The impact of Nutrition and Gastrointestinal Symptoms on Health-related Quality of Life in Survivorship after Oesophageal Cancer Surgery

Bennett, Sarah A.; Murphy, Conor; Fanning, Michelle; Reynolds, John V.; Doyle, Suzanne; Donohoe, Claire L.

doi:10.1016/j.nutos.2021.11.005

Cited by 6 publications

(4 citation statements)

References 98 publications

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“…The pivotal role of nutrition care particularly applies to cancer care and is founded on the basis that anti-cancer treatments can be more effective in patients with a balanced nutrition status, leading to less delays in treatment, and less dose-limiting toxicities [42,162]. However, across the cancer care continuum, and for the increasing group of people living with and beyond cancer, as well as those who live with the chronic 'late effects' of cancer appropriate and timely nutrition care still remains a documented unmet need [163][164][165][166][167][168][169].…”

Section: Discussionmentioning

confidence: 99%

Nutrition care is an integral part of patient-centred medical care: a European consensus

Erickson

Sullivan

Kalliostra³

et al. 2023

Med Oncol

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While healthcare is becoming more patient-centred, evidence-based nutrition interventions are still not accessible to all patients with cancer. As nutrition interventions directly improve clinical and socioeconomic outcomes, patient-centred care is not complete without nutrition care. While awareness of the negative impact of malnutrition on clinical outcomes, quality of life, and functional and emotional wellbeing in cancer is growing, there is relatively poor awareness amongst patients, clinicians, policymakers, and payers that nutrition interventions -particularly those begun in the early stages of the disease course- are an effective method for improving such outcomes. The European Beating Cancer Plan recognises the need for a holistic approach to cancer but lacks actionable recommendations to implement integrated nutrition cancer care at member state level. When considering nutrition care as a human right, the impact on quality of life and functional status must be prioritized, as these may be equally as important to patients, especially in advanced cancer where improvements in clinical outcomes such as survival or tumour burden may not be attainable. We formulate actions needed at the regional and the European level to ensure integrated nutrition care for all patients with cancer. The 4 main Take Home Messages are as follows: 1. The goals of Europe’s Beating Cancer Plan cannot be achieved without integrating nutrition across the cancer care continuum. 2. Malnutrition negatively impacts clinical outcomes and has socioeconomic consequences for patients and healthcare systems. 3. Championing integrating nutrition care into cancer care is therefore the duty and ethical responsibility of clinicians (Hippocratic Oath—primum non nocere) and 4. Nutrition care is a cost effective, evidence-based therapy.

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Section: Discussionmentioning

confidence: 99%

Nutrition care is an integral part of patient-centred medical care: a European consensus

Erickson

Sullivan

Kalliostra³

et al. 2023

Med Oncol

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“…It was well known that malnutrition is a signi cant risk factor for morbidity and mortality after gastrointestinal surgery. The nutritional risk index (NRI) and the NLR are two well-tested tools that are used for diagnosis and prognosis outcomes in surgery [22][23][24][25][26]. For many years, the nutritional status of the patient before surgery was considered one of the key factors in uencing the occurrence of various complications after surgery, and there are several studies on the possibility of using the NRI as a screening tool for malnutrition to predict postoperative complications and the impact on patient survival [27].…”

Section: Introductionmentioning

confidence: 99%

Physiological stress level and screening for malnutrition as preoperative predictors of postoperative complications in pancreatic surgery: A retrospective study

