Relation between preoperative prognostic Onodera´s Index and postsurgery complications in the R0 gastric carcinoma resection

Authors

  • F. Borda Complejo Hospitalario de Navarra
  • C. Miranda
  • A. Borda Complejo Hospitalario de Navarra
  • E. Echeverría
  • A. Guerra
  • J.J. Iñigo
  • J.M. Zozaya

DOI:

https://doi.org/10.23938/ASSN.0007

Keywords:

Gastric carcinoma. Onodera´s Index. R0 surgical resection. Postoperative complications. Predictive value.

Abstract

Background. It has been postulated in the Asian literature that a low prognostic nutritional index (OI) could be associated with a higher rate of complications following radical gastric cancer surgery, but there is a lack of data concerning western countries. The aim is to analyze the relationship between a low preoperative OI and the frequency and severity of surgical complications in R0 gastric cancer resection.

Patients and methods. In the present article, 124 cases of gastric cancer with R0 resection were reviewed. An OI <45 was considered pathologically low. The complication rate was compared between both groups: OI <45 vs OI ≥45.  A multivariate analysis was performed adjusting for: age > 68 years, ASA score, preoperative hemoglobin level <12 g/dL, pTNM stage, serosal infiltration, lymph node invasion and type of gastrectomy. The relationship between a PNI<45 and the severity of complications graded according to the Clavien-Dindo classification was determined.

Results. We registered mild complications in 11.3% of cases, severe complications in 9.7% and a mortality rate of 2.4%.  Patients with a OI <45 showed a higher complication rate: 37.7% versus 12.7% [odds ratio (OR) = 4.17; CI95% = (1.71 - 10.20 p = 0.001)], confirmed by multivariate analysis: [OR = 4.17; CI95% = (1.54 - 11.30) ; p = 0.005].  Patients with OI <45 had more severe complication-exitus: 20.8% versus 5.6% [OR = 4.39; CI95% = (1.31 - 14.68); p = 0.011].

Conclusions.  We confirmed that patients with a low preoperative OI show a higher independent risk of complications after a R0 gastric cancer resection in a western country as well. Complications, in these cases with OI <45, registered a significantly higher severity grade.

Downloads

Download data is not yet available.

References

ZHOU J, ZHOU Y, CAO S, LI S, WANG H, NIU Z et al. Multivariate logistic regression analysis of postoperative complications and risk model establishment of gastrectomy for gastric cancer: A single-center cohort report. Scand J Gastroenterol 2016; 51: 8-15.

DEGIULI M, SASAKO M, PONTI A. Italian Gastric Cancer Study Group. Morbidity and mortality in the Italian Gastric Cancer Study Group randomized clinical trial on D1 versus D2 resection for gastric cancer. Br J Surg 2010; 97: 643-649.

KIM MC, KIM W, KIM HH, RYU SW, RYU SY, SONG KY et al. Risk factors associated with complication following laparoscopy-assisted gastrectomy for gastric cancer: A large-scale Korean multicenter study. Ann Surg Oncol 2008; 15: 2692-7000.

DINC T, YLDIZ BD, KAYILIOGLU I, SOZEN I, TEZ M, COSTUN F. Prognostic value of preoperative inflammation-based prognostic scores on hospital mortality after gastric cancer surgery. Asian Pac J Cancer Prev 2014; 15: 7909-7911.

ONODERA T, GOSEKI N, KOSAKI G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi 1984; 85: 1001-1005.

SUN KY, XU JB, CHEN SL, YUAN YJ, WU H, PENG JJ et al. Novel immunological and nutritional-based prognostic index for gastric cancer. World J Gastroenterol 2015; 21: 5961-5971.

SAKURAI K, OHIRA M, TAMURA T, TOYOKAWA T, AMANO R, KUBO N et al. Predictive potential of preoperative nutritional status in long term outcome projections for patients with gastric cancer. Ann Surg Oncol 2016; 23: 525-533.

JIANG N, DENG JY, KE B, LIU N, ZHANG RP, LIANG H. Prognostic nutritional index predicts postoperative complications and long-term outcomes of gastric cancer. World J Gastroenterol 2014; 20: 10537-10544.

WATANABE M, IWATSUKI M, IWAGAMI S, ISHIMOTO T, BABA Y, BABA H. Prognostic nutritional index predicts outcomes of gastrectomy in the elderly. World J Surg 2012; 36: 1632-1639.

LEE JY, KIM HI, KIM YN, HONG JH, ALSHOMIMI S, AN JY et al. Clinical significance of the prognostic nutritional index for predicting short and long-term surgical outcomes after gastrectomy. Medicine (Baltimore). 2016; 95: e3539.

MIGITA K, TAKAYAMA T, SAEKI K, MATSUMOTO S, WAKATSUKI K, ENOMOTO K et al. The prognostic nutritional index predicts long-term outcomes of gastric cancer patients independent of tumor stage. Ann Surg Oncol 2013; 20: 2647-2654.

KANDA M, MIZUNO A, TANAKA C, KOBAYASHI D, FUJIWARA M, IWATA N et al. Nutritional predictors for postoperative short-term and long-term outcomes of patients with gastric cancer. Medicine (Baltimore). 2016; 95: e3781.

EO WK, CHANG HJ, SUH J, AHN J, SHIN J, HUR JY et al. The Prognostic Nutritional Index Predicts Survival and Identifies Aggressiveness of Gastric Cancer. Nutr Cancer 2015; 67: 1260-1267.

