Comparative analysis of the prognostic utility of preoperative nutritional parameters in patients with resectable esophageal carcinoma.
Esophageal carcinoma
Esophagectomy
Nutrition
Outcome
Transthyretin
Journal
General thoracic and cardiovascular surgery
ISSN: 1863-6713
Titre abrégé: Gen Thorac Cardiovasc Surg
Pays: Japan
ID NLM: 101303952
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
16
10
2020
accepted:
16
11
2020
pubmed:
28
11
2020
medline:
15
4
2021
entrez:
27
11
2020
Statut:
ppublish
Résumé
Although surgical resection is a mainstay in the management of esophageal carcinoma (EC), its postoperative outcomes remain unsatisfactory. To optimize surgical strategies for EC, a simple method of stratifying patients according to risk factors is desired. Controlling nutritional status (CONUT), the prognostic nutritional index (PNI), transthyretin and transferrin are nutritional parameters used to predict the long-term outcomes of EC patients. We aimed to comparatively evaluate the prognostic significance of these four markers, measured preoperatively, in patients with operable EC. In total, 224 patients undergoing surgical resection for EC were retrospectively reviewed. Overall/cancer-specific survivals (OS/CSS) were estimated applying the Cox proportional hazard model to univariate and multivariate analyses. PNI, transthyretin and transferrin levels were treated as continuous variables in these analyses. Preoperative CONUT had significant associations with tumor location, depth and preoperative irradiation. The other three markers all showed significant relationships with age and tumor depth. On univariate Cox regression analysis, preoperative CONUT, PNI, transthyretin and transferrin all correlated significantly with OS and CSS. On multivariate Cox regression analysis, the preoperative transthyretin level was identified as an independent predictor of OS (HR 0.51 per 10 mg/dL increase, 95% CI 0.29-0.88, p = 0.017) and CSS (HR 0.50, 95% CI 0.27-0.91, p = 0.027) as well as tumor depth, nodal metastasis and preoperative irradiation, while the other three parameters were not. Preoperative transthyretin, as a continuous variable, independently predicted both OS and CSS in resectable EC patients, appearing to be the best prognosticator among conventional nutrition-related parameters.
Identifiants
pubmed: 33245476
doi: 10.1007/s11748-020-01555-4
pii: 10.1007/s11748-020-01555-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
326-335Références
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