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Published in: BMC Surgery 1/2022

Open Access 01-12-2022 | Nutrition | Research

The effects of nutritional support team intervention on postoperative immune function, nutritional statuses, inflammatory responses, clinical outcomes of elderly patients with gastric cancer

Authors: Jiansheng Chen, Liling Zou, Wenxing Sun, Junfeng Zhou, Qingliang He

Published in: BMC Surgery | Issue 1/2022

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Abstract

Background

To explore the effects of nutrition support team (NST) intervention on elderly patients with gastric cancer (GC).

Methods

The elderly GC patients (tumor stage I/II/III), admitted to our department from January 2015 to September 2021, were retrospectively analyzed and divided into NST group and traditional nutrition (TN) group according to nutritional management methods. The immune, inflammatory, nutrition-related indices, postoperative recovery and long-term prognosis of two groups were analyzed.

Results

A total of 258 elderly GC patients were included (NST group, n = 125; TN group, n = 133). After propensity score matching (PSM) in ratio of 1:1, 73 pairs of patients were matched. There were statistically significant differences in CD3 and CD4 level postoperative one month and IgG level postoperative one week between NST group and TN group (P < 0.05). There was no significant differences in serum CRP and IL-6 levels preoperative one day, postoperative one week and one month between two groups (P > 0.05). There were significant differences in body mass index (BMI) between the two groups postoperative one month (P < 0.05). The rate of infectious complications in TN group was significantly higher than that in NST group (P < 0.05). There was no statistically significant differences in 3-year relapse-free survival (RFS) or 3-year overall survival (OS) between NST group and TN group (P > 0.05).

