Postoperative Changes in Nutritional and Functional Status of Gastroesophageal Cancer Patients

Abstract

Objective

Disease-related malnutrition is a debilitating condition frequently observed in patients with cancer. The aim of the current study was to prospectively examine postoperative changes in nutritional and functional status of patients undergoing surgery for gastric, esophageal, and gastroesophageal junction cancer.

Methods

Participants were prospectively recruited from September 2015 to September 2019. The assessment of malnutrition was based on the Patient-Generated Subjective Global Assessment tool. The functional assessment included the evaluation of muscle strength and physical performance, while muscle mass assessment was based on Skeletal Muscle Mass Index (SMI) derived from the analysis of computed tomography scans. The follow up of patients was scheduled at six months postoperatively.

Results

A total of 98 patients were analyzed. Mean patient age was 60.79 ± 10.19 years and 80.6% were males. The mean unintentional weight loss at 6 months was 11.7 ± 8.0%. Patients who underwent McKeown esophagectomy reported the greatest weight loss postoperatively (16.2 ± 9.6%), whereas the lowest rate of weight loss was observed in patients who underwent partial gastrectomy (5.6 ± 6.7%). The rate of severe malnutrition declined at six months postoperatively (39.7% vs 27%). Muscle strength and physical performance were significantly deteriorated at 6 months postoperatively, except for the group of partial gastrectomy, while SMI significantly decreased in all groups of patients except for McKewon esophagectomy group. Finally, the prevalence of low muscle mass increased significantly from 43.5% in the preoperative period to 66.7% at the follow-up.

Conclusions

Our study revealed a significant deterioration in gastroesophageal cancer patient nutritional and functional status at six months postoperatively. The high prevalence of malnutrition and low muscle mass requires systematic follow-up and multidirectional monitoring in order to ensure the successful rehabilitation of these patients.

Keywords:

• Malnutrition
• functional status
• muscle mass
• esophageal cancer
• gastric cancer

Author contributions

Irene Lidoriki: conceived and designed the study, analyzed the data, interpreted the data, wrote the paper, reviewed the content of the article and approved the final version of the article.

Dimitrios Schizas: designed the study, analyzed the data, interpreted the data, wrote the article, reviewed the content of the article and approved the final version of the article.

Konstantinos S. Mylonas: analyzed the data, wrote the article, reviewed the content of the article and approved the final version of the article.

Chrysovalantis Vergadis: analyzed the data, wrote the article, reviewed the content of the article and approved the final version of the article.

Lysandros Karydakis: analyzed the data, wrote the article, reviewed the content of the article and approved the final version of the article.

Andreas Alexandrou: reviewed the content of the article and approved the final version of the article.

Ioannis Karavokyros: reviewed the content of the article and approved the final version of the article.

Theodoros Liakakos: interpreted the data, contributed to the drafting of the article, reviewed the content of the paper and approved the final version of the article.

Disclosure statement

The authors declare no conflict of interest.

Additional information

Funding

The authors received no specific funding for this work.