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Open Access 01-07-2018 | Original Scientific Report

Preoperative Prognostic Nutritional Index Predicts Long-Term Surgical Outcomes in Patients with Esophageal Squamous Cell Carcinoma

Published in: World Journal of Surgery | Issue 7/2018

Abstract

Background

The purpose of the present study is to investigate the utility of prognostic nutritional index (PNI) as a simple and readily available marker in esophageal squamous cell carcinoma (ESCC).

Methods

We retrospectively analyzed 169 patients who underwent potentially curative esophagectomy, for histologically verified ESCC. We decided to set the optimal cutoff value for preoperative PNI levels at 49.2, based on the cancer-specific survival (CSS) and the overall survival (OS) by receiver operating characteristic curve analysis.

Results

Multivariate logistic regression analysis identified that TNM pStage III [hazard ratio (HR) 3.261, p < 0.0001] and PNI < 49.2 (HR 3.887, p < 0.0001) were confirmed as independent poor predictive factors for CSS, and age >70 (HR 2.024, p < 0.0042), TNM pStage III (HR 2.510, p = 0.0002), and PNI < 49.2 (HR 2.248, p = 0.0013) were confirmed as independent poor predictive factors for OS. In non-elderly patients, TNM pStage III (CSS; HR 3.488, p < 0.0001, OS; HR 2.615, p = 0.0007) and PNI < 49.2 (CSS; HR 3.849, p < 0.0001, OS; HR 2.275, p = 0.001) were confirmed as independent poor predictive factors for CSS, and OS when multivariate logistic regression analysis was applied. But in elderly patients, univariate analyses demonstrated that the TNM pStage III was the only significant risk factor for CSS (HR 3.701, p = 0.0057) and OS (HR 1.974, p = 0.0224).

Conclusions

The PNI was a significant and independent predictor of CSS and OS of ESCC patients after curative esophagectomy. The PNI was cost-effective and readily available, and it could act as a marker of survival.

Mainous MR, Deitch EA (1994) Nutrition and infection. Surg Clin N Am 74(3):659–676PubMed

Mellman I, Coukos G, Dranoff G (2011) Cancer immunotherapy comes of age. Nature 480(7378):480–489CrossRefPubMedPubMedCentral

Weimann A, Braga M, Harsanyi L et al (2006) ESPEN guidelines on enteral nutrition: surgery including organ transplantation. Clin Nutr 25:224–244CrossRefPubMed

Oh SJ, Hyung WJ, Li C et al (2009) Effect of being overweight on postoperative morbidity and long-term surgical outcomes in proximal gastric carcinoma. J Gastroenterol Hepatol 24:475–479. https://doi.org/10.1111/j.1440-1746.2008.05704.x CrossRefPubMed

Forrest LM, McMillan DC, McArdle CS et al (2004) Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. Br J Cancer 90:1704–1706CrossRefPubMedPubMedCentral

Onodera T, Goseki N, Kosaki G (1984) Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi 85:1001–1005 (in Japanese) PubMed

Nozoe T, Minomiya M, Maeda T et al (2010) Prognostic nutritional index: a tool to predict the biological aggressiveness of gastric carcinoma. Surg Today 40:440–443. https://doi.org/10.1007/s00595-009-4065-y CrossRefPubMed

Kanda M, Fujii T, Kodera Y et al (2011) Nutritional predictors of postoperative outcome in pancreatic cancer. Br J Surg 98:268–274. https://doi.org/10.1002/bjs.7305 CrossRefPubMed

Smale BF, Mullen JL, Buzby GP et al (1981) The efficacy of nutritional assessment and support in cancer surgery. Cancer 47:2375–2381CrossRefPubMed

10.

Seaton K (2001) Albumin concentration controls cancer. J Natl Med Assoc 93:490–493PubMedPubMedCentral

11.

Gupta D, Lis CG (2010) Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J 9:69. https://doi.org/10.1186/1475-2891-9-69 CrossRefPubMedPubMedCentral

12.

Liu YP, Ma L, Wang SJ et al (2010) Prognostic value of lymph node metastases and lymph node ratio in esophageal squamous cell carcinoma. Eur J Surg Oncol 36:155–159. https://doi.org/10.1016/j.ejso.2009.09.005 CrossRefPubMed

13.

Dind D, Demartines N, Clavien PS (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRef

14.

Pohl H, Welch HG (2005) The role of over diagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J Natl Cancer Inst 97:142–146CrossRefPubMed

15.

Sobin LH, Gospodarowicz MK, Wittekind CH (2009) TNM classification of malignant tumours, 7th edn. Willey, Hoboken

16.

Lien YC, Hsieh CC, Wu YC et al (2004) Preoperative serum albumin level is a prognostic indicator for adenocarcinoma of the gastric cardia. J Gastointest Surg 8:1041–1048CrossRef

17.

Buzby GP, Mullen JL, Matthews DC et al (1980) Prognostic nutritional index in gastrointestinal surgery. Am J Surg 139:160–167CrossRefPubMed

18.

Schwegler I, von Holzen A, Gutzwiller JP et al (2010) Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer. Br J Surg 97:92–97. https://doi.org/10.1002/bjs.6805 CrossRefPubMed

19.

