Analysis of Factors Associated with Weight Loss After Esophagectomy for Esophageal Cancer

Kitagawa, Hiroyuki; Namikawa, Tsutomu; Munekage, Masaya; Fujisawa, Kazune; Munekage, Eri; Kawanishi, Yuji; Kobayashi, Mariko; Hanazaki, Kazuhiro

doi:10.21873/anticanres.11117

Cited by 19 publications

(13 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…reported that the absence of pyloroplasty was the sole risk factor for > 10% weight loss of PWL one year after esophagectomy . A retrospective study with six months follow‐up after esophagectomy showed that preoperative BMI and a shorter LOS resulted in > 10% weight loss . In this study, however, except for VCP, we found no definitive association between the PBW, BMI, and LOS with long‐term SWL.…”

Section: Discussioncontrasting

confidence: 84%

See 1 more Smart Citation

Analysis of the associated factors for severe weight loss after minimally invasive McKeown esophagectomy

Wang

Sun

et al. 2018

Thoracic Cancer

View full text Add to dashboard Cite

BackgroundThis study investigated the risk factors for severe weight loss (SWL) within one year after minimally invasive McKeown esophagectomy.MethodsEsophageal cancer patients who underwent McKeown esophagectomy between January and July 2017 were prospectively enrolled. Preoperative body weight (PBW) was chosen as the initial body weight.ResultsForty‐four patients were enrolled and successfully followed up for one year. Median weight loss was 7.4% (quartile: 5.3–8.1%) and 12.6% (quartile: 8.8–17.7%) four weeks and one year after surgery, respectively. Accelerated weight loss occurred during the first two weeks after discharge, with median weight loss of 5.6% (quartile: 4.2–7.1%). Multivariable analysis showed that age ≥ 70 years (odds ratio [OR] 7.65; P = 0.030), preoperative sarcopenia (OR 7.18; P = 0.030), the first surgery in the daily schedule (OR 6.87; P = 0.032) and vocal cord paralysis (OR 12.30; P = 0.046) were independent risk factors for short‐term (4 weeks) SWL (> 7.5% PBW), while an American Society of Anesthesiologists score of 3–4 (OR 6.58; P = 0.047), a high fat‐free mass (OR 21.91; P = 0.003), and vocal cord paralysis (OR 25.83; P = 0.017) were independent risk factors for long‐term (1 year) SWL (> 13.0% PBW) after esophagectomy. Postoperative symptoms of insomnia, appetite loss, dysphagia, eating difficulties, and taste issues were also related to SWL.ConclusionsIn esophageal cancer patients who have undergone esophagectomy, the first two weeks after hospital discharge is a key period for nutrition intervention. Patients with associated factors for SWL require postoperative nutrition support.

show abstract

Section: Discussioncontrasting

confidence: 84%

“…5 A retrospective study with six months follow-up after esophagectomy showed that preoperative BMI and a shorter LOS resulted in > 10% weight loss. 44 In this study, however, except for VCP, we found no definitive association between the PBW, BMI, and LOS with long-term SWL.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the associated factors for severe weight loss after minimally invasive McKeown esophagectomy

Wang

Sun

et al. 2018

Thoracic Cancer

View full text Add to dashboard Cite

show abstract

“…In addition, reconstruction of the gastric tube, which is commonly required with esophagectomy, is associated with a high incidence of anastomotic leakage [1]. From a clinical perspective, postoperative weight loss is common after esophagectomy, even in the absence of any complications [4], with severe weight loss being associated with a poor prognosis [5].…”

Section: Introductionmentioning

confidence: 99%

Bowel obstruction associated with a feeding jejunostomy and its association to weight loss after thoracoscopic esophagectomy

Kitagawa¹,

Namikawa²,

Iwabu³

et al. 2019

BMC Gastroenterol

Self Cite

View full text Add to dashboard Cite

Background Our aim was to clarify the incidence of bowel obstruction associated with a feeding jejunostomy (BOFJ) after thoracoscopic esophagectomy and its association to characteristics and postoperative change in body weight. Methods We reviewed 100 consecutive patients who underwent thoracoscopic esophagectomy with gastric tube reconstruction and placement of a jejunostomy feeding catheter for esophageal cancer. The incidence of BOFJ was evaluated and the change in body weight after surgery was compared between patients with and without BOFJ. Results BOFJ developed in 17 patients. Compared to patients without BOFJ, those with BOFJ had a higher preoperative body mass index (23.3 kg/m 2 versus 20.9 kg/m 2 , P = 0.022), and greater postoperative body weight loss rate: 3 month, decrease to 84.2% of initial body weight versus 89.3% ( P = 0.002). Patients with BOFJ had shorter distance between the jejunostomy and midline (40 mm versus 48 mm, P = 0.011) compared to patients without BOFJ. On multivariate analysis, higher preoperative body mass index (odds ratio (OR) = 9.248; 95% confidence interval (CI) = 1.344–63.609; p = 0.024), higher postoperative weight loss at 3 months (OR = 8.490; 95% CI = 1.765–40.837, p = 0.008), and shorter distance between the jejunostomy and midline (OR = 8.160; 95% CI = 1.675–39.747, p = 0.009) were independently associated with BOFJ. Conclusion Patients of BOFJ had greater preoperative body mass, shorter distance between jejunostomy and midline, and greater postoperative weight loss.