Conclusions

Compared with TN management, NST intervention might be benefit to the immune function recovery and nutritional status, but there was no evidence that NST could improve the prognosis of elderly GC patients.
Literature
1.
go back to reference Venerito M, Link A, Rokkas T, Malfertheiner P. Review: gastric cancer-clinical aspects. Helicobacter. 2019;24(Suppl 1): e12643.PubMed Venerito M, Link A, Rokkas T, Malfertheiner P. Review: gastric cancer-clinical aspects. Helicobacter. 2019;24(Suppl 1): e12643.PubMed
2.
go back to reference Smyth EC, Nilsson M, Grabsch HI, van Grieken NC, Lordick F. Gastric cancer. Lancet. 2020;396(10251):635–48.CrossRef Smyth EC, Nilsson M, Grabsch HI, van Grieken NC, Lordick F. Gastric cancer. Lancet. 2020;396(10251):635–48.CrossRef
3.
go back to reference Gao K, Wu J. National trend of gastric cancer mortality in China (2003–2015): a population-based study. Cancer Commun. 2019;39(1):24.CrossRef Gao K, Wu J. National trend of gastric cancer mortality in China (2003–2015): a population-based study. Cancer Commun. 2019;39(1):24.CrossRef
4.
go back to reference Pilleron S, Sarfati D, Janssen-Heijnen M, Vignat J, Ferlay J, Bray F, Soerjomataram I. Global cancer incidence in older adults, 2012 and 2035: a population-based study. Int J Cancer. 2019;144(1):49–58.CrossRef Pilleron S, Sarfati D, Janssen-Heijnen M, Vignat J, Ferlay J, Bray F, Soerjomataram I. Global cancer incidence in older adults, 2012 and 2035: a population-based study. Int J Cancer. 2019;144(1):49–58.CrossRef
5.
go back to reference Joharatnam-Hogan N, Shiu KK, Khan K. Challenges in the treatment of gastric cancer in the older patient. Cancer Treat Rev. 2020;85: 101980.CrossRef Joharatnam-Hogan N, Shiu KK, Khan K. Challenges in the treatment of gastric cancer in the older patient. Cancer Treat Rev. 2020;85: 101980.CrossRef
6.
go back to reference Sahin U, Tureci O, Manikhas G, Lordick F, Rusyn A, Vynnychenko I, Dudov A, Bazin I, Bondarenko I, Melichar B, et al. FAST: a randomised phase II study of zolbetuximab (IMAB362) plus EOX versus EOX alone for first-line treatment of advanced CLDN18.2-positive gastric and gastro-oesophageal adenocarcinoma. Ann Oncol. 2021;32(5):609–19.CrossRef Sahin U, Tureci O, Manikhas G, Lordick F, Rusyn A, Vynnychenko I, Dudov A, Bazin I, Bondarenko I, Melichar B, et al. FAST: a randomised phase II study of zolbetuximab (IMAB362) plus EOX versus EOX alone for first-line treatment of advanced CLDN18.2-positive gastric and gastro-oesophageal adenocarcinoma. Ann Oncol. 2021;32(5):609–19.CrossRef
7.
go back to reference Catenacci DV, Rosales M, Chung HC, Yoon HH, Shen L, Moehler M, Kang YK. MAHOGANY: margetuximab combination in HER2+ unresectable/metastatic gastric/gastroesophageal junction adenocarcinoma. Future Oncol. 2021;17(10):1155–64.CrossRef Catenacci DV, Rosales M, Chung HC, Yoon HH, Shen L, Moehler M, Kang YK. MAHOGANY: margetuximab combination in HER2+ unresectable/metastatic gastric/gastroesophageal junction adenocarcinoma. Future Oncol. 2021;17(10):1155–64.CrossRef
8.
go back to reference Lopez-Basave HN, Morales-Vasquez F, Ruiz-Molina JM, Namendys-Silva SA, Vela-Sarmiento I, Ruan JM, Rosciano AE, Calderillo-Ruiz G, Diaz-Romero C, Herrera-Gomez A, et al. Gastric cancer in young people under 30 years of age: worse prognosis, or delay in diagnosis? Cancer Manag Res. 2013;5:31–6.CrossRef Lopez-Basave HN, Morales-Vasquez F, Ruiz-Molina JM, Namendys-Silva SA, Vela-Sarmiento I, Ruan JM, Rosciano AE, Calderillo-Ruiz G, Diaz-Romero C, Herrera-Gomez A, et al. Gastric cancer in young people under 30 years of age: worse prognosis, or delay in diagnosis? Cancer Manag Res. 2013;5:31–6.CrossRef
9.
go back to reference Chen X, Zeng Y, Huang Y, Xu J, Meng W, Wang X, Zhu C, Zhu G, Mao C, Shen X. Preoperative Cachexia predicts poor outcomes in young rather than elderly gastric cancer patients: a prospective study. Cancer Manag Res. 2019;11:8101–10.CrossRef Chen X, Zeng Y, Huang Y, Xu J, Meng W, Wang X, Zhu C, Zhu G, Mao C, Shen X. Preoperative Cachexia predicts poor outcomes in young rather than elderly gastric cancer patients: a prospective study. Cancer Manag Res. 2019;11:8101–10.CrossRef
10.
go back to reference Dias Rodrigues V, Barroso de Pinho N, Abdelhay E, Viola JP, Correia MI, Brum Martucci R. Nutrition and immune-modulatory intervention in surgical patients with gastric cancer. Nutr Clin Pract. 2017;32(1):122–9.CrossRef Dias Rodrigues V, Barroso de Pinho N, Abdelhay E, Viola JP, Correia MI, Brum Martucci R. Nutrition and immune-modulatory intervention in surgical patients with gastric cancer. Nutr Clin Pract. 2017;32(1):122–9.CrossRef
11.
