Preoperative Nutritional Deficiency Is a Useful Predictor of Postoperative Outcome in Patients Undergoing Curative Resection for Gastric Cancer

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• 作者：Xuechao Liu^* ; ^&dagger ; ; ¹ ; Pengfei Xu^* ; ^&Dagger ; ; ¹ ; Haibo Qiu^* ; ^&dagger ; ; Dazhi Xu^* ; ^&dagger ; ; Wei Li^* ; ^&dagger ; ; Youqing Zhan^* ; ^&dagger ; ; Yuanfang Li^* ; ^&dagger ; ; Yingbo Chen^* ; ^&dagger ; ; Zhiwei Zhou^* ; ^&dagger ; ; Xiaowei Sun^* ; ^&dagger ; ; ^{sunxw@sysucc.org.cn}
• 刊名：Translational Oncology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：9
• 期：6
• 页码：482-488
• 全文大小：772 K
• 卷排序：9

文摘

BACKGROUND: Preoperative nutritional deficiency (ND) has been shown to be a valuable prognostic factor in urologic malignancies. We aimed to investigate the prognostic value of ND in patients with gastric cancer (GC). METHODS: A single-center cohort of 1026 GC patients undergoing curative resection between 2003 and 2012 was categorized to ND and nutritionally replete (NR) groups. Patients with body mass index <18.5 kg/m2, preoperative albumin <35 g/l, or preoperative weight loss ≥5% of body weight were defined as ND. RESULTS: Of the 1026 patients included in the study, 585 (57.0%) were categorized as ND. Overall survival (OS) at 5 years was 68.5% for ND patients and 44.0% for NR patients (P < .001). Multivariate analysis revealed that ND was a significant predictor of OS (hazard ratio: 1.954; 95% confidence interval: 1.552-2.460; P < .001). In stage-stratified analysis, it was still independently associated with OS in tumor-nodes-metastasis stage II and III (P = .004 and P < .001, respectively). Of note, the prognostic significance of ND was still maintained when stratified by age, sex, anemia, and adjuvant chemotherapy (all Ps < .05). CONCLUSION: Preoperative ND is a novel predictor of outcome in GC, especially in stage II to III GC, and may help clinicians identify high-risk patients for proactive nutritional interventions.