PS02.189: A STUDY ON PRETREATMENT NUTRITIONAL SCORE OF ESOPHAGEAL CANCER PATIENTS WHO UNDERWENT PREOPERATIVE TREATMENT

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 175-175
Author(s):  
Itaru Omoto ◽  
Yasuto Uchikado ◽  
Ken Sasaki ◽  
Yusaku Osako ◽  
Hiroshi Okumura ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Adverse Events ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Tube Feeding ◽  
Treatment Result ◽  
Preoperative Treatment ◽  
Nutritional Score ◽  
Histopathological Result

Abstract Background Esophageal cancer tends to be malnourished due to anorexia, transit disorder, so it is important to conduct sufficient nutritional assessment and treatment. For standard treatment of neoadjuvant chemotherapy for esophageal cancer, Cisplatin + 5-fluorouracil (FP) therapy is common, but sufficient therapeutic effect has not been obtained. As a more powerful regimen, DCF therapy with Docetaxel added to FP therapy and chemoradiotherapy have been introduced. In this study, we examined pretreatment nutritional score of esophageal cancer patients who underwent neoadjuvant therapy. Methods We studied 105 patients undergoing preoperative treatment diagnosed as esophageal cancer or esophagogastric junctional carcinoma from July 2012 to August 2017. Esophagectomy with lymph node dissection after neoadjuvant therapy. Relationship between Glassgow Prognostic Score (GPS) and Controlling Nutrition Status Score (CONUT) score, sex, age, staging, main tumor location, adverse event, postoperative complication and tube feeding nutrition are examined. Results Median age was 66 years, male/female = 92/13, and cases requiring tube feeding were 29 cases. The breakdown of the clinical stage is Stage IA, B/IIA, B/IIIA, B, C/IV = 9/34/50/12. The breakdown of neoadjuvant therapy is FP/DCF/FPRT/DCFRT/other = 9/27/26/39/4. The incidences of grade 3/4 adverse events during preoperative treatment were 66 cases (63%) in 105 patients. The treatment effect is CR/PR/SD/PD = 6/41/50/8. Histopathological result is Grade 0/1a/1b/2/3 = 3/52/13/6/31. Postoperative complications were Clavien-Dindo classification Grade IIIa or more in 20 cases, in-hospital death was 1 case.CONUT score was judged to be cut-off by more than 2, there was a significant relationship between presence of tube nutrition and treatment result (P = 0.0376, 0.0231). GPS was judged to be 1 or more cutoff, there was a significant association with tube nutrition availability and histopathological result (P = 0.0019, 0.0083). There was no significant difference between occurrence of adverse events and occurrence of postoperative complications. Conclusion It was suggested that CONUTscore and GPS at hospitalization are useful as predictors of treatment result and histopathological result in esophageal cancer patients who undergo neoadjuvant therapy. Disclosure All authors have declared no conflicts of interest.

Enteral Access is not Required for Esophageal Cancer Patients Undergoing Neoadjuvant Therapy

2016 ◽  
Vol 102 (3) ◽  
pp. 948-954 ◽  
Author(s):  
Mary E. Huerter ◽  
Eric J. Charles ◽  
Emily A. Downs ◽  
Yinin Hu ◽  
Christine L. Lau ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Enteral Access

PS02.125: NEOADJUVANT CHEMOTHERAPY PLUS SURGERY FOR NON-T4 CSTAGE II/III ESOPHAGEAL CANCER: A SINGLE INSTITUTION EXPERIENCE IN JAPAN

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 156-157
Author(s):  
Masahiko Ikebe ◽  
Mitsuhiko Ohta ◽  
Masahiko Sugiyama ◽  
Masaru Morita ◽  
Yasushi Toh
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Neoadjuvant Chemotherapy ◽  
Adverse Events ◽  
Standard Treatment ◽  
Conflicts Of Interest ◽  
Radical Surgery ◽  
Hospital Death ◽  
Number Of Patients ◽  
Grade 3

Abstract Background In Japan, following the results of JCOG 9907 trial, neoadjuvant chemotherapy (NAC) and radical surgery has been a standard treatment for Non-T4 cStage II/III esophageal cancer. Since 2009 we have also positioned NAC as standard treatment. We examined treatment outcomes and problems in our institute. Methods From 2009 to 2015, there were 64 patients with non-T4 stage II/III esophageal cancer treated with chemotherapy who are planned to undergo curative surgery. The standard NAC regimen consists of 2 courses of CDDP/5-FU (CF) therapy. As standard surgical procedure, subtotal esophagectomy, cervical anastomosis, three regional lymph node dissection were performed. Results The number of patients was 23/41 cases of cStage II/III respectively. 53 patients (88%) completed two courses of NAC. At the end of first course, NAC was terminated due to adverse events in 4 cases and due to the increasing tendency of tumors in 7 cases. NAC-induced adverse events of grade 3 or higher consists of myelosuppression in 27 cases (42%), appetite loss in 5 cases and so on. Surgery was performed in 61 cases (95%), of which R0 operation in 56 cases (88%), R1 operation in 3 cases and R2 operation in 2 cases. Three patients did not undergo surgery due to progressive disease. There were 7 cases (11%) of postoperative complications of Grade 3 or higher, but there was no in-hospital death. In the histological therapeutic effect, there were 5/41/7/4/3 cases for Grade 0/1a/1b/2/3, respectively. Three-year and five-year overall survival rate of all 64 patients were 68% and 47%. In 56 patients who underwent R0 surgery, they were 76% and 61% respectively. Conclusion From the viewpoint of adverse events and postoperative complications, NAC plus radical surgery for cStage II/III esophageal cancer could be performed safely. Considering that more than 60% of the patients belong to cStage III, this treatment strategy resulted in relatively favorable prognosis. Disclosure All authors have declared no conflicts of interest.

