Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Nutr Cancer. 2022;74(8):2910-2919. doi: 10.1080/01635581.2022.2042573. Epub 2022 Mar 2.
Few studies have focused on preoperative nutritional status of esophageal cancer patients eligible for upfront surgery. We aimed to investigate the association of preoperative nutritional status with prognosis of patients who undergo upfront surgery for esophageal cancer. A total of 274 patients who underwent upfront surgery for esophageal squamous cell carcinoma between January 2012 and December 2016 were eligible. Preoperative nutritional status was evaluated using prognostic nutritional index (PNI) scoring system, nutritional risk screening 2002 (NRS 2002), and controlling nutritional status. The median age was 63 years (interquartile range, 58-70) and 94.7% of patients were male. The pathological stages were Stage I-74.5% (204/274), Stage II-20.4% (56/274), and Stage III-5.1% (14/274). Multivariate analysis revealed that advanced stage, a low PNI, and a high NRS 2002 were independent predictors of overall survival. During median follow-up period of 55 mo, overall survival rates were lower in the high NRS 2002 group ( < 0.001). A high NRS 2002 score was associated with frequent postoperative complications, especially pneumonia and anastomosis site leakage ( = 0.003). The poor preoperative nutritional status with a high NRS 2002 is associated with postoperative complications as well as poor overall survival in patients with upfront surgery for esophageal cancer.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2022.2042573.
很少有研究关注适合 upfront 手术的食管癌患者的术前营养状况。我们旨在研究 upfront 手术治疗食管癌患者的术前营养状况与预后的关系。共有 274 名于 2012 年 1 月至 2016 年 12 月期间接受 upfront 手术治疗的食管鳞状细胞癌患者符合条件。采用预后营养指数（PNI）评分系统、营养风险筛查 2002（NRS 2002）和营养控制状况评估术前营养状况。中位年龄为 63 岁（四分位间距，58-70），94.7%的患者为男性。病理分期为 I 期-74.5%（204/274）、II 期-20.4%（56/274）和 III 期-5.1%（14/274）。多因素分析显示，晚期、低 PNI 和高 NRS 2002 是总生存的独立预测因素。在中位随访 55 个月期间，高 NRS 2002 组的总生存率较低（ < 0.001）。高 NRS 2002 评分与术后并发症频繁发生相关，尤其是肺炎和吻合口漏（ = 0.003）。高 NRS 2002 评分提示术前营养状况较差与 upfront 手术治疗食管癌患者术后并发症和总体生存不良有关。本文的补充数据可在 https://doi.org/10.1080/01635581.2022.2042573. 上获取。