Кryvoruchko

Staikov

Boyko

et al. 2023

Preprint

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Background Assessment of ‘physiological stress levels’ and ‘nutritional status’ before surgery is important for predicting complications and indirect interventions on the pancreas. The aim of this study was to determine neutrophil-lymphocyte ratio (NLR) and nutritional risk index (NRI) indicators before surgery to predict 90-day complications and mortality in a cohort of patients with complicated chronic pancreatitis and cancer of the head of the pancreas. Methods We evaluated preoperative levels of NLR and NRI among 225 subjects treated at different centres located in three countries. Short-term outcomes included length of hospital stay, postoperative complications, and mortality at 90 days and were appreciated based on NLR and NRI. The level of physiological stress was divided according by the formulas: neutrophil-lymphocyte ratio (NLR) = (neutrophil count, %)/(lymphocyte count, %). The nutritional state of the patients was divided according to the INR: NRI = (1.519 x serum albumin, g/L) + (41.7 x present weight, kg / usual weight, kg)] Results All patients were operated. An analysis of the operations performed in three institutions demonstrated mortality in chronic pancreatitis and pancreatic pseudocysts in 1.4 %, in chronic pancreatitis and the presence of an inflammatory mass mainly in the pancreatic head in 1.2 %, and in cancer of the pancreatic head in 5.9 %. The mean preoperative NLR was normal in 33.8% of the patients, the mild physiologic stress level was 54.7%, and the moderate was 11.5% before surgery. 10.2% of patients had a normal nutritional status, 20% had mild, 19.6% had moderate, and 50.2% had severe malnutrition. In a univariate analysis, at the cutoff of NLR³9.5 (AUC=0.803) and the cutoff of NRI≤98.5 (AUC=0.801), increasing the risk of complications was observed (hazard ratio, 2.01; 95% CI, 1.247-3.250, p=0.006), but at the cutoff of NRI≤83.55 (AUC=0.81), we observed a survival difference in operated patients (hazard ratio, 2.15; 95% CI, 1.334-3.477, p=0.0025). Conclusions Our study demonstrated that NLR and NRI were predictors of postoperative complications, but only NRI was a predictor of 90-day mortality in patients after surgery.

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“…It was well known that malnutrition is a significant risk factor for morbidity and mortality after gastrointestinal surgery. The nutritional risk index (NRI) and the NLR are two well-tested tools that are used for diagnosis and prognosis outcomes in surgery [ 22 – 26 ]. For many years, the nutritional status of the patient before surgery was considered one of the key factors influencing the occurrence of various complications after surgery, and there are several studies on the possibility of using the NRI as a screening tool for malnutrition to predict postoperative complications and the impact on patient survival [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

Physiological stress level and screening for malnutrition as preoperative predictors of postoperative complications in pancreatic surgery: a retrospective study

Кryvoruchko¹,

Staikov²,

Boyko³

et al. 2023

BMC Surg

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Background Assessment of ‘physiological stress levels’ and ‘nutritional status’ before surgery is important for predicting complications and indirect interventions on the pancreas. The aim of this study was to determine neutrophil–lymphocyte ratio (NLR) and nutritional risk index (NRI) indicators before surgery to predict 90-day complications and mortality in a cohort of patients with complicated chronic pancreatitis and cancer of the head of the pancreas. Methods We evaluated preoperative levels of NLR and NRI among 225 subjects treated at different centres located in three countries. Short-term outcomes included length of hospital stay, postoperative complications, and mortality at 90 days and were appreciated based on NLR and NRI. The level of physiological stress was divided according by the formulas: neutrophil–lymphocyte ratio (NLR) = (neutrophil count, %)/(lymphocyte count, %). The nutritional state of the patients was divided according to the INR: NRI = (1.519 × serum albumin, g/L) + (41.7 × present weight, kg / usual weight, kg)]. Results All patients were operated. An analysis of the operations performed in three institutions demonstrated mortality in chronic pancreatitis and pancreatic pseudocysts in 1.4%, in chronic pancreatitis and the presence of an inflammatory mass mainly in the pancreatic head in 1.2%, and in cancer of the pancreatic head in 5.9%. The mean preoperative NLR was normal in 33.8% of the patients, the mild physiologic stress level was 54.7%, and the moderate was 11.5% before surgery. 10.2% of patients had a normal nutritional status, 20% had mild, 19.6% had moderate, and 50.2% had severe malnutrition. In a univariate analysis, at the cutoff of NLR ≥ 9.5 (AUC = 0.803) and the cutoff of NRI ≤ 98.5 (AUC = 0.801), increasing the risk of complications was observed (hazard ratio, 2.01; 95% CI, 1.247–3.250, p = 0.006), but at the cutoff of NRI ≤ 83.55 (AUC = 0.81), we observed a survival difference in operated patients (hazard ratio, 2.15; 95% CI, 1.334–3.477, p = 0.0025). Conclusions Our study demonstrated that NLR and NRI were predictors of postoperative complications, but only NRI was a predictor of 90-day mortality in patients after surgery.

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The impact of Nutrition and Gastrointestinal Symptoms on Health-related Quality of Life in Survivorship after Oesophageal Cancer Surgery

Cited by 6 publications

References 98 publications

Nutrition care is an integral part of patient-centred medical care: a European consensus

Nutrition care is an integral part of patient-centred medical care: a European consensus

Physiological stress level and screening for malnutrition as preoperative predictors of postoperative complications in pancreatic surgery: A retrospective study

Physiological stress level and screening for malnutrition as preoperative predictors of postoperative complications in pancreatic surgery: a retrospective study

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