Malnutrition by European Society for Clinical Nutrition and Metabolism criteria predicts prognosis in patients with gastrointestinal and hepatobiliary-pancreatic cancer
Malnutrition by European Society for Clinical Nutrition and Metabolism criteria predicts prognosis in patients with gastrointestinal and hepatobiliary-pancreatic cancer
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DOI：
10.1016/j.clnesp.2021.01.023
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发表时间：
2021-03-19
影响因子：
3
通讯作者：
Hamada, Yasuhiro
中科院分区：
文献类型：
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作者：
Aotani, Nozomi;Yasui-Yamada, Sonoko;Hamada, Yasuhiro
背景与目的：欧洲临床营养与代谢学会（ESPEN）于2015年提出了ESPEN营养不良诊断标准（EDC）。目前尚无关于EDC与胃肠道（GI）和肝胆胰（HBP）癌症患者预后之间关系的报道。本研究旨在（1）确定 EDC 营养不良的患病率，（2）调查 EDC 作为营养和预后指标的有效性，以及（3）检查 EDC 的哪些成分与 GI 和 HBP 癌症患者的长期预后最相关。方法：回顾性招募了 634 名在 2014 年 7 月至 2018 年 3 月期间接受首次切除手术的原发性 GI 和 HBP 癌症患者。根据 EDC 的说法，患者被分为营养不良组和非营养不良组。比较两组之间的临床参数和生存率。使用Cox比例风险模型分析EDC和EDC组成部分的预后效果。结果：EDC营养不良的患病率为22%。人体测量数据和生化数据与 EDC 营养不良相关。营养不良组的 5 年生存率 (72%) 低于非营养不良组 (73%；P = 0.007)。多变量分析表明，营养不良组是死亡的独立危险因素（营养不良组的风险比=1.70；95%置信区间1.08-2.63；P=0.024）。在 EDC 成分中，体重指数 (BMI) 为
Background & aims: The European Society for Clinical Nutrition and Metabolism (ESPEN) proposed the ESPEN diagnostic criteria (EDC) for malnutrition in 2015. There is no report on the association between the EDC and prognosis in patients with gastrointestinal (GI) and hepatobiliary-pancreatic (HBP) cancer. This study aimed to (1) determine the prevalence of EDC malnutrition, (2) investigate the validity of the EDC as a nutritional and prognostic indicator, and (3) examine which components of the EDC are most related to long-term prognosis in patients with GI and HBP cancers.Methods: A total of 634 patients with primary GI and HBP cancers who underwent their first resection surgery between July 2014 and March 2018 were retrospectively recruited. According to the EDC, patients were divided into malnourished and non-malnourished groups. Clinical parameters and survival between these two groups were compared. The prognostic effects of the EDC and the EDC components were analyzed using Cox proportional hazard models.Results: The prevalence of EDC malnutrition was 22%. Anthropometric data and biochemical data were associated with EDC malnutrition. The 5-year survival rate was lower in the malnourished group (72%) than in the non-malnourished group (73%; P = 0.007). The multivariate analysis demonstrated that the malnourished group was an independent risk factor for mortality (hazard ratio = 1.70 in the malnourished group; 95% confidence interval 1.08-2.63; P = 0.024). Among EDC components, body mass index (BMI) of