Mantovani A, Allavena P, Sica A et al (2008) Cancer-related inflammation. Nature 454:436–444. https://doi.org/10.1038/nature07205 CrossRefPubMed

20.

Balkwill F (2009) Tumour necrosis factor and cancer. Nat Rev Cancer 9:361–371. https://doi.org/10.1038/nrc2628 CrossRefPubMed

21.

Brenner D, Blaser H, Mak TW (2015) Regulation of tumour necrosis factor signalling: live or let die. Nat Rev Immunol 15:362–374. https://doi.org/10.1038/nri3834 CrossRefPubMed

22.

Ray-Coquard I, Cropet C, Van Glabbeke M et al (2009) Lymphopenia as a prognostic factor for overall survival in advanced carcinomas, sarcomas, and lymphomas. Cancer Res 69:5383–5391. https://doi.org/10.1158/0008-5472.CAN-08-3845 CrossRefPubMedPubMedCentral

23.

Ryan AM, Reynolds JV, Healy L et al (2009) Enteral nutrition enriched with eicosapentaenoic acid (EPA) preserves lean body mass following esophageal cancer surgery: results of a double-blinded randomized controlled trial. Ann Surg 249:355–363. https://doi.org/10.1097/SLA.0b013e31819a4789 CrossRefPubMed

24.

Esper DH, Harb WA (2005) The cancer cachexia syndrome: a review of metabolic and clinical manifestations. Nutr Clin Pract 20:369–376CrossRefPubMed

25.

Coussens LM, Werb Z (2002) Inflammation and cancer. Nature 420:860–867CrossRefPubMedPubMedCentral

26.

Yoo HM, Lee HH, Shim JH et al (2011) Negative impact of leakage on survival of patients undergoing curative resection for advanced gastric cancer. J Surg Oncol 104:734–740. https://doi.org/10.1002/jso.22045 CrossRefPubMed

27.

Takeuchi D, Koide N, Suzuki A et al (2015) Postoperative complications in elderly patients with gastric cancer. J Surg Res 198:317–326. https://doi.org/10.1016/j.jss.2015.03.095 CrossRefPubMed

28.

Ahmed T, Haboubi N (2010) Assessment and management of nutrition in older people and its importance to health. Clin Interv Aging 5:207–216PubMedPubMedCentral

29.

Aoyama T, Murakawa M, Katayama Y et al (2015) Impact of postoperative complications on sutvival and recurrence inpancreatic cancer. Anticancer Res 35:2401–2409PubMed

30.

Kulu Y, Tarantio I, Warschkow R et al (2015) Anastomotic leakage is associated with impaired overall and disease-free survival after curative rectal cancer resction: a propensity score analysis. Ann Surg Oncol 22:2059–2067. https://doi.org/10.1245/s10434-014-4187-3 CrossRefPubMed

31.

Tokunaga M, Tanizawa Y, Bando E et al (2013) Poor survival rate in patients with postoperative intra-abdominal infectious complications following curative gastrectomy for gastric cancer. Ann Surg Oncol 20:1575–1583. https://doi.org/10.1245/s10434-012-2720-9 CrossRefPubMed

32.

Jeon HG, Choi DK, Sung HH et al (2016) Preoperative prognostic nutritional index is a significant predictor of survival in renal cell carcinoma patients undergoing nephrectomy. Ann Surg Oncol 23:321–327. https://doi.org/10.1245/s10434-015-4614-0 CrossRefPubMed

33.

Shimizu K, Okita R, Saisho S et al (2015) Prognostic nutritional index before adjuvant chemotherapy predicts chemotherapy compliance and survival among patients with non-small-cell lung cancer. Ther Clin Risk Manag 8(11):1555–1561. https://doi.org/10.2147/TCRM.S92961 CrossRef

34.

He ZQ, Ke C, Al-Nahari F et al (2017) Low preoperative prognostic nutritional index predicts poor survival in patients with newly diagnosed high-grade gliomas. J Neurooncol 132(2):239–247. https://doi.org/10.1007/s11060-016-2361-0 CrossRefPubMed

35.

Sun P, Zhang F, Chen C et al (2013) Comparison of the prognostic values of various nutritional parameters in patients with esophageal squamous cell carcinoma from Southern China. J Thorac Dis 5:484–491. https://doi.org/10.3978/j.issn.2072-1439.2013.08.38 PubMedPubMedCentralCrossRef

36.

Lai CC, You JF, Yeh CY et al (2011) Low preoperative serum albumin in colon cancer: a risk factor for poor outcome. Int J Colorectal Dis 26:473–481. https://doi.org/10.1007/s00384-010-1113-4 CrossRefPubMed

Title: Preoperative Prognostic Nutritional Index Predicts Long-Term Surgical Outcomes in Patients with Esophageal Squamous Cell Carcinoma
Publication date: 01-07-2018
Published in: World Journal of Surgery / Issue 7/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4437-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Preoperative Prognostic Nutritional Index Predicts Long-Term Surgical Outcomes in Patients with Esophageal Squamous Cell Carcinoma

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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