The prognostic influence of body mass index, resting energy expenditure and fasting blood glucose on postoperative patients with esophageal cancer

Wu, Ning; Zhu, Yaping; Kadel, Dhruba; Pang, Liewen; Chen, Gang; Chen, Zhiming

doi:10.1186/s12876-016-0549-6

Cited by 22 publications

(20 citation statements)

References 28 publications

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“…A more pronounced decline in REE in very old subjects could even be a marker of frailty and sarcopenia as suggested by the results of a recent study [56]. In patients with esophageal cancer, not only was the REE not increased [57], but a low REE was also associated with worse survival at five years [58].…”

Section: Discussionmentioning

confidence: 92%

Energy Expenditure in Older People Hospitalized for an Acute Episode

et al. 2019

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Weight loss and worsening of nutritional state is a frequent downfall of acute hospitalization in older people. It is usually accepted that acute inflammation is responsible for hypercatabolism. However, several studies suggest, on the contrary, a reduction in resting energy expenditure (REE). This study aimed to obtain a reliable measure of REE and total energy expenditure (TEE) in older patients hospitalized for an acute episode in order to better assess patients’ energy requirements and help understand the mechanisms of weight loss in this situation. Nineteen hospitalized older patients (mean age 83 years) with C-reactive protein (CRP) level >20mg/L were recruited. REE and TEE were measured using gold standard methods of indirect calorimetry and doubly labeled water (DLW), respectively. REE was then compared to data from a previous study on aged volunteers from nursing homes who were free of an acute stressor event. Energy requirements measured by DLW were confirmed at 1.3 × REE. Energy intake covered the needs but did not prevent weight loss in these patients. TEE was not increased in hospitalized patients and was not influenced by inflammation, while the relationship between REE and inflammation was uncertain. Our results suggest that lean mass remains the major determinant of REE in hospitalized older people and that weight loss may not be explained solely by a state of hypercatabolism.

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Section: Discussionmentioning

confidence: 92%

Energy Expenditure in Older People Hospitalized for an Acute Episode

et al. 2019

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“…carried out a prospective cohort study with 387 stage I-IV NSCLC patients and found that patients with a low FBG (<4 mmol/L) had a significantly higher risk of death than those with a high FBG [23]. Wu et al conducted a study that included 306 stage 0-III esophageal cancer patients who underwent esophagectomy and found that low postoperative FBG was related to poor survival, and an FBG ≤4 mmol/L was independently linked to poor survival [16]. In our study, we selected patients without a background of a prior preoperative aberrant FBG and found that a low postoperative FBG (<5.11 mmol/L) was associated with poor survival for CRC, which was partially consistent with the results of these studies [16,23].…”

Section: Discussionmentioning

confidence: 99%

“…Wu et al conducted a study that included 306 stage 0-III esophageal cancer patients who underwent esophagectomy and found that low postoperative FBG was related to poor survival, and an FBG ≤4 mmol/L was independently linked to poor survival [16]. In our study, we selected patients without a background of a prior preoperative aberrant FBG and found that a low postoperative FBG (<5.11 mmol/L) was associated with poor survival for CRC, which was partially consistent with the results of these studies [16,23]. Notably, we also found that 58.75% (47/80) of patients maintained a relatively high FBG compared to their preoperative value at the 3-6 m follow-up, but FBG failed to present any prognostic value for DFS.…”

Section: Discussionmentioning

confidence: 99%

“…Although it is mainly regulated by insulin, the level of FBG in individuals has been found to be closely related to some characteristics, including body mass index (BMI) [15,16] and the neutrophil-lymphocyte ratio (NLR). The NLR was found to be positively associated with FBG in patients with T2DM or high FBG [17] but was negatively correlated with FBG in normal subjects [18].…”

Section: Introductionmentioning

confidence: 99%

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Postoperative Fasting Blood Glucose Predicts Prognosis in Stage I-III Colorectal Cancer Patients Undergoing Resection

Xu¹,

You²,

Li³

et al. 2020

Gastroenterology Research and Practice

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Purpose. The relationship between high blood glucose and colorectal cancer (CRC) has been studied, but the role of postoperative fasting blood glucose (FBG) in patients with a prior normal FBG has never been addressed. Methods. A total of 120 CRC patients staged I-III were enrolled, and the prognostic value of postoperative FBG for disease-free survival (DFS) was determined by Kaplan-Meier analysis. Univariate and multivariate analyses were conducted to test other clinicopathological parameters, including preoperative hemoglobin (HGB) and the neutrophil-lymphocyte ratio (NLR). Results. By a cut-off point of 5.11 mmol/L, 51 and 69 patients were divided into low postoperative FBG (<5.11 mmol/L) and high postoperative FBG (≥5.11 mmol/L) groups, respectively. A high postoperative FBG was more common in older age (P=0.01), left-located tumor (P=0.02), smaller tumor diameter (P=0.01), node negative involvement (P=0.01), lesser positive lymph nodes (P=0.02), and high preoperative HGB (P=0.01). Further, high postoperative FBG patients displayed a significantly better DFS than low postoperative FBG patients (48.80±22.12 months vs. 40.06±24.36 months, P=0.04), but it was less likely to be an independent prognostic factor. Conclusions. Postoperative FBG plays a temporal prognostic role for patients with stage I-III CRC with a prior normal FBG, but it is not an independent prognostic factor.

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“…Nutritional status is thought to be a prognostic factor for esophageal cancer patients. 4) In addition, low serum albumin 5) and high C-reactive protein (CRP) 6) are reported to be the significant predictors of poor prognosis in such patients. Conflicting reports have proposed a prognostic role of body mass index (BMI) for histologic types of esophageal cancer.…”

Section: Introductionmentioning

confidence: 99%

Does Preoperative Low HbA1c Predict Esophageal Cancer Outcomes?

Kochi

Suzuki

Yajima

et al. 2020

ATCS

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Background: Although several reports have shown that diabetes is a poor prognostic factor for esophageal cancer, no reports assessed prognostic impact of hemoglobin A1c (HbA1c) in the patients with esophageal cancer. Therefore, we evaluated the prognostic significance of HbA1c in patients with esophageal cancer. Methods: A total of 137 patients with esophageal carcinoma surgically treated at our institute between 2009 and 2017 were enrolled in this retrospective study. We divided these patients into quarters according to pretreatment levels of HbA1c. We used 5.5% as a cutoff for classifying patients into low (Q1; n = 30) and high (Q2, Q3, Q4; n = 107) HbA1c groups. Univariate and multivariate analyses were then used to evaluate the clinicopathological and prognostic significance of pretreatment level of HbA1c. Results: There was no significant relationship between HbA1c level and clinicopathological factors. The low HbA1c group had a significantly worse survival rate as compared to that of the high HbA1c group (overall survival p = 0.04, relapse-free survival p = 0.02). However, the difference was not confirmed in the multivariate analysis. Conclusion: Although low level of pretreatment HbA1c might be associated with poor prognosis for patients with esophageal cancer, low HbA1c was not an independent risk factor.

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The prognostic influence of body mass index, resting energy expenditure and fasting blood glucose on postoperative patients with esophageal cancer

Cited by 22 publications

References 28 publications

Energy Expenditure in Older People Hospitalized for an Acute Episode

Energy Expenditure in Older People Hospitalized for an Acute Episode

Postoperative Fasting Blood Glucose Predicts Prognosis in Stage I-III Colorectal Cancer Patients Undergoing Resection

Does Preoperative Low HbA1c Predict Esophageal Cancer Outcomes?

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