DAN YY, SO JB, YEOH KG. Endoscopic screening for gastric cancer. Clin Gastroenterol Hepatol 2006; 4: 709-716.

DINDO D, DEMARTINES N, CLAVIEN PA. Classification of surgical complications. A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004; 240: 205-213.

EDGE SB, BYRD DR, COMPTON CC, FRILZ AG, GREENE FL, TROTTI A. Editors. AJCC Cancer staging Manual 7th ed New York Springer 2010.

KLEK S, SIERZEGA M, SZYBINSKY P, SZCEPANEK K, SCISLO L, WALEWSKA E et al. The immunomodulating enteral nutrition in malnourished surgical patients. A prospective, randomized, double blind clinical trial. Clin Nutr 2011; 30: 282-288.

MI RJ, YOUNG KP, JANG WS. Definition and classification of complications of gastrectomy for gastric cancer based on the accordion severity grading system. World J Surg 2012; 36: 2400-2411.

BILIMORIA KY, LIU Y, PARUCH JL, ZHOU L, KMIECIK TE, KO CY et al. Development and evaluation of the universal ACS NSQIP surgical risk calculator: A decision aid and informed consent tool for patients and surgeons. Am J Coll Surg 2013; 217: 833-842.

ZHOU J, YU P, SHI Y, TANG B, HAO Y, ZHAO Y et al. Evaluation of Clavien-Dindo classification in patients undergoing total gastrectomy for gastric cancer. Med Oncol 2015; 32: 120-126.

LEE KG, LEE HJ, YANG JY, OH SY, BARD S, SUH YS et al. Risk factors associated with complication following gastrectomy for gastric cancer: retrospective analysis of prospectively collected data base on the Clavien-Dindo system. J Gastrointest Surg 2014; 18: 1269-1277.

BIRKMEYER NJ, GOODNEY PP, STUKEL TA, HILLNER BE, BIRKMEYER JD. Do cancer centers designated by the National Cancer Institute have better surgical outcomes? Cancer 2005; 103: 435-441.

SMITH DI, ELTING IS, LEARN PA, RAUT CP, MANSFIELD PF. Factors influencing the volume-outcome relationships in gastrectomies: a population-based study. Ann Surg Oncol 2007; 14: 1846-1852.

SABESAN A, PETRELLI NJ, BENNETT JJ. Outcomes of gastric cancer resections performed in a high volume community cancer center. Surg Oncol 2015; 24: 16-20.

KNOPS AM, LEGEMATE DA, GOOSSENS A; BOSSUYT PM, UBBINK DT. Decisions aids for patients facing a surgical treatment decision: A systematic review and meta-analysis. Ann Surg 2013; 257: 860-866.

MAYOL A, MARTÍ R, LÓPEZ MOZOS F, BÁGUENA G, ORTEGA J. Influencia de la edad avanzada en la morbi-mortalidad del cáncer gástrico tras la cirugía con intención curativa. Rev Esp Enferm Dig 2013; 105: 194-199.

BORDA A, BORDA F, VILA J, FERNÁNDEZ URIÉN I, ZOZAYA JM, GUERRA A. Valor predictivo pre-tratamiento del Índice Pronóstico Nutricional sobre la supervivencia del carcinoma gástrico. An Sist Sanit Navar 2016; 39: 227-235.

SAKURAI K, TAMURA T, TOYOKAWA T, AMANO R, KUBO N, TANAKA H et al. Low preoperative prognostic nutritional index predicts poor survival post-gastrectomy in elderly patients with gastric cancer. Ann Surg Oncol 2016; 23: 3669-3676.

NOZOE T, NINOMIYA M, MAEDA T, MATSUKUMA A, NAKASHIMA H, EZAKI T. Prognostic nutritional index: a tool to predict the biological aggressiveness of gastric carcinoma. Surg Today 2010; 40: 440-443.

YANG Y, GAO P, SONG Y, SUN J, CHEN X, ZHAO J et al. The prognostic nutritional index is a predictive indicator of prognosis and postoperative complications in gastric cancer: A meta-analysis. Eur J Surg Oncol 2016; 42: 1176-1182.

Downloads

Additional Files

Published

2017-04-30

How to Cite

Borda, F., Miranda, C., Borda, A., Echeverría, E., Guerra, A., Iñigo, J., & Zozaya, J. (2017). Relation between preoperative prognostic Onodera´s Index and postsurgery complications in the R0 gastric carcinoma resection. Anales Del Sistema Sanitario De Navarra, 40(1), 67–75. https://doi.org/10.23938/ASSN.0007

Issue

Vol. 40 No. 1 (2017)

Section

Research articles

License

Copyright (c) 2017 Anales del Sistema Sanitario de Navarra

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

La revista Anales del Sistema Sanitario de Navarra es publicada por el Departamento de Salud del Gobierno de Navarra (España), quien conserva los derechos patrimoniales (copyright ) sobre el artículo publicado y favorece y permite la difusión del mismo bajo licencia Creative Commons Reconocimiento-CompartirIgual 4.0 Internacional (CC BY-SA 4.0). Esta licencia permite copiar, usar, difundir, transmitir y exponer públicamente el artículo, siempre que siempre que se cite la autoría y la publicación inicial en Anales del Sistema Sanitario de Navarra, y se distinga la existencia de esta licencia de uso.

Most read articles by the same author(s)

1 2 3 > >>