go back to reference Kiuchi J, Komatsu S, Kosuga T, Kubota T, Okamoto K, Konishi H, Shiozaki A, Fujiwara H, Ichikawa D, Otsuji E. Long-term postoperative nutritional status affects prognosis even after infectious complications in gastric cancer. Anticancer Res. 2018;38(5):3133–8.PubMed Kiuchi J, Komatsu S, Kosuga T, Kubota T, Okamoto K, Konishi H, Shiozaki A, Fujiwara H, Ichikawa D, Otsuji E. Long-term postoperative nutritional status affects prognosis even after infectious complications in gastric cancer. Anticancer Res. 2018;38(5):3133–8.PubMed
12.
go back to reference Omura Y, Toiyama Y, Okugawa Y, Yamamoto A, Yin C, Kusunoki K, Kusunoki Y, Shigemori T, Ide S, Kitajima T, et al. Crohn’s-like lymphoid reaction is associated with oncological prognosis and nutritional status in patients with pathological stage II/III gastric cancer. Ann Surg Oncol. 2020;27(1):259–67.CrossRef Omura Y, Toiyama Y, Okugawa Y, Yamamoto A, Yin C, Kusunoki K, Kusunoki Y, Shigemori T, Ide S, Kitajima T, et al. Crohn’s-like lymphoid reaction is associated with oncological prognosis and nutritional status in patients with pathological stage II/III gastric cancer. Ann Surg Oncol. 2020;27(1):259–67.CrossRef
13.
go back to reference Rabito EI, Marcadenti A, da Silva FJ, Figueira L, Silva FM. Nutritional risk screening 2002, short nutritional assessment questionnaire, malnutrition screening tool, and malnutrition universal screening tool are good predictors of nutrition risk in an emergency service. Nutr Clin Pract. 2017;32(4):526–32.CrossRef Rabito EI, Marcadenti A, da Silva FJ, Figueira L, Silva FM. Nutritional risk screening 2002, short nutritional assessment questionnaire, malnutrition screening tool, and malnutrition universal screening tool are good predictors of nutrition risk in an emergency service. Nutr Clin Pract. 2017;32(4):526–32.CrossRef
14.
go back to reference Cong M, Song C, Xu H, Song C, Wang C, Fu Z, Ba Y, Wu J, Xie C, Chen G, et al. The patient-generated subjective global assessment is a promising screening tool for cancer cachexia. BMJ Support Palliat Care. 2020;12:e39.CrossRef Cong M, Song C, Xu H, Song C, Wang C, Fu Z, Ba Y, Wu J, Xie C, Chen G, et al. The patient-generated subjective global assessment is a promising screening tool for cancer cachexia. BMJ Support Palliat Care. 2020;12:e39.CrossRef
15.
go back to reference Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Goisser S, Hooper L, Kiesswetter E, Maggio M, Raynaud-Simon A, Sieber CC, et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2019;38(1):10–47.CrossRef Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Goisser S, Hooper L, Kiesswetter E, Maggio M, Raynaud-Simon A, Sieber CC, et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2019;38(1):10–47.CrossRef
16.
go back to reference Volkert D, Berner YN, Berry E, Cederholm T, Coti Bertrand P, Milne A, Palmblad J, Schneider S, Sobotka L, Stanga Z, et al. ESPEN guidelines on enteral nutrition: geriatrics. Clin Nutr. 2006;25(2):330–60.CrossRef Volkert D, Berner YN, Berry E, Cederholm T, Coti Bertrand P, Milne A, Palmblad J, Schneider S, Sobotka L, Stanga Z, et al. ESPEN guidelines on enteral nutrition: geriatrics. Clin Nutr. 2006;25(2):330–60.CrossRef
17.
go back to reference Wei J, Chen W, Zhu M, Cao W, Wang X, Shi H, Dong B, Sun J, Chen H, Zhou Y, et al. Guidelines for parenteral and enteral nutrition support in geriatric patients in China. Asia Pac J Clin Nutr. 2015;24(2):336–46.PubMed Wei J, Chen W, Zhu M, Cao W, Wang X, Shi H, Dong B, Sun J, Chen H, Zhou Y, et al. Guidelines for parenteral and enteral nutrition support in geriatric patients in China. Asia Pac J Clin Nutr. 2015;24(2):336–46.PubMed
18.
go back to reference Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRef Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRef
19.
go back to reference Dudrick SJ, Palesty JA. Historical highlights of the development of total parenteral nutrition. Surg Clin North Am. 2011;91(3):693–717.CrossRef Dudrick SJ, Palesty JA. Historical highlights of the development of total parenteral nutrition. Surg Clin North Am. 2011;91(3):693–717.CrossRef
20.
go back to reference Sakai T, Maeda K, Wakabayashi H, Nishioka S, Seki H. Nutrition support team intervention improves activities of daily living in older patients undergoing in-patient rehabilitation in Japan: a retrospective cohort study. J Nutr Gerontol Geriatrics. 2017;36(4):166–77.CrossRef Sakai T, Maeda K, Wakabayashi H, Nishioka S, Seki H. Nutrition support team intervention improves activities of daily living in older patients undergoing in-patient rehabilitation in Japan: a retrospective cohort study. J Nutr Gerontol Geriatrics. 2017;36(4):166–77.CrossRef
21.