P23 MALNUTRITION INDICES AS PROGNOSTIC FACTORS FOR POSTOPERATIVE COMPLICATIONS IN ESOPHAGEAL CANCER PATIENTS

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Lidoriki Irene ◽  
Schizas Dimitrios ◽  
Mpaili Efstratia ◽  
Mpoura Maria ◽  
Hasemaki Natasha ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Factors ◽  
High Risk ◽  
Postoperative Complications ◽  
Anastomotic Leakage ◽  
Cancer Patients ◽  
Preoperative Assessment ◽  
Low Risk ◽  
Major Complications ◽  
The Impact

Abstract Aim To investigate the impact of malnutrition on postoperative complications in esophageal cancer patients. Background and Methods Malnutrition is common in esophageal cancer patients due to the debilitating nature of their disease. Several methods of nutritional assessment have emerged as significant prognostic factors for short-and long-term outcomes in patients operated for esophageal cancer. The study sample consisted of 85 patients with esophageal (n=11) and gastroesophageal junction (n=74) cancer who were admitted for surgery in the First Department of Surgery, Laikon General Hospital, Athens, Greece, between September 2015 and March 2019. Out of them, 65 patients underwent esophagectomy, while 20 patients underwent total gastrectomy. The assessment of nutritional status included the Geriatric Nutritional Risk Index (GNRI), the Patient Generated Subjective Global Assessment (PG-SGA) and sarcopenia. GNRI was based on preoperative values of patients’ serum albumin and body weight. The preoperative assessment of sarcopenia was based on Skeletal Muscle Index (SMI) derived from analysis of CT scans using SliceOmatic® Software version 4.3 (Tomovision, Montreal, Canada). Postoperative complications were graded according to Clavien-Dindo classification. Minor complications included categories I-II, whereas major complications included categories III-V. Results Thirty nine patients (47.6%) developed postoperative complications. More specifically, 21 patients (24.7%) developed minor complications and 18 patients (21.2%) developed major complications, while anastomotic leakage occurred in 10 patients (11.8%). Eighty patients (94.1%) had a high-risk GNRI (<92), while 5 patients (5.9%) had a low-risk GNRI (≥92). Forty four patients (51.8%) were diagnosed with sarcopenia. The mean PG-SGA score was 8.82 ± 5.57. Patients with a high-risk GNRI demonstrated significantly higher rate of overall complications compared to low-risk GNRI patients (100% vs 44.2%, p<0.05 respectively). Moreover, the rate of anastomotic leakage was significantly higher in the sarcopenia group than in the non-sarcopenia group (29% vs 3.4%, p<0.05). Nonetheless, PG-SGA was not significantly associated with postoperative outcomes. Conclusion Higher-risk scores on the GNRI are associated with an increased risk for developing postoperative complications, while sarcopenia is associated with higher risk for anastomotic leakage among esophageal cancer patients. Preoperative assessment of GNRI and sarcopenia should be performed in all patients in order to detect patients who are at greater risk of postoperative morbidity.

Randomized study of the effect of synbiotics during neoadjuvant chemotherapy on adverse events in esophageal cancer patients

2017 ◽  
Vol 36 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Masaaki Motoori ◽  
Masahiko Yano ◽  
Hiroshi Miyata ◽  
Keijiro Sugimura ◽  
Takuro Saito ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Adverse Events ◽  
Cancer Patients ◽  
Randomized Study

scholarly journals Correlation analyses between pre- and post-operative adverse events in gastric cancer patients receiving preoperative treatment and gastrectomy

BMC Cancer ◽  
2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Shuang-Xi Li ◽  
Sang Hyuk Seo ◽  
Yoon Young Choi ◽  
Masatoshi Nakagawa ◽  
Ji Yeong An ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adverse Events ◽  
Cancer Patients ◽  
Preoperative Treatment ◽  
Correlation Analyses ◽  
Gastric Cancer Patients

scholarly journals PO-0805 Analysis of esophageal cancer patients treated with neoadjuvant therapy who never made it to surgery

