperative controlling nutritional status (CONUT) score in patients with resectable non-small cell lung cancer

Combining the Platelet-to-Albumin Ratio with Serum and Pathologic Variables to Establish a Risk Assessment Model for Lymph Node Metastasis of Gastric Cancer and Evaluation of Its Predictive Value

Pre- and post-operative low prognostic nutritional index influences survival in older patients with gastric carcinoma

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