The prevalence of malnutrition in EC patients has been estimated to be as high as 79% ( 10), which has a significant negative impact on the incidence of postoperative complications, tolerance to treatment, and survival ( 11, 12). In oncology patients, malnutrition may be induced by the metabolic and physical effects of the cancer, or may be a side-effect of anti-cancer treatments ( 8, 9). Thus, strategies that can improve the postoperative complications ( 3), clinical outcomes ( 4) and quality of life (QOL) ( 5) for EC patients are garnering accumulating interest in the oncology community, with newer approaches utilizing inter- or multi-disciplinary cancer treatment ( 6, 7). However, due to the recent advances in both the prevention and treatment of the disease, the mortality of EC has been exhibiting a decreasing trend in China ( 2). China accounts for ~55% of the global EC-related deaths ( 2). These results support the importance of preoperatively identifying malnutrition using appropriate assessment tools, because it can facilitate the selection of management strategies that will optimize the clinical outcomes of EC patients.Įsophageal cancer (EC) remains the sixth most common cause of cancer-related death according to the latest global cancer statistics ( 1). Moreover, GLIM-defined malnutrition exhibited the highest power to identify the incidence of complications among all independent predictors in a pooled analysis.Ĭonclusion: Among the PG-SGA, the ESPEN 2015 and the GLIM, the GLIM framework defines the highest prevalence rate of malnutrition and appears to be the optimal method for predicting postoperative complications in EC patients undergoing esophagectomy. GLIM- and ESPEN 2015-defined malnutrition were both associated with the total number of postoperative complications in multivariable analyses. The overall incidence of postoperative complications for the study population was 58.1% (209/360).
The PG-SGA and GLIM had higher diagnostic concordance (Kappa = 0.519, P < 0.001) compared to the ESPEN 2015 vs. Results: The prevalence of malnutrition before surgery was 23.1% (83/360), 12.2% (44/360), and 33.3% (120/360) in the study population, as determined by the PG-SGA, the ESPEN 2015 and the GLIM, respectively. The prevalence of malnutrition and association with postoperative complications were compared in parallel for the three methods. The prevalence of malnutrition in the study population was prospectively defined using the PG-SGA (≥9 defined malnutrition), and retrospectively defined using the ESPEN 2015 and the GLIM. Methods: We performed a single center, observational cohort study that included 360 EC patients undergoing esophagectomy from December 2014 to November 2019 at Daping Hospital in China.
3Department of Thoracic Surgery, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, Chinaīackground: There are several approaches that can be used for the pre-treatment identification of malnutrition in oncology populations including the Patient-Generated Subjective Global Assessment (PG-SGA), the 2015 consensus statement by the European Society for Clinical Nutrition and Metabolism (ESPEN 2015) and the Global Leadership Initiative on Malnutrition (GLIM).Īims: This study aimed to evaluate whether malnutrition, as defined by these three methods, can be used to predict complications in esophageal cancer (EC) patients after esophagectomy.2Institute of Hepatopancreatobiliary Surgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.1Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China.Liangyu Yin 1,2, Nian Cheng 3, Ping Chen 3, Mengyuan Zhang 1, Na Li 1, Xin Lin 1, Xiumei He 1, Yingjian Wang 3, Hongxia Xu 1 *, Wei Guo 3 * and Jie Liu 1 *
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