show abstract

“…Indeed, unintentional weight loss is a major concern both before and during the treatment of cancer. Several studies have demonstrated that weight loss before esophageal cancer resection might be related to the postoperative survival [6][7][8][9][10][11][12]. To our knowledge, no research has focused on weight loss during neoadjuvant CRT or on the relationship between this weight loss and the survival outcomes in patients with esophageal cancer.…”

Section: Discussionmentioning

confidence: 99%

“…However, the overall survival (OS) varies in such patients, and some fail to benefit from neoadjuvant chemoradiotherapy, indicating a need to identify the factors associated with the prognosis and provide more information about the most appropriate clinical interventions to improve outcomes among highrisk patients. One such factor is weight loss, which is common and often occurs by the time of diagnosis or during treatment in patients with esophageal cancer [4][5][6][7][8]. Although weight loss before treatment has been shown to be a key prognostic indicator of the OS in such patients [9-demographics, neoadjuvant treatment, toxicity, weight records and follow-up results were reviewed in detail from the medical records and the follow-up system.…”

Section: Introductionmentioning

confidence: 99%

Effect of Weight Loss on Survival in Esophageal Cancer Patients undergoing Neoadjuvant Chemoradiotherapy and Surgery

Lyu¹,

Li²,

Han³

et al. 2020

Journal of Nutritional Oncology

View full text Add to dashboard Cite

12], the impact of weight loss during neoadjuvant CRT on the long-term survival of patients with esophageal cancer remains unknown. Therefore, this retrospective study aimed to investigate the association of weight loss during neoadjuvant CRT with survival outcomes in patients with esophageal cancer. Materials & Methods Study design and participants A total of 102 patients with esophageal squamous cell cancer undergoing neoadjuvant CRT followed by surgery at Sichuan Cancer Hospital & Institute from March 2003 to August 2017 were retrospectively identified. Enrolled patients met the following inclusion criteria: ① newly diagnosed, histologically-confirmed primary esophageal squamous cell cancer; ② clinically stage II or III before treatment according to the 2002 American Joint Committee on Cancer Staging System (version 6.0); ③ Karnofsky performance score ≥ 80; and ④ patients underwent neoadjuvant chemoradiotherapy followed by radical esophagectomy. The exclusion criteria were as follows: ① missing weight records pre-or post-CRT; ② metastatic disease before or during preoperative treatment; ③ nonsquamous cell carcinoma; and ④ other active malignancy (except for basal cell carcinoma of the skin). The patient Abstract: Objective This study aimed to determine the impact of weight loss during neoadjuvant chemoradiotherapy on the survival of patients with esophageal carcinoma. Methods We retrospectively examined 102 consecutive patients with esophageal carcinoma who underwent neoadjuvant chemoradiotherapy followed by radical resection at Sichuan Cancer Hospital & Institute between 2003 and 2017. The patients were divided into three groups based on the amount of body weight lost during neoadjuvant chemoradiotherapy: severe weight loss (>10%), high weight loss (5%~10%), and low weight loss (< 5%). The correlations of weight loss with toxicity, progressionfree survival, and overall survival were investigated. Results The median overall survival was 49.7 months in the low weight loss group compared with 35.4 and 25.1 months in the high and severe weight loss groups (P = 0.041). The 1-year overall survival rates in the severe, high, and low weight loss groups were 62.5%, 85.0%, and 90.7%, respectively; the corresponding 3-year overall survival rates were 21.9%, 47.3%, and 68.8%, respectively, and the corresponding 5-year overall survival rates were 21.9%, 31.0%, and 44.4%, respectively. The multivariate analysis indicated that a pathological complete response and severe weight loss were independent prognostic factors for overall survival. Any leukopenia (P = 0.024), leukopenia of at least grade 3 (P = 0.021), and anemia (P = 0.042) occurred more frequently in the severe weight loss group. Conclusions Weight loss during neoadjuvant CRT is an independent and adverse prognostic factor in esophageal carcinoma patients, whereas a stable weight confers a better prognosis.

show abstract

Analysis of Factors Associated with Weight Loss After Esophagectomy for Esophageal Cancer

Abstract: Abstract. Background/Aim: This study aimed to clarify the relationship between dosimetric factors and parotid gland (PG) atrophy after carbon ion radiotherapy (C-ion RT

Cited by 19 publications

References 5 publications

Analysis of the associated factors for severe weight loss after minimally invasive McKeown esophagectomy

Analysis of the associated factors for severe weight loss after minimally invasive McKeown esophagectomy

Bowel obstruction associated with a feeding jejunostomy and its association to weight loss after thoracoscopic esophagectomy

Effect of Weight Loss on Survival in Esophageal Cancer Patients undergoing Neoadjuvant Chemoradiotherapy and Surgery

Contact Info

Product

Resources

About