Prospective Study of Malabsorption and Malnutrition After Esophageal and Gastric Cancer Surgery

Heneghan, Helen; Zaborowski, Alexandra; Fanning, Michelle; McHugh, Aisling; Doyle, Suzanne; Moore, Jenny; Ravi, Nayarasamy; Reynolds, John V.

doi:10.1097/sla.0000000000001445

Cited by 131 publications

(131 citation statements)

References 34 publications

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“…In the present study, severe diarrhoea was more common in the group of patients with >10% BWL (13% versus 0%). In a recent systematic study of a prospective consecutive series of 45 disease-free patients after esophagectomy or gastrectomy, Henegham et al (16) found that the incidence of malabsorption at 18 to 24 months postoperatively was 71% in the gastrectomy group. The proportion of patients with Climent 11 more than 15% weight loss had significantly lower nutritional risk index scores, and a higher incidence of malabsorption compared with those who had less than 15% weight loss at 24 months.…”

Section: Discussionmentioning

confidence: 99%

“…Based on previous studies, a cut-off of 10% was chosen because this percentage of BWL is considered as a severe nutritional risk marker (12)(13)(14)16). Mean scores and 95% confidence intervals (CIs) for HRQL were calculated preoperatively and at 2 years after surgery.…”

Section: Data Analysesmentioning

confidence: 99%

“…Previous studies have found that patients undergoing total gastrectomy will lose 7%-15% of their body weight, usually within the first year of surgery, and will not return to a preoperative weight (14)(15)(16). The reduction in calorie intake as well as malabsorption are considered the main factors responsible for BWL (14).…”

Section: Introductionmentioning

confidence: 99%

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Weight loss and quality of life in patients surviving 2 years after gastric cancer resection

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European Journal of Surgical Oncology (EJSO)

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Section: Discussionmentioning

confidence: 99%

Section: Data Analysesmentioning

confidence: 99%

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Weight loss and quality of life in patients surviving 2 years after gastric cancer resection

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et al. 2017

European Journal of Surgical Oncology (EJSO)

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“…Previous studies have demonstrated that an increased level of CRP may be associated with poorer prognosis in patients with tumors, including ovarian cancer, penile cancer and non-small cell lung cancer (36)(37)(38). In addition, malabsorption and malnutrition may be associated with decreased survival time in various tumors, including esophageal squamous cell carcinomas and endometrial cancer (39,40). In a previous study, Alb was used to estimate nutritional status.…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study, Alb was used to estimate nutritional status. For patients with GC, protein digestion and absorption were decreased, whereas protein metabolism was increased, resulting in a negative nitrogen balance (18,39). The CRP/Alb ratio is a useful prognostic indicator that was initially used to identify patients with serious conditions on an acute medical ward by Fairclough et al (41).…”

Section: Discussionmentioning

confidence: 99%

C‑reactive protein/albumin and neutrophil/lymphocyte ratios and their combination predict overall survival in patients with gastric cancer

et al. 2017

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Abstract. Multiple studies have reported the prognostic association of certain inflammatory factors with various types of cancer. The present study assessed the prognostic value of the C-reactive protein (CRP)/albumin (Alb) ratio and the neutrophil/lymphocyte ratio (NLR), separately and in combination, in gastric cancer (GC). A total of 337 cases pathologically diagnosed with gastric adenocarcinoma were retrospectively evaluated. The clinicopathological and prognostic relevance of the CRP/Alb ratio and NLR and their combination were analyzed. The optimal cut-off values of the CRP/Alb ratio and NLR were 0.38 and 3.14, respectively. High CRP/Alb ratio (≥0.38) and NLR (≥3.14) values were associated with increased tumor invasion, more distant metastasis and a more advanced tumor-node-metastasis stage (all P<0.05). In addition, a high NLR value was also associated with increased tumor size (P= 0.02). The CRP/Alb ratio (≥0.38/<0.38) and NLR (≥3.14/<3.14) were independent prognostic factors for overall survival time (OS) in GC by multivariate analysis (P= 0.005 and P= 0.001). Using the CRP/Alb ratio and NLR classification, patients were stratified into three subgroups with different OS time (P<0.001), which were identified as independent prognostic variables in multivariate analysis (P<0.001). The present study demonstrated that the CRP/Alb ratio and NLR were independent prognostic factors for OS in patients with GC. The combination of these indexes was associated with significant prognostic value and may further stratify prognosis. IntroductionGastric cancer (GC) is one of the most common types of tumor globally. In 2015, GC had the second highest incidence and rate of mortality among cancer patients in China (1). Due to the rapid progression of GC and the absence of early specific symptoms and signs, the majority of patients are diagnosed at the late stage of gastric carcinoma (2-5). At present, surgery is the preferred treatment for patients without distant metastasis, and postoperative metastasis and recurrence are the predominant causes of mortality (3,5). Although disease-free and overall survival (OS) may be improved by postoperative chemotherapy and radiotherapy, the prognosis of GC remains poor (3,6). Identifying simple but effective prognostic markers for GC remains an important aim for researchers.Inflammation occurs in various types of tumor, and serves a crucial function in tumor development and distant metastasis (7-10). Previous studies have indicated that inflammation is associated with the formation of the tumor microenvironment by inflammatory mediators, including vasoactive amines and cytokines (11-13). The C-reactive protein (CRP)/albumin (Alb) ratio is used as a novel inflammation-based prognostic indicator in multiple types of tumor. Previous studies have demonstrated the prognostic value of CRP/Alb ratio in colorectal (14) and esophageal cancer (15), hepatocellular carcinoma (16), and renal (17) and pancreatic cancer (18). Another important inflammatory marker is the neutrophil/lymphocyte ratio (...

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Diagnosis and Therapy of Exocrine Pancreatic Insufficiency after Gastric and Pancreatic Surgery

Pezzilli

2021

Clinical Pancreatology for Practising Gastroenterologists and Surgeons

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Prospective Study of Malabsorption and Malnutrition After Esophageal and Gastric Cancer Surgery

Abstract: Malabsorption and malnutrition are prevalent in survivorship of esophageal and stomach cancer. This may be underappreciated, and both gut and pancreatic insufficiency represent modifiable targets in the interdisciplinary approach to recovery of HR-QL.

Cited by 131 publications

References 34 publications

Weight loss and quality of life in patients surviving 2 years after gastric cancer resection

Weight loss and quality of life in patients surviving 2 years after gastric cancer resection

C‑reactive protein/albumin and neutrophil/lymphocyte ratios and their combination predict overall survival in patients with gastric cancer

Diagnosis and Therapy of Exocrine Pancreatic Insufficiency after Gastric and Pancreatic Surgery

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