2019 ◽  
Vol 133 ◽  
pp. S418
Author(s):  
M. Thomas ◽  
L. Depypere ◽  
J. Moons ◽  
W. Coosemans ◽  
T. Lerut ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Therapy ◽  
Cancer Patients

PS01.170: IMPACT OF MUSCLE MASS, NUTRITIONAL STATUS AND MUSCLE STRENGTH ON OUTCOMES FOLLOWING SURGERY FOR ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 97-97
Author(s):  
Eliza Hagens ◽  
Minke Feenstra ◽  
Mark I Van Berge Henegouwen ◽  
Suzanne Gisbertz
Keyword(s):  
Skeletal Muscle ◽  
Overall Survival ◽  
Esophageal Cancer ◽  
Muscle Strength ◽  
Nutritional Status ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Surface Area ◽  
Muscle Function ◽  
Skeletal Muscle Index

Abstract Background Muscle function loss and loss of skeletal muscle have been associated with worse outcomes following surgery for malignancies of gastrointestinal origin. The influence on post-operative outcomes and survival after esophageal surgery remains unclear. Primary objectives of this study were to evaluate the incidence of sarcopenia and malnutrition and to evaluate the influence of skeletal muscle surface area and muscle strength on postoperative outcomes and overall survival in esophageal cancer patients. Methods A retrospective cohort study from a prospective database was conducted in patients with resectable esophageal cancer who underwent curative-intent treatment between January 2011 and January 2016. Skeletal muscle surface area was calculated with CT scans at L3 level and corrected for height and weight before start of treatment and in the interval between neoadjuvant treatment and surgery. Muscle strength was evaluated with various tests on muscle functions and lung function tests. Nutritional status was evaluated using BMI. Results 273 Patients were included. There were 4 patients with sarcopenia before neoadjuvant therapy and only one patient with sarcopenia after completion of neoadjuvant therapy. Median skeletal muscle surface area was 78cm2/m2 for men and 61cm2/m2 for woman. Table 1 shows skeletal muscle surface area, muscle strength and BMI in relation to no, minor or major complications. Muscle strength and nutritional status did not have a significant influence on postoperative complications and overall survival. Conclusion Sarcopenia did not occur frequently in this cohort with potentially curable esophageal cancer patients. Muscle function, skeletal muscle index and BMI did not statistically influence post-operative complications or survival. Disclosure All authors have declared no conflicts of interest.

Postoperative Complications Do Not Affect Long-Term Outcome in Esophageal Cancer Patients

2014 ◽  
Vol 38 (10) ◽  
pp. 2652-2661 ◽  
Author(s):  
Kirsten Lindner ◽  
Mathias Fritz ◽  
Christina Haane ◽  
Norbert Senninger ◽  
Daniel Palmes ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Term Outcome ◽  
Long Term Outcome

Clinical lymph node staging by imaging in colorectal cancer: A flip of the coin?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15160-e15160 ◽  
Author(s):  
Nelleke Pietronella Maria Brouwer ◽  
Rutger Carel Hubert Stijns ◽  
Lemmens Valery ◽  
Iris D. Nagtegaal ◽  
Regina GH Beets-Tan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Lymph Node Staging ◽  
Preoperative Treatment ◽  
Positive Lymph Nodes

e15160 Background: Clinical lymph node staging by MRI and CT is important in stratification for neoadjuvant therapy in colorectal cancer. Overstaging may result in unnecessary neoadjuvant therapy, but understaging may refrain patients from adequate preoperative treatment. This study aims to provide insight in current daily practice in clinical lymph node staging in CRC in the Netherlands. Methods: All patients with primary CRC, diagnosed between 2003-2014, who underwent lymph node dissection were selected from the nationwide population-based Netherlands Cancer Registry (n=100,211). Trends in patient- and tumor-characteristics, and lymph node staging were analyzed. For the years 2011-2014, sensitivity, specificity, positive (PPV) and negative predictive value (NPV) were calculated for clinical lymph node staging, with histology as the gold standard. Only patients without preoperative treatment were analyzed. Since prospective studies have shown that 5x5 Gy radiotherapy (RT) followed by total mesorectal excision within 10 days does not lead to nodal downstaging, an additional analysis was performed in this group. Results: The proportion clinically positive lymph nodes increased significantly between 2003-2014; from 7% to 22% for colon cancer and from 7% to 53% for rectal cancer. The proportion histological positive lymph nodes remained fairly stable over time (±35% colon, ±33% rectum). During 2011-2014, clinical lymph node staging was available in the registry in 86% of colon cancer patients, 92% of rectal cancer patients without neoadjuvant treatment and 95% of rectal cancer patients with 5x5 Gy RT. The parameters based on data from this period are presented in table 1. Conclusions: With a sensitivity and PPV of approximately 50%, clinical lymph node staging is about as accurate as flipping a coin. This leads to overtreatment in patients with rectal cancer with neoadjuvant RT. Acceptable specificity and NPV limit the risk of undertreatment. [Table: see text]

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