A Clinical Investigation of the Association between Perioperative Oral Management and Prognostic Nutritional Index in Patients with Digestive and Urinary Cancers

Abstract

Background The prognostic nutritional index (pni) is a simple metric calculated using serum albumin and the peripheral lymphocyte count. It was reported that a low pni score is significantly associated with major postoperative complications and poor prognosis. The purpose of the present study was to investigate the effects of perioperative oral management (pom) on the perioperative pni profiles of patients with digestive system or urinary cancers.
 Study Design The medical records of 181 patients with cancer who underwent surgery and for whom a pni could be calculated were retrospectively reviewed.
 Results The intervention rate with pom was 34.8%. The median preoperative pni score was 48.25 in all patients with a pom intervention [25% to 75% interquartile range (iqr): 44.38–54.13] and 47.25 in those without an intervention (iqr: 42.0–53.5). Compared with patients not receiving pom, those who received pom had significantly higher pni scores from the early postoperative period (p < 0.05). Notably, of patients who could resume oral intake within 3 days after surgery, those who received pom intervention, compared with those who did not, had significantly higher pni scores from the early postoperative period (p < 0.05).
 Conclusions Perioperative oral management interventions might have positive effects on the postoperative pni scores of patients with cancer.

Prognostic Nutritional Index (PNI) in Patients With Breast Cancer Treated With Neoadjuvant Chemotherapy as a Useful Prognostic Indicator

“…The PNI was initially developed to evaluate the postoperative complications in patients who received gastrointestinal surgery ( Onodera et al, 1984 ). Lymphocytes and serum albumin are significantly closely related to the prognosis of cancer patients ( Otagiri et al, 2020 ; Powell et al, 2020 ). Lymphocytes play an active role in the adaptive immune system to clear tumors from the body and to prevent their development and spread ( Hanahan and Weinberg, 2011 ).…”

The effects of perioperative oral management on perioperative serum albumin levels in patients treated surgically under general anesthesia

“…In a recent report investigated the correlation between POMs and PNI score in cancer patients, patients who received POMs showed significantly higher PNI scores from the early postoperative period, compared those not receiving POMs. [ 15 ] Additionally, among patients who could resume oral intake within postoperative 3 days, those who received POMs intervention showed significantly higher PNI scores from the early postoperative period, compared to patients without POMs. [ 15 ] Although these results might suggest the favorable effects of POMs on perioperative nutrition status in cancer patients, there was limitations such as a retrospective study based on relatively small number of cases at single institute.…”

“…[ 15 ] Additionally, among patients who could resume oral intake within postoperative 3 days, those who received POMs intervention showed significantly higher PNI scores from the early postoperative period, compared to patients without POMs. [ 15 ] Although these results might suggest the favorable effects of POMs on perioperative nutrition status in cancer patients, there was limitations such as a retrospective study based on relatively small number of cases at single institute. Therefore, in the present study, to obtain new evidence to support POMs for patients treated surgically under general anesthesia, perioperative serum albumin levels were examined in a large number of cases in a multicenter study.…”

“…[ 14 ] Increased oral bacteria, dental infections, oral mucositis, masticatory disorders due to the teeth loss result in the decline of the oral function. [ 15 ] As a result, the decline of oral function affects on the nutrition condition in cancer patients. Although oral and dental conditions play important roles in nutrition, the effects of POMs on perioperative serum albumin levels have not yet been investigated except for 1 recent report.…”

“…Although oral and dental conditions play important roles in nutrition, the effects of POMs on perioperative serum albumin levels have not yet been investigated except for 1 recent report. [ 15 ] In this report, perioperative POMs intervention might have positive effects on the postoperative prognostic nutrition index (PNI), which was calculated using serum albumin and the peripheral lymphocyte count, in the patients with digestive systems or urinary cancer. [ 15 , 16 ] Therefore, the purpose of the present study was to investigate the efficacy of POMs on perioperative serum albumin levels in patients treated surgically under general anesthesia based on a large number of cases using a multicenter retrospective analysis.…”