Nutritional Status Indicators Affecting the Tolerability of Postoperative Chemotherapy After Total Gastrectomy in Patients With Gastric Cancer

Toyota Kazuhiro; Mori Masayuki; Hirahara Satoshi; Yoshioka Shoko; Kubota Haruna; Yano Raita; Kobayashi Hironori; Hashimoto Yasushi; Sakashita Yoshihiro; Yokoyama Yujiro; Murakami Yoshiaki; Miyamoto Katsunari

doi:10.5230/jgc.2022.22.e5

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자료유형: 학술저널

저자정보: Toyota Kazuhiro (Department of Surgery Hiroshima Memorial Hospital Hiroshima Japan.) Mori Masayuki (Department of Surgery Hiroshima Memorial Hospital Hiroshima Japan.) Hirahara Satoshi (Department of Surgery Hiroshima Memorial Hospital Hiroshima Japan.) Yoshioka Shoko (Department of Surgery Hiroshima Memorial Hospital Hiroshima Japan.) Kubota Haruna (Department of Surgery Hiroshima Memorial Hospital Hiroshima Japan.) Yano Raita (Department of Surgery Hiroshima Memorial Hospital Hiroshima Japan.) Kobayashi Hironori (Department of Surgery Hiroshima Memorial Hospital Hiroshima Japan.) Hashimoto Yasushi (Department of Surgery Hiroshima Memorial Hospital Hiroshima Japan.) Sakashita Yoshihiro (Department of Surgery Hiroshima Memorial Hospital Hiroshima Japan.) Yokoyama Yujiro (Department of Surgery Hiroshima Memorial Hospital Hiroshima Japan.) Murakami Yoshiaki (Department of Surgery Hiroshima Memorial Hospital Hiroshima Japan.) Miyamoto Katsunari (Department of Surgery Hiroshima Memorial Hospital Hiroshima Japan.)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제22권 제1호

발행연도: 2022.3

수록면: 56 - 66 (11page)

DOI: 10.5230/jgc.2022.22.e5

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Purpose: Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy. Materials and Methods: We included 101 patients who underwent curative total gastrectomy and postoperative chemotherapy at Hiroshima Memorial Hospital. The effects of 37 factors, including perioperative inflammatory, nutritional, and tumor status, on the persistence of postoperative chemotherapy were analyzed. Results: In univariate analysis of preoperative factors, age, carbohydrate antigen 19-9, platelet-to-neutrophil ratio, Onodera's prognostic nutritional index (PNI), controlling nutritional status score, and nutritional risk screening (NRS-2002) score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of preoperative factors, age (≥74 years) was an independent factor for a shorter duration of postoperative chemotherapy (hazard ratio [HR], 5.24; 95% confidence interval [CI], 2.19?12.96; P<0.01). In univariate analysis of factors before postoperative chemotherapy, intraoperative blood loss, perioperative weight loss rate, postoperative performance status, PNI, albumin-to-bilirubin index, and NRS-2002 score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of factors before postoperative therapy, age (≥74 years) (HR, 5.75; 95% CI, 1.90?19.49; P<0.01) and PNI (<39) (HR, 3.29; 95% CI, 1.26?8.56; P=0.02) were independent factors for a shorter duration of postoperative chemotherapy. Conclusions: Age and PNI are useful predictors of postoperative chemotherapy intolerance after total gastrectomy and may determine the treatment strategy and timing of chemotherapy initiation.

#Gastric cancer #Total gastrectomy #Postoperative chemotherapy #Nutritional assessment #Prognostic nutritional index

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