go back to reference Hebuterne X, Lemarie E, Michallet M, de Montreuil CB, Schneider SM, Goldwasser F. Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr. 2014;38(2):196–204.CrossRef Hebuterne X, Lemarie E, Michallet M, de Montreuil CB, Schneider SM, Goldwasser F. Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr. 2014;38(2):196–204.CrossRef
22.
go back to reference Guo ZQ, Yu JM, Li W, Fu ZM, Lin Y, Shi YY, Hu W, Ba Y, Li SY, Li ZN, et al. Survey and analysis of the nutritional status in hospitalized patients with malignant gastric tumors and its influence on the quality of life. Support Care Cancer. 2020;28(1):373–80.CrossRef Guo ZQ, Yu JM, Li W, Fu ZM, Lin Y, Shi YY, Hu W, Ba Y, Li SY, Li ZN, et al. Survey and analysis of the nutritional status in hospitalized patients with malignant gastric tumors and its influence on the quality of life. Support Care Cancer. 2020;28(1):373–80.CrossRef
23.
go back to reference Heneghan HM, Zaborowski A, Fanning M, McHugh A, Doyle S, Moore J, Ravi N, Reynolds JV. Prospective study of malabsorption and malnutrition after esophageal and gastric cancer surgery. Ann Surg. 2015;262(5):803–7.CrossRef Heneghan HM, Zaborowski A, Fanning M, McHugh A, Doyle S, Moore J, Ravi N, Reynolds JV. Prospective study of malabsorption and malnutrition after esophageal and gastric cancer surgery. Ann Surg. 2015;262(5):803–7.CrossRef
24.
go back to reference Wang P, Chen X, Liu Q, Liu X, Li Y. Good performance of the Global Leadership Initiative on Malnutrition criteria for diagnosing and classifying malnutrition in people with esophageal cancer undergoing esophagectomy. Nutrition. 2021;91–92: 111420.CrossRef Wang P, Chen X, Liu Q, Liu X, Li Y. Good performance of the Global Leadership Initiative on Malnutrition criteria for diagnosing and classifying malnutrition in people with esophageal cancer undergoing esophagectomy. Nutrition. 2021;91–92: 111420.CrossRef
25.
go back to reference Liu ZH, Su GQ, Zhang SY, Zhang JB, Huang XR. Study on early postoperative nutritional support in elderly patients with gastric cancer. Chin J Gastrointes Surg. 2013;16(11):1063. Liu ZH, Su GQ, Zhang SY, Zhang JB, Huang XR. Study on early postoperative nutritional support in elderly patients with gastric cancer. Chin J Gastrointes Surg. 2013;16(11):1063.
26.
go back to reference Lu L, Xie M, Wei S, Xiong Z. Effect of enteral nutrition during preoperative and early postoperative periods on immunologic function and postoperative nutritional status in old patients with gastric cancer. Chin J Clin Oncol 2014. Lu L, Xie M, Wei S, Xiong Z. Effect of enteral nutrition during preoperative and early postoperative periods on immunologic function and postoperative nutritional status in old patients with gastric cancer. Chin J Clin Oncol 2014.
27.
go back to reference Chen R, Yin W, Gao H, Zhang H, Huang Y. The effects of early enteral nutrition on the nutritional statuses, gastrointestinal functions, and inflammatory responses of gastrointestinal tumor patients. Am J Transl Res. 2021;13(6):6260–9.PubMedPubMedCentral Chen R, Yin W, Gao H, Zhang H, Huang Y. The effects of early enteral nutrition on the nutritional statuses, gastrointestinal functions, and inflammatory responses of gastrointestinal tumor patients. Am J Transl Res. 2021;13(6):6260–9.PubMedPubMedCentral
28.
go back to reference Ma BQ, Chen SY, Jiang ZB, Wu B, He Y, Wang XX, Li Y, Gao P, Yang XJ. Effect of postoperative early enteral nutrition on clinical outcomes and immune function of cholangiocarcinoma patients with malignant obstructive jaundice. World J Gastroenterol. 2020;26(46):7405–15.CrossRef Ma BQ, Chen SY, Jiang ZB, Wu B, He Y, Wang XX, Li Y, Gao P, Yang XJ. Effect of postoperative early enteral nutrition on clinical outcomes and immune function of cholangiocarcinoma patients with malignant obstructive jaundice. World J Gastroenterol. 2020;26(46):7405–15.CrossRef
29.
go back to reference Fujiya K, Kawamura T, Omae K, Makuuchi R, Irino T, Tokunaga M, Tanizawa Y, Bando E, Terashima M. Impact of malnutrition after gastrectomy for gastric cancer on long-term survival. Ann Surg Oncol. 2018;25(4):974–83.CrossRef Fujiya K, Kawamura T, Omae K, Makuuchi R, Irino T, Tokunaga M, Tanizawa Y, Bando E, Terashima M. Impact of malnutrition after gastrectomy for gastric cancer on long-term survival. Ann Surg Oncol. 2018;25(4):974–83.CrossRef
Metadata
Title
The effects of nutritional support team intervention on postoperative immune function, nutritional statuses, inflammatory responses, clinical outcomes of elderly patients with gastric cancer
Authors
Jiansheng Chen
Liling Zou
Wenxing Sun
Junfeng Zhou
Qingliang He
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-022-01784-9

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