Matsumoto Hideo, Okamoto Yuko, Kawai Akimasa, Ueno Daisuke, Kubota Hisako, Murakami Haruaki, Higashida Masaharu, Hirai Toshihiro
a Department of Digestive Surgery , Kawasaki Medical School , Kurashiki City, Okayama , Japan.
Nutr Cancer. 2017 Aug-Sep;69(6):849-854. doi: 10.1080/01635581.2017.1339093. Epub 2017 Jul 20.
Preoperative nutritional status may impact surgical outcome and prognosis. We evaluated the predictive value of Onodera's prognostic nutritional index (O's-PNI) of surgical outcome following esophagectomy in esophageal cancer patients.
In total, 144 patients undergoing esophagectomy for esophageal cancer from April 2010 to May 2015 were evaluated, retrospectively. Eighty-four patients were enrolled in this study. O's-PNIs were calculated before surgery, discharge, and 1, 2, and 6 mo after discharge. The relationship between O's-PNI and occurrence of complications as classified by the Clavien-Dindo (C-D) classification, length of hospital stay, and survival time was investigated.
The mean O's-PNI for patients with complications of more than Grade 2 by the C-D classification was 37.4, which was significantly lower than that for Grades 0 or 1 (40.5, P = 0.0094). A negative correlation was obtained between O's-PNI and hospital stay length (P = 0.0006), whereas a positive correlation was obtained for O's-PNI at 6 mo postsurgery and overall survival (P = 0.0171, P = 0.0201).
O's-PNI may represent a useful indicator of the occurrence of complications and length of hospital stay, and may influence overall survival at 6 mo postsurgery. Nutritional management during the perioperative period could therefore contribute to satisfactory outcomes following esophagectomy in esophageal cancer patients.
术前营养状况可能会影响手术结果和预后。我们评估了小野寺预后营养指数(O氏-PNI)对食管癌患者食管切除术后手术结果的预测价值。
回顾性评估了2010年4月至2015年5月期间因食管癌接受食管切除术的144例患者。本研究纳入了84例患者。在手术前、出院时以及出院后1、2和6个月计算O氏-PNI。研究了O氏-PNI与根据Clavien-Dindo(C-D)分类法分类的并发症发生情况、住院时间和生存时间之间的关系。
C-D分类法中2级以上并发症患者的平均O氏-PNI为37.4,显著低于0级或1级患者(40.5,P = 0.0094)。O氏-PNI与住院时间呈负相关(P = 0.0006),而术后6个月时O氏-PNI与总生存率呈正相关(P = 0.0171,P = 0.0201)。
O氏-PNI可能是并发症发生和住院时间的有用指标,并可能影响术后6个月的总生存率。因此,围手术期的营养管理有助于食管癌患者食管切除术后获得满意的结果。