Influence of nutrition on stage-stratified survival in gastric cancer patients with postoperative complications
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Noriyuki Hirahara1, Takeshi Matsubara1, Shunsuke Kaji2, Yuki Uchida1, Ryoji Hyakudomi1, Tetsu Yamamoto1, Kiyoe Takai1, Yohei Sasaki3, Koki Kawakami2 and Yoshitsugu Tajima1
1 Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
2 Department of Surgery, Matsue Red Cross Hospital, Shimane, Matsue, Horomachi, Japan
3 Department of Surgery, Masuda Red Cross Hospital, Shimane, Masuda, Otoyoshi-cho, Japan
Keywords: gastric cancer; prognostic nutritional index; laparoscopic gastrectomy; postoperative complications; prognosis
Received: October 18, 2021 Accepted: January 06, 2022 Published: January 21, 2022
Background: We assessed the relationship between preoperative prognostic nutritional index (PNI) and short- and long-term outcomes among gastric cancer patients because the clinical significance of PNI in these patients remains controversial.
Materials and Methods: We retrospectively reviewed the medical records of 434 consecutive patients who underwent curative laparoscopic gastrectomy for gastric cancer.
Results: Patients with postoperative complications had a significantly poorer overall survival (OS) than those without. On multivariate analyses, postoperative complications were independently associated with PNI value and operative procedure type. In the low PNI group (n = 118), those with postoperative complications experienced significantly poorer OS than those without complications. Among the low PNI group with pTNM stage I and II disease, those with postoperative complications experienced significantly worse OS than those without complications. However, among the high PNI group and patients with stage II and III disease in the low PNI group, OS was similar with respect to postoperative complications.
Conclusions: The present study confirmed that long-term prognosis was unaffected by postoperative complications in well-nourished gastric cancer patients. In addition, preoperative nutritional status and postoperative complications, may be crucial in determining the prognosis of gastric cancer, especially in early-stage cancer.
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