Nutritional Status Indicators Affecting the Tolerability of Postoperative Chemotherapy After Total Gastrectomy in Patients With Gastric Cancer

Abstract

Purpose Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy. Materials and Methods We included 101 patients who underwent curative total gastrectomy and postoperative chemotherapy at Hiroshima Memorial Hospital. The effects of 37 factors, including perioperative inflammatory, nutritional, and tumor status, on the persistence of postoperative chemotherapy were analyzed. Results In univariate analysis of preoperative factors, age, carbohydrate antigen 19-9, platelet-to-neutrophil ratio, Onodera's prognostic nutritional index (PNI), controlling nutritional status score, and nutritional risk screening (NRS-2002) score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of preoperative factors, age (≥74 years) was an independent factor for a shorter duration of postoperative chemotherapy (hazard ratio [HR], 5.24; 95% confidence interval [CI], 2.19–12.96; P<0.01). In univariate analysis of factors before postoperative chemotherapy, intraoperative blood loss, perioperative weight loss rate, postoperative performance status, PNI, albumin-to-bilirubin index, and NRS-2002 score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of factors before postoperative therapy, age (≥74 years) (HR, 5.75; 95% CI, 1.90–19.49; P<0.01) and PNI (<39) (HR, 3.29; 95% CI, 1.26–8.56; P=0.02) were independent factors for a shorter duration of postoperative chemotherapy. Conclusions Age and PNI are useful predictors of postoperative chemotherapy intolerance after total gastrectomy and may determine the treatment strategy and timing of chemotherapy initiation.

The prognostic role of neutrophil/lymphocyte ratio and monocyte/lymphocyte ratio in advanced stage gastric cancer patients receiving chemotherapy: a single center experience

“…Albumin-bilirubin index, Nutritional risk score (NRS-2002), NLR, Platelet-Lymphocyte Ratio (PLO), monocyte-lymphocyte ratio (MLR), Gamma- * Since the age variable provides the assumption of normality, the p value was determined according to the independent sample student's t-test, and the p value of the other variables was defined by the chi-square test. NLR: Neutrophil/lymphocyte ratio, MLR, Monocyte-lymphocyte ratio, OS: Overall survival time, BMI: Body-Mass Index interferon/Interleukin-4 ratio are among the reported and investigated markers (16)(17)(18). There are many studies shows a relationship between NLR and gastric cancer prognosis, however, these studies focused on postoperative survival in patients with early or operable gastric cancer rather than metastatic gastric cancer patients (19)(20)(21).…”

Quality of Life, Sarcopenia and Nutritional Status in Patients with Esophagogastric Tumors before and after Neoadjuvant Therapy

“…Recent attention has been attributed to muscle function and strength as assessed by handgrip strength or physical exercise rather than the measurement of plain muscle mass [ 19 , 44 , 45 , 46 ]. On the other hand, nutritional scores, which are easy and fast to assess, have also been shown to correlate with OS, duration of chemotherapy and HRQoL [ 47 , 48 , 49 , 50 , 51 , 52 ]. Not only the QLQ-C30 summary score but also singular eating-related QLQ-OG25 symptom scores have been shown to be associated with OS [ 29 ].…”