Department of Clinical Nutrition, Affiliated Hospital of Jiangnan University, Jiangsu, China.
University of California, California, USA.
Asia Pac J Clin Nutr. 2020;29(4):706-711. doi: 10.6133/apjcn.202012_29(4).0005.
Nutritional parameters may predict the prognosis of patients with gastric cancer. This study investigated whether changes in nutritional parameters before and after chemotherapy were associated with survival among patients who underwent gastrectomy for gastric cancer.
We retrospectively reviewed data from 77 Chinese patients who had undergone gastrectomy for stage III gastric cancer at a single center. Laboratory data from before and after chemotherapy were collected regarding peripheral albumin, prealbumin, total protein, hemoglobin, and total cholesterol concentrations. The prognostic nutritional index (PNI) values were calculated and compared before and after chemotherapy. The relationships between survival and the pre-chemotherapy and post-chemotherapy nutritional statuses were evaluated.
Among the 77 patients, survival was associated with the staging, the pre-chemotherapy PNI values, and the postchemotherapy body mass index (BMI) values. Significantly better overall survival was associated with a high pre-chemotherapy PNI value (hazard ratio [HR]: 0.485, 95% confidence interval (CI): 0.255-0.920) and a normal post-chemotherapy BMI value (HR: 0.475, 95% CI: 0.249-0.907). Even better survival was associated with the co-existence of a high pre-chemotherapy PNI value and a normal post-chemotherapy BMI value (vs. one or more abnormal parameter, HR: 0.337, 95% CI: 0.167-0.679).
Chinese patients who underwent gastrectomy for gastric cancer had nutritional statuses that deteriorated after adjuvant chemotherapy. High prechemotherapy PNI values and normal post-chemotherapy BMI values were associated with better survival outcomes. Thus, low pre-chemotherapy PNI values and/or low post-chemotherapy BMI values may predict poor outcomes among these patients.
营养参数可能预测胃癌患者的预后。本研究旨在探讨胃癌患者接受化疗前后营养参数的变化是否与生存相关。
我们回顾性分析了单中心 77 例行胃癌根治术的 III 期胃癌患者的数据。收集化疗前后外周白蛋白、前白蛋白、总蛋白、血红蛋白和总胆固醇浓度的实验室数据。计算并比较化疗前后的预后营养指数（PNI）值。评估生存与化疗前和化疗后营养状况的关系。
在 77 例患者中，生存与分期、化疗前 PNI 值和化疗后 BMI 值相关。较高的化疗前 PNI 值（风险比 [HR]：0.485，95%置信区间 [CI]：0.255-0.920）和正常的化疗后 BMI 值（HR：0.475，95%CI：0.249-0.907）与总生存时间显著延长相关。化疗前 PNI 值较高且化疗后 BMI 值正常与更好的生存相关（与一个或多个参数异常相比，HR：0.337，95%CI：0.167-0.679）。
接受胃癌根治术的中国患者在辅助化疗后营养状况恶化。较高的化疗前 PNI 值和正常的化疗后 BMI 值与更好的生存结局相关。因此，化疗前 PNI 值较低和/或化疗后 BMI 值较低可能预示这些患者预后不良。
