Influence of Preoperative Nutritional Status on Patients Who Undergo Upfront Surgery for Esophageal Squamous Cell Carcinoma

Abstract

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 (P < 0.001). A high NRS 2002 score was associated with frequent postoperative complications, especially pneumonia and anastomosis site leakage (P = 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

Keywords:

• Esophageal cancer
• body mass/BMI
• cachexia
• cancer risk
• cohort study

Author contributions

Jin Hee Noh, Hee Kyong Na, Yong-Hee Kim, Ho June Song, Hyeong Ryul Kim, Kee Don Choi, Gin Hyug Lee, and Hwoon-Yong Jung contributed to the design of the research. Jin Hee Noh, Hee Kyong Na, Yong-Hee Kim, and Ho June Song contributed to the acquisition and analysis of the data. Jin Hee Noh, Hee Kyong Na, and Yong-Hee Kim contributed to the interpretation of the data. Jin Hee Noh and Hee Kyong Na drafted the manuscript. Jin Hee Noh, Hee Kyong Na, Yong-Hee Kim, Ho June Song, Hyeong Ryul Kim, Kee Don Choi, Gin Hyug Lee, and Hwoon-Yong Jung critically revised the manuscript, and agree to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Funding

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