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Comparison of Preoperative Nutritional Indexes for Outcomes after Primary Esophageal Surgery for Esophageal Squamous Cell Carcinoma

Yoon JP 1 , Nam JS 1 , Abidin MFBZ 2 , Kim SO 3 , Lee EH 4 , Choi IC 1 Show all authors , Chin JH 1

Affiliations 

  • 1 Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
  • 2 Department of Anesthesia and Intensive Care, University Malaya Medical Centre, Petaling Jaya 59100, Malaysia
  • 3 Asan Medical Center, Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Seoul 05505, Korea
  • 4 Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea
Nutrients, 2021 Nov 15;13(11).
PMID: 34836339 DOI: 10.3390/nu13114086

Abstract

BACKGROUND: This study aimed to compare the controlling nutritional status (CONUT) score, prognostic nutritional index (PNI), and geriatric nutritional risk index (GNRI) for predicting postoperative outcomes in patients with esophageal squamous cell carcinoma undergoing esophagectomy.

METHODS: We retrospectively reviewed the data of 1265 consecutive patients who underwent elective esophageal surgery. The patients were classified into no risk, low-risk, moderate-risk, and high-risk groups based on nutritional scores.

RESULTS: The moderate-risk (hazard ratio [HR]: 1.55, 95% confidence interval [CI]: 1.24-1.92, p < 0.001 in CONUT; HR: 1.61, 95% CI: 1.22-2.12, p = 0.001 in GNRI; HR: 1.65, 95% CI: 1.20-2.26, p = 0.002 in PNI) and high-risk groups (HR: 1.91, 95% CI: 1.47-2.48, p < 0.001 in CONUT; HR: 2.54, 95% CI: 1.64-3.93, p < 0.001 in GNRI; HR: 2.32, 95% CI: 1.77-3.06, p < 0.001 in PNI) exhibited significantly worse 5-year overall survival (OS) compared with the no-risk group. As the nutritional status worsened, the trend in the OS rates decreased (p for trend in all indexes < 0.05).

CONCLUSIONS: Malnutrition, evaluated by any of three nutritional indexes, was an independent prognostic factor for postoperative survival.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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