The Impact of Nutritional and Functional Status on Postoperative Outcomes following Esophageal Cancer Surgery

Abstract

Malnourished patients undergoing esophagectomy have increased risk of postoperative complications. The aim of the current study was to identify nutritional and functional risk factors for postoperative complications in patients with esophageal and gastroesophageal junction cancer who underwent esophagectomy. Seventy patients who were admitted at the First Department of Surgery, Laikon General Hospital, Athens, Greece, were included in this study. Laboratory data and data regarding nutritional and functional status were recorded preoperatively. Postoperative complications were graded according to Clavien-Dindo classification. Thirty-seven patients (52.9%) developed postoperative complications. Albumin and Geriatric Nutritional Risk Index (GNRI) levels were lower in patients who developed major complications compared to patients who did not develop postoperative complications (3.90 ± 0.44 vs 4.18 ± 0.37 g/dL, p = 0.014 and 107.40 ± 15.76 vs 114.98 ± 12.26, p = 0.050 respectively). Major complications were associated with higher percentage of weight loss (12.1 ± 11.1 vs 6.2 ± 7.5%, p = 0.019) and with low handgrip strength (80 vs 16.9%, p = 0.006). Albumin (3.93 ± 0.18 vs 4.15 ± 0.41 g/dL, p = 0.019) and low muscle mass (22.6 vs 2.8%, p = 0.016) were significantly associated with anastomotic leakage occurence. The incorporation of patients’ nutritional and functional status in the preoperative risk assessment might increase prognostic ability concerning postoperative complications of patients undergoing esophagectomy.

Conflict of Interest Statement

All authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Financial Disclosure Statement

The authors have nothing to disclose.

Source of Funding

The authors received no specific funding for this work.

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Additional information

Notes on contributors

Irene Lidoriki

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.

Konstantinos S. Mylonas

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

Athanasios Syllaios

Athanasios Syllaios: analyzed the data, reviewed the content of the article and approved the final version of the article.

Chrysovalantis Vergadis

Chrysovalantis Vergadis: reviewed the content of the article and approved the final version of the article.

Panagiota Stratigopoulou

Panagiota Stratigopoulou: reviewed the content of the article and approved the final version of the article.

Georgios Marinos

Georgios Marinos: reviewed the content of the article and approved the final version of the article.

Aikaterini Mastoraki

Aikaterini Mastoraki: reviewed the content of the article and approved the final version of the article.

Ioannis Karavokyros

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

Dimitrios Schizas

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