Predictive Potential of Preoperative Nutritional Status in Long-Term Outcome Projections for Patients with Gastric Cancer

Sakurai, Katsunobu; Ohira, Masaichi; Tajiri, Tatsuro; Toyokawa, Takahiro; Amano, Ryosuke; Kubo, Naoshi; Tanaka, Hiroaki; Muguruma, Kazuya; Yashiro, Masakazu; Maeda, Kiyoshi; Hirakawa, Kosei

doi:10.1245/s10434-015-4814-7

Cited by 134 publications

(96 citation statements)

References 27 publications

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“…In our practice, a detailed preoperative nutritional assessment is performed to determine the potential malnutrition in patients with gastric cancer (9,10). In addition to simple anthropometric measurements (e.g., weight, body mass index, weight loss ratio, and Nutritional Risk Screening (11).…”

Section: Management Of Locoregional Diseasementioning

confidence: 99%

Recent trends of gastric cancer treatment in Turkey

Güner

2017

Transl. Gastroenterol. Hepatol.

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Gastric cancer is the fifth most common type of cancer and is the fourth most common death due to cancer in Turkey. Incidence and mortality rates are one of the highest among European countries. Despite the high rates, management of gastric cancer is still an issue of debate in Turkey and national guidelines have yet to be established. While the treatment plan following the diagnosis of gastric cancer is determined by a multidisciplinary meeting at high-volume centers, the plan in the majority of cases in Turkey is decided based on the decision of an individual physician. The primary goal of the treatment strategy is to obtain the best oncological outcomes and quality of life within the acceptable treatment-related morbidity. Therefore, R0 resection is intended by using standardized surgery with an individualized approach, while avoiding surgery if a curative resection is not possible. In this review, presenting on the recent trends of gastric cancer treatment including surgical, endoscopic, adjuvant/neoadjuvant and conversion treatment options in Turkey are aimed by exploring the institutional approach.

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Section: Management Of Locoregional Diseasementioning

confidence: 99%

Recent trends of gastric cancer treatment in Turkey

Güner

2017

Transl. Gastroenterol. Hepatol.

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“…Preoperative PNI is hypothesized to be a prognostic marker for a number of malignancies, including long-term survival for patients with GC (10,11,17,45). However, no association between either preoperative or postoperative PNI and survival in patients with GC who received S-1 ACT was demonstrated.…”

Section: Discussionmentioning

confidence: 99%

“…The prognostic significance of a number of clinical parameters has been examined for patients with GC subsequent to radical surgery (8)(9)(10)(11)(12)(13)(14)(15). Of these, the preoperative prognostic nutritional index (PNI) as a reflection of the immunological and nutritional condition of the patients has been associated with the outcomes of patients who undergo gastrectomy for a number of stages of GC (10,11,16,17).…”

Section: Introductionmentioning

confidence: 99%

“…Of these, the preoperative prognostic nutritional index (PNI) as a reflection of the immunological and nutritional condition of the patients has been associated with the outcomes of patients who undergo gastrectomy for a number of stages of GC (10,11,16,17). Although the association between body mass index (BMI) and postoperative complications has been investigated (18)(19)(20)(21)(22), the association between BMI and long-term survival subsequent to curative gastrectomy remains unclear (23)(24)(25)(26)(27)(28) In the present study, the dose-response effects of S-1 ACT on survival in patients who received gastrectomy for GC were clarified, and other clinical factors that affected their survival were analyzed, including BMI and PNI as nutritional parameters.…”

Section: Introductionmentioning

confidence: 99%

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Outcome predictors for patients with stage II/III gastric cancer who undergo gastrectomy and S-1 adjuvant chemotherapy

et al. 2017

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Abstract. Predictors of survival in patients with stage II/III gastric cancer (GC) who received tegafur/gimeracil/oteracil (S-1) adjuvant chemotherapy (ACT) subsequent to gastrectomy were examined. Additionally, the association between dose intensity of S-1 and survival rate was investigated. A total of 62 patients with stage II/III gastric cancer were retrospectively evaluated, each of whom had received a curative D2 gastrectomy and S-1 ACT. The relative performance (RP; administered/planned S-1 doses x100%), body mass index (BMI), prognostic nutritional index (PNI) and body weight (BW) were calculated, and the association of survival with these factors and other clinicopathological parameters was examined. The 1-year treatment continuation rate for S-1 was 94.2%, excluding patients who experienced cancer recurrences during their ACT year. The initial S-1 reduction rate was 38.7%. Patients with stage II/IIIA disease exhibited significantly improved 5-year overall survival rates compared with patients with stage IIIB GC, 81.6/73.7 vs. 33.8% (P<0.01). No association between RP and survival was observed. BMI, BW and PNI were significantly decreased following surgery compared with preoperative states. In the univariate analysis, postoperative BW loss (BMI loss), pathological stage and >7 lymph node metastases were significantly associated with outcome (P<0.05); in the multivariate analysis, postoperative BW loss >10.6% and pathological stages were independent prognostic factors for survival. Continuing S-1 ACT for the full year exhibited a greater effect on survival compared with dosage. Early postoperative nutritional deterioration may decrease the survival rates in these patients.

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“…In a recent meta-analysis, PNI was associated with depth of invasion and lymph node metastasis in GC [29]. Sakurai et al [30] showed that in patients with GC, the preoperative PNI is an independent predictive factor for both overall survival and disease-specific survival. Notably, the patients with UICC stage 1 and 2 disease had significantly worse outcomes in the low-PNI group than in the high-PNI group.…”

Section: Evaluation Of Nutritional Statusmentioning

confidence: 99%

Nutrition in Patients with Gastric Cancer: An Update

Rosania¹,

Chiapponi

Malfertheiner³

et al. 2015

Gastrointest Tumors

113

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Background: Nutritional management of patients with gastric cancer (GC) represents a challenge. Summary: This review provides an overview of the present evidence on nutritional support in patients with GC undergoing surgery as well as in those with advanced disease. Key Message: For patients undergoing surgery, the preoperative nutritional condition directly affects postoperative prognosis, overall survival and disease-specific survival. Perioperative nutritional support enriched with immune-stimulating nutrients reduces overall complications and hospital stay but not mortality after major elective gastrointestinal surgery. Early enteral nutrition after surgery improves early and long-term postoperative nutritional status and reduces the length of hospitalization as well. Vitamin B₁₂ and iron deficiency are common metabolic sequelae after gastrectomy and warrant appropriate replacement. In malnourished patients with advanced GC, short-term home complementary parenteral nutrition improves the quality of life, nutritional status and functional status. Total home parenteral nutrition represents the only modality of caloric intake for patients with advanced GC who are unable to take oral or enteral nutrition. Practical Implications: Early evaluations of nutritional status and nutritional support represent key aspects in the management of GC patients with both operable and advanced disease.

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Predictive Potential of Preoperative Nutritional Status in Long-Term Outcome Projections for Patients with Gastric Cancer

Abstract: Preoperative PNI may have merit as a gauge of prognosis for patients with GC at stages 1 and 2, but PNI and postoperative morbidity showed no correlation in this setting.

Cited by 134 publications

References 27 publications

Recent trends of gastric cancer treatment in Turkey

Recent trends of gastric cancer treatment in Turkey

Outcome predictors for patients with stage II/III gastric cancer who undergo gastrectomy and S-1 adjuvant chemotherapy

Nutrition in Patients with Gastric Cancer: An Update

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