Preoperative malnutrition and prognosis after neoadjuvant chemotherapy followed by subsequent esophagectomy

Yoshida, Naoya; Baba, Yoshifumi; Baba, Hideo

doi:10.21037/jtd.2017.09.02

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…It is proven that proper nutritional support improves the outcomes of the treatment. Since patients with esophageal cancer are often malnourished, nutritional intervention should be undertaken (14). Available data also shows that frailty rather than age is a major risk factor of perioperative complications (15).…”

Section: Preoperative Periodmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) programs for esophagectomy

Rubinkiewicz¹,

Witowski²,

Su³

et al. 2019

J. Thorac. Dis

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A perioperative treatment protocol, enhanced recovery after surgery (ERAS) focuses on accelerating patient recovery. Previous studies confirmed that ERAS decreases surgical trauma and the stress response, which improved outcomes including reduced length of hospital stay (LOS) and decreased postoperative morbidity. While ERAS protocols have been successfully implemented in a variety of surgical disciplines (colorectal, bariatric, orthopedic, and gynecologic surgery), its use in esophageal surgery is still limited. This paper analyzes the feasibility and value of the ERAS protocol for esophageal surgery. Reviewing the literature found that implementation of ERAS resulted in decreased costs, length of stay and pulmonary specific complication reduction, but not overall morbidity. The evidence lacks randomized control trials. Further, the ERAS Society published recommendations for esophageal resection. This opportunity for unification of the protocol would make the studies more comparable and leads to stronger conclusions. Surgery specific items also require further confirmation. Nonetheless, the successful introduction of the ERAS protocol into a wide variety of surgical disciplines provides optimism for ERAS's effectiveness in esophageal surgery.

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Section: Preoperative Periodmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) programs for esophagectomy

Rubinkiewicz¹,

Witowski²,

Su³

et al. 2019

J. Thorac. Dis

View full text Add to dashboard Cite

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“…Hypoalbuminemia is a well-documented surgical risk factor (7). Hypoalbuminemia is, however, more a reflection of the extent of physiologic stress resulting from disease of treatment-related inflammation rather than the lack of adequate nutritional intake or malnutrition (40)(41)(42).…”

Section: Screening and Assessment Of Malnutritionmentioning

confidence: 99%

Preoperative nutritional optimization of esophageal cancer patients

Steenhagen¹

2019

J. Thorac. Dis

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Optimization of the nutritional and metabolic state prior to major surgery leads to improved surgical outcomes and is increasingly seen as an important part of oncology disease management. For locally advanced esophageal cancer the treatment is multimodal, including neoadjuvant chemoradiotherapy or perioperative chemotherapy in combination with esophageal resection. Patients undergoing such a multimodal treatment have a higher risk for progressive decline in their nutritional status. Preoperative malnutrition and loss of skeletal muscle mass has been reported to correlate with unfavorable outcomes in patients who undergo esophageal cancer surgery. Decline in nutritional status is most likely caused by insufficient nutritional intake, reduced physical activity, systemic inflammation and the effects of anticancer therapy. To ensure an optimal nutritional status prior to surgery, it is key to assess the nutritional status in all preoperative esophageal cancer patients, preferable early in the treatment trajectory, and to apply nutritional interventions accordingly. Nutritional management of esophageal cancer can be challenging, the optimal nutritional therapy is still under debate, and warrants more nutritional scientific research. In this review, the most recent findings regarding preoperative nutrition associated with outcomes in patients with esophageal cancer will be explored.

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