The Effect of Immunonutrition on the Postoperative Complications in Thymoma with Myasthenia Gravis

Abstract

Object. To test whether preoperative immunonutrition is efficacious in reducing postoperative complications in patients of thymoma with myasthenia gravis (MG). Material and Methods. A total of 244 patients operated on for thymoma with myasthenia gravis were prospectively assigned to two groups, each receiving seven-day preoperative and seven-day postoperative nutrition. The patients in immunonutrition group were given oral immunonutrition (IN). The patients in control group received oral standard nutrition. Immunonutritional and inflammatory biomarkers (IgA, IgG, IgM, CD3t, CD4t, CD8t, CD4t/CD8t ratio, NK-cell, prealbumin, albumin, white blood cells counts, and C-reactive protein) and clinical variables (age, gender, BMI, performance status, type of thymoma, type of MG, operative time, pathology, operative approach, postoperative complications, quantity of drainage, hospital stays) were examined. Results. A significant reduction in the length of hospital stay, quantity of drainage, and postoperative complications was observed in the IN group (p < 0.05). An increase in the level of IgA, IgG, IgM, CD3+T, CD4+T, CD4+T/CD8+T, WBC, CRP, and NK-cell in the IN group was observed after thymectomy, while a decrease was seen with regard to prealbumin and albumin (p < 0.05). Conclusion. Preoperative immunonutrition support is effective in reducing postoperative complications in patients of thymoma with MG. It helps to lower the risk of postoperative infectious complications and hospital stays.

Nomogram Predict Overall Survival of Patients with Thymic Epithelial Tumors After Surgery

“…However, they considered only the clinicopathological characteristics or treatment methods of patients and do not consider relevant hematological indicators. At the same time, many studies on hematological indicators have shown that Hb, NE, LY, platelet (PLT), NLR, ALB, GLB, ALB/GLB, platelet-lymphocyte ratio (PLR), NLR, and SII [12,13,15,25] have potential to become prognostic hematological indicators for various tumors including thymic epithelial tumors.…”

“…[6,27] In addition, a higher preoperative serum ALB level can often result in a more satisfactory prognosis, which is consistent with the ndings of other studies reporting better prognosis in patients with thymic epithelial tumors with higher ALB levels. [15] In predicting the prognosis of certain cancers, nomograms have been developed and proven to be more accurate than traditional staging systems. [28, 29] Therefore because thymectomy is an effective treatment for thymic epithelial tumors, [30][31][32][33] we constructed a prognostic nomogram for patients with thymic epithelial tumors after surgery.…”

“…At the same time, an increasing number of studies have used clinical factors such as history of hypertension, diabetes, [9] smoking, [10] and body mass index (BMI) [11]and hematological indicators including hemoglobin (Hb) [12], neutrophil-to-lymphocyte ratio (NLR) [13,14], albumin (ALB) [15], and other such indicators to analyze the prognosis of various tumors. However, only few studies have comprehensively analyzed a combination of the two types of indicators to establish a prognostic model for patients with thymic epithelial tumors after thymectomy.…”

Impact of oral preoperative and perioperative immunonutrition on postoperative infection and mortality in patients undergoing cancer surgery: systematic review and meta-analysis with trial sequential analysis

“…There are trials of immunonutrition underway, as well as some results in patients with ovarian, bladder and thymus cancers, but the evidence is still very limited on the effect of immunonutrition in a variety of cancer subtypes 28,43,48 . Different cancer subtypes involve operations of highly variable extent, with their own risks of complications and mortality.…”

“…In the majority of the studies, the duration of follow-up was 30 days after surgery 26,28,32,36,38,41 , 30 days after discharge [20][21][22][23]27,31 or not reported [33][34][35]37,42,43 . In the rest, follow-up was until discharge (median length of hospital stay less than 30 days) 24,25,39,40 , 35 days after surgery 30 or 7 days after surgery 29 .…”