食管癌手术后的长期体重变化。

Long-term weight change after oesophageal cancer surgery.

作者信息

Martin L, Lagergren P

机构信息

Unit of Oesophageal and Gastric Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

出版信息

Br J Surg. 2009 Nov;96(11):1308-14. doi: 10.1002/bjs.6723.

DOI:10.1002/bjs.6723

PMID:19847871

Abstract

BACKGROUND

Malnutrition is common after oesophageal cancer surgery. This study investigated weight changes and the risk of malnutrition among long-term survivors.

METHODS

A nationwide cohort study was conducted in Sweden in 2001-2004, with follow-up to 2008. Weight was assessed before oesophagectomy, after 6 months and at 3 years. Logistic regression was performed with adjustment for confounders. Odds ratios (ORs) for postoperative weight loss of at least 15 per cent were estimated.

RESULTS

Some 203 patients survived at least 3 years after oesophagectomy. Continuous weight loss occurred for up to 3 years. Women and men had a similar risk of malnutrition after 3 years (OR 0.85 (95 per cent confidence interval 0.24 to 2.98)). In overweight patients (preoperative body mass index at least 25 kg/m(2)) the risk of malnutrition was increased almost fivefold at 6 months (OR 4.90 (2.27 to 10.59)) and 3 years (OR 4.60 (1.80 to 11.78)). There was no difference in weight loss at 6 months between survivors and those who died between 6 months and 3 years after surgery (OR 1.11 (0.64 to 1.94)).

CONCLUSION

Weight loss can be long lasting after oesophagectomy; overweight patients are at particularly increased risk of malnutrition.

摘要

背景

食管癌手术后营养不良很常见。本研究调查了长期幸存者的体重变化和营养不良风险。

方法

2001年至2004年在瑞典进行了一项全国性队列研究，随访至2008年。在食管切除术前、术后6个月和3年时评估体重。进行逻辑回归分析并对混杂因素进行校正。估计术后体重减轻至少15%的比值比（OR）。

结果

约203例患者在食管切除术后至少存活3年。体重持续下降长达3年。3年后，女性和男性发生营养不良的风险相似（OR 0.85（95%置信区间0.24至2.98））。超重患者（术前体重指数至少25 kg/m²）在6个月时（OR 4.90（2.27至10.59））和3年时（OR 4.60（1.80至11.78））发生营养不良的风险增加近五倍。幸存者与术后6个月至3年之间死亡者在6个月时的体重减轻没有差异（OR 1.11（0.64至1.94））。