Preoperative nutritional evaluation of prostate cancer patients undergoing laparoscopic radical prostatectomy

Abstract

Background and objective Prostate cancer (PCa) is one of the most common malignant tumors in men. Geriatric Nutritional Risk Index (GNRI) is an objective index for evaluating nutritional status of elderly people over 65 years old. The aim of the current study was to explore the correlation and predictive value between GNRI and postoperative recovery and complications in PCa patients undergoing laparoscopic radical prostatectomy (LRP). Methods Taking 98 as the GNRI boundary value, 96 PCa patients (aged≥65 y) undergoing LRP in the Department of Urology, Affiliated Hospital of North Sichuan Medical College from January 2018 to December 2020 were grouped into malnutrition group (MNg, 34 patients, 35.4%) and normal nutrition group (NNg, 62 patients, 64.6%). Basic information, laboratory examination indexes, operation conditions, postoperative complications and postoperative recovery indexes of patients were recorded and retrospectively analyzed. Clavien-Dindo Classification System (CDCS) was used to assess postoperative complications. T-test was used to analyze differences between the two groups. ROC curve was generated to determine the predictive value of GNRI for postoperative complications. Results Percentage of complications was significantly higher in MNg group compared with that in NNg group (P < 0.01). The average grade based on CDCS was significantly lower in NNg group compared with that in MNg group (P < 0.01). Body weight, Body Mass Index (BMI), preoperative hemoglobin value (HGB), serum albumin (ALB) values of MNg and NNg were significantly positively correlated with GNRI (P<0.01). Incidence and severity of postoperative complications of MNg patients were significantly higher compared with those of NNg patients (P<0.05). Average hospitalization cost of MNg patients was higher in MNg patients compared with that of NNg patients (P<0.05). Duration of post-anesthesia care unit (PACU), duration of antibiotic use and duration of indwelling drainage tube were longer in MNg patients compared with those in NNg patients (P<0.05). Furthermore, volume of indwelling drainage tube was higher in MNg patients compared with that in NNg patients (P<0.05). Conclusion GNRI is an effective and reliable tool for evaluation of preoperative nutritional status of prostate cancer patients. The findings showed that GNRI is correlated with postoperative recovery and complications, and is an effective predictive marker.

Impact of geriatric nutritional risk index on outcomes after gastrectomy in elderly patients with gastric cancer: a retrospective multicenter study in Japan

“…It is possible that the stage of cancer, one of the clinicopathological factors, might have been more advanced in patients with low GNRI. Previous studies reported the association of low GNRI with advanced stage in various cancers [19,37,[39][40][41], similar to our findings. Various cytokines are released in advanced cancer [42][43][44], and some studies reported that increased inflammation markers and decreased nutritional marker were associated with increased catabolism, resulting in anorexia and a negative effect on nutritional status [45,46], which may also account for a low GNRI.…”

Geriatric nutritional risk index as a predictor for postoperative complications in patients with solid cancers: a meta-analysis

“…The sample sizes of these studies ranged from 62 to 7863 participants. Six studies were from Japan ( 14 , 19 , 22 – 25 ), three studies were from China ( 8 , 18 , 20 ), one study from USA ( 17 ) and one study from Korea ( 21 ). Three studies reported colorectal cancer ( 8 , 20 , 23 ), two studies reported Esophageal cancer ( 14 , 25 ), two studies reported Gastric cancer ( 22 , 24 ), two studies reported renal cancer ( 17 , 19 ), one study reported liver cancer ( 21 ) and one study reported prostate cancer ( 18 ).…”

“…Four studies were lacked relevant outcomes. Therefore, our metaanalysis included 11 studies involving 11,002patients (8,14,(17)(18)(19)(20)(21)(22)(23)(24)(25).…”

“…The baseline information of the 11 eligible studies is presented in Table 1. Out of these studies, 10 were single-center retrospective studies (8,14,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27), while one study was based on a retrospective analysis of a database (17). All of the included studies in this analysis were published between 2015 and 2023.…”

Construction of a comprehensive management plan for patients undergoing radical prostatectomy based on the pender model: A delphi method study

“…Unfortunately, there is still considerable controversy over how to standardize this nursing measure. Although there have been numerous reports on nursing measures, a considerable proportion lack evidence-based medical evidence [14][15].…”