Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer

Schwegler, Igor; Holzen, A. von; Gutzwiller, Jean‐Pierre; Schlumpf, R.; Mühlebach, Stefan; Stanga, Zeno

doi:10.1002/bjs.6805

Cited by 331 publications

(259 citation statements)

References 28 publications

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“…Although there is no single marker which is consistent with nutritional assessment for the critically ill, there are several indicators used in identifying malnutrition in patients [11]. Indeed it was noted that the mean age of patients was similar to recent work involving elective surgical patients [12]. Similarly, on admission the number of malnourished patients was approximately 32 % which is also similar to previous findings [13,14].…”

Section: Discussionsupporting

confidence: 80%

Complications associated with malnutrition in elective surgical patients in a Malaysian setting

Latiff¹,

Ahmad

Islahudin³

2016

Trop. J. Pharm Res

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Section: Discussionsupporting

confidence: 80%

Complications associated with malnutrition in elective surgical patients in a Malaysian setting

Latiff¹,

Ahmad

Islahudin³

2016

Trop. J. Pharm Res

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“…Preoperative immunological and nutritional conditions are associated with both the postoperative and long-term outcomes of malignant tumors [1,24] . Identifying prognostic factors before surgery to help determine the optimal preoperative therapy and timing of surgery is important.…”

Section: Discussionmentioning

confidence: 99%

Novel immunological and nutritional-based prognostic index for gastric cancer

Sun

Chen

et al. 2015

WJG

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AIM:To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index (PNI), neutrophillymphocyte ratio (NLR), and platelet-lymphocyte ratio in gastric cancer. METHODS:We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between 1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate. Univariate and multivariate analyses were performed to identify risk factors for overall survival (OS). Propensity score analysis was performed to adjust variables to control for selection bias. RESULTS:Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring (hazard ratio, 1.668; 95% confidence interval: 1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage Ⅱ- Retrospective Study ORIGINAL ARTICLEⅢ disease (P = 0.019, P < 0.001), T3-T4 tumors (P < 0.001), or lymph node metastasis (P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS (P = 0.022, P = 0.030, P < 0.001, and P = 0.024, respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively. CONCLUSION:PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer. Core tip: This is the first study to compare the prognostic significance of different immuno-nutritional indices including prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR) and plateletlymphocyte ratio (PLR) in gastric cancer. We found that PNI was an independent prognostic factor for overall survival in gastric cancer before and after the propensity score analysis, especially in patients with advanced disease, deep tumors, or lymph node metastasis. We also proposed that a new index-Canton score (a combination of PNI, NLR and PLT) is a superior prognostic factor compared to PNI, NLR, or PLR alone, as it better represents the relative contribution of each of these indices.Sun KY, Xu JB, Chen SL, Yuan YJ, Wu H, Peng JJ, Chen CQ, Guo P, Hao YT, He YL. Novel immunological and nutritionalbased prognostic index for gastric cancer.

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“…preoperatively in an attempt to decrease postsurgical morbidity and mortality (6,19,24) . However, the nutritional status is frequently not adequately assessed by the medical staff, which negatively affects the response to treatment and increases the incidence of adverse effects (2,19) .…”

Section: Immediate Preoperative Nutritional Status Of Patients With Cmentioning

confidence: 99%

“…However, the nutritional status is frequently not adequately assessed by the medical staff, which negatively affects the response to treatment and increases the incidence of adverse effects (2,19) . Another difficulty in terms of nutritional assessment is the absence of an internationally accepted standard method for classifying nutritional status, as there is no single ideal method that includes all aspects of malnutrition (10,13) .…”

Section: Immediate Preoperative Nutritional Status Of Patients With Cmentioning

confidence: 99%

IMMEDIATE PREOPERATIVE NUTRITIONAL STATUS OF PATIENTS WITH COLORECTAL CANCER: a warning

Barbosa

Lacerda‐Filho

Barbosa

2014

Arq. Gastroenterol.

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-Context -Weight loss and malnutrition are disorders observed in colorectal cancer patients. Objetives -We sought to evaluate the immediate preoperative nutritional status of patients with colorectal cancer. Methods -This is a cross-sectional clinical study conducted at a single center. Sixty-six consecutive patients in preoperative for elective surgical treatment were studied. The clinical history, socio-demographic data and nutritional status of the patients were evaluated using Subjective Global Assessment and objective (anthropometry) methods. The primary outcome measures were nutritional status classification as nourished or malnourished and the relationship between nutritional status and socio-demographic and clinical features. Results -Most of patients exhibited left colon tumors and disease stage II. According to the Subjective Global Assessment, 36.4% of patients were malnourished. Malnutrition ranged from 7.6% to 53% depending on the evaluation method used, with poor correlation to Subjective Global Assessment. The prevalence of malnutrition was significantly greater in females and non-married patients and in those with two or more symptoms of colorectal cancer. Conclusion -More than a third of patients in the immediate preoperative period for colorectal cancer exhibited malnutrition. Therefore, routine nutritional assessment is highly advisable so that appropriate measures may be taken to minimize the potential postoperative complications. HEADINGS -Colorectal neoplasms. Preoperative period. Malnutrition. Nutrition assessment.

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Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer

Abstract: Nutritional risk screening may be able to predict mortality and morbidity after surgery for colorectal cancer. However, the diverse results reflect either the imprecision of the tests or the small sample size.

Cited by 331 publications

References 28 publications

Complications associated with malnutrition in elective surgical patients in a Malaysian setting

Complications associated with malnutrition in elective surgical patients in a Malaysian setting

Novel immunological and nutritional-based prognostic index for gastric cancer

IMMEDIATE PREOPERATIVE NUTRITIONAL STATUS OF PATIENTS WITH COLORECTAL CANCER: a warning

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