Department of General Surgery, University of Health Sciences Izmir Tepecik Training and Research Hospital, Turkey.
Acta Chir Belg. 2023 Jun;123(3):251-256. doi: 10.1080/00015458.2021.1977462. Epub 2021 Sep 15.
The aim of this study was to determine the impact of preoperative prognostic nutritional index (PNI) value and skeletal muscle area (SMA) on short-term outcomes of patients with gastric cancer.
A total of 107 patients underwent gastrectomy due to gastric cancer between January 2016 and December 2019 were retrospectively analyzed. The patients were divided into groups according to the determined PNI and SMA cutoff values. Clinicopathological features and short-term results were compared.
Overall morbidity was 29% ( = 31) in patients who underwent gastrectomy. Preoperative PNI value was ranged from 24.5 to 61.5 (median, 49.5). Preoperative SMA values were ranged respectively from 55.7 to 142 (median, 98.9) in women and 77.5 to 203.3 (median, 129.3) in men. It was observed that the risk of postoperative complications increased in patients with low PNI (OR 0.270 = .003). The average postoperative length of hospital stay was 12.1 days. The longer postoperative hospital stay was seen in lower PNI group (PNI ≤ 48, 15.1 days vs. PNI> 48, 10 days; = .033). Clavien-Dindo classification was high in patients with low PNI and sarcopenia (PNI ≤ 48, = .004 and Sarcopenia, = .006). Likewise, mortality was significantly increased in patients with low PNI and sarcopenia (PNI ≤ 48, 20% vs. PNI > 48, 0%; < .001 and Sarcopenia, 13.7% vs. Nonsarcopenia, 3.6%; OR 0.233, = .053).
As a result, preoperative SMA and PNI values were found closely related to the postoperative hospital stay, morbidity and mortality results of patients with gastric cancer. Preoperative nutritional support may help to overcome longer hospital stay, higher mortality and morbidity rates in patients with gastric cancer.
本研究旨在探讨术前预后营养指数（PNI）值和骨骼肌面积（SMA）对胃癌患者短期预后的影响。
回顾性分析 2016 年 1 月至 2019 年 12 月期间因胃癌接受胃切除术的 107 例患者。根据确定的 PNI 和 SMA 截断值将患者分为两组。比较临床病理特征和短期结果。
接受胃切除术的患者总体发病率为 29%（31 例）。术前 PNI 值范围为 24.5 至 61.5（中位数 49.5）。女性术前 SMA 值范围分别为 55.7 至 142（中位数 98.9），男性为 77.5 至 203.3（中位数 129.3）。结果显示，低 PNI 患者术后并发症风险增加（OR 0.270，.003）。术后平均住院时间为 12.1 天。低 PNI 组患者的术后住院时间较长（PNI ≤ 48，15.1 天比 PNI > 48，10 天； =.033）。低 PNI 合并肌肉减少症患者的 Clavien-Dindo 分级较高（PNI ≤ 48， =.004 和肌肉减少症， =.006）。同样，低 PNI 和肌肉减少症患者的死亡率显著增加（PNI ≤ 48，20%比 PNI > 48，0%； <.001 和肌肉减少症，13.7%比非肌肉减少症，3.6%；OR 0.233， =.053）。
因此，术前 SMA 和 PNI 值与胃癌患者的术后住院时间、发病率和死亡率密切相关。术前营养支持可能有助于克服胃癌患者住院时间延长、死亡率和发病率升高的问题。
