术前营养状况对盆腔廓清术患者术后并发症和总体生存的影响：一项多学科、多机构队列研究。

The effect of preoperative nutritional status on postoperative complications and overall survival in patients undergoing pelvic exenteration: A multi-disciplinary, multi-institutional cohort study.

机构信息

University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.

The Ohio State University, James Cancer Hospital, Columbus, OH, USA.

出版信息

Am J Surg. 2019 Aug;218(2):275-280. doi: 10.1016/j.amjsurg.2019.03.021. Epub 2019 Apr 4.

DOI:10.1016/j.amjsurg.2019.03.021

PMID:30982571

Abstract

INTRODUCTION

Optimization of preoperative nutritional status has been recommended and associated with improved outcomes for other oncologic procedures, but has not been studied in patients undergoing pelvic exenteration.

METHODS

A retrospective chart review of 199 patients was conducted. Overall survival (OS) was calculated using the Kaplan-Meier method and multivariate analysis was performed with Cox proportional hazards.

RESULTS

199 patients underwent PE with 61 (31%), 78 (40%) and 58 (29%) patients having colorectal, gynecologic and urologic histological diagnoses, respectively. Median OS following PE was 25 months. Preoperative serum albumin <3.5 g/dL was associated with worsened OS (HR 1.661; 95% CI 1.052-2.624) as well as increased incidence of any postoperative complication (85.9% vs 72.3%, p = 0.034), but was not associated with 90-day mortality (11.3% vs 7.9%, p = 0.457).

CONCLUSION

Poor preoperative nutritional status is associated with increased complications and decreased OS. Surgeons should maximize preoperative nutritional status to improve perioperative outcomes and long-term survival.

摘要

简介

优化术前营养状况已被推荐用于其他肿瘤治疗，并与改善治疗结果相关，但在接受盆腔廓清术的患者中尚未进行研究。

方法

对 199 例患者进行了回顾性图表审查。采用 Kaplan-Meier 法计算总生存率（OS），并采用 Cox 比例风险进行多变量分析。

结果

199 例患者接受了 PE 治疗，其中 61 例（31%）、78 例（40%）和 58 例（29%）分别为结直肠、妇科和泌尿科组织学诊断。PE 后中位 OS 为 25 个月。术前血清白蛋白<3.5g/dL 与 OS 恶化相关（HR 1.661；95%CI 1.052-2.624），以及术后任何并发症发生率增加（85.9%比 72.3%，p=0.034），但与 90 天死亡率无关（11.3%比 7.9%，p=0.457）。