Abstract 2637: Impact of pre-diagnosis weight loss on outcomes in a prospective cohort of esophageal cancer patients

Author(s):  
Sherry Shen ◽  
James L. Araujo ◽  
Nasser K. Altorki ◽  
Joshua R. Sonett ◽  
Adriana Rodriguez ◽  
...  
2017 ◽  
Vol 30 (9) ◽  
pp. 1-7 ◽  
Author(s):  
S. Shen ◽  
J. L. Araujo ◽  
N. K. Altorki ◽  
J. R. Sonett ◽  
A. Rodriguez ◽  
...  

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 133-133 ◽  
Author(s):  
Sabrina D Saeed ◽  
Jacques Fontaine ◽  
Luis Pena ◽  
Sarah E. Hoffe ◽  
Jessica Frakes ◽  
...  

133 Background: Malnutrition, linked to decreased patient tolerance to chemotherapy and increased rates of therapy-related toxicity, negatively affects cancer prognosis. Esophageal carcinomas (EC) frequently present with dysphagia and significant weight loss which may be exacerbated by neoadjuvant chemoradiation, placing EC patients at an increased risk of malnutrition. We therefore aim to assess the prognostic value of pre-operative malnutrition for esophageal cancer patients undergoing neoadjuvant therapy (NAT). Methods: Query of our institution’s IRB approved database of 1113 EC patients (pts) identified 725 individuals who underwent NAT followed by resection from 1994-2018. Seventy-six pts were considered to be at higher nutritional risk during NAT, as indicated by significant weight loss and enteral feeding tube requirement (ETF+), while 644 did not receive pre-operative feeding tube placement (ETF–). Clinicopathologic characteristics, post-operative outcomes, and survival were compared between ETF+ and ETF– using various statistical methods. Results: Of the included pts, 83% were male with a median age of 64.5 (28-86) years. Between ETF+ (n = 76) and ETF– (n = 644), pt characteristics were balanced in terms of initial stage, age, histology and tumor location. A higher percentage of ETF+ pts had > 5% weight loss before NAT (32 vs. 6%; p < .01). ETF+ was associated with a significantly worse median survival (27 vs. 77 m; p < .01), but not with increased post-operative length of hospital stay (p = .69), complications (p = .20) or tumor recurrence (p = .89). Although completion of chemotherapy (p = .46) and radiation (p = .49) were comparable between ETF+ and ETF–, tumor response was worse in the ETF+ group (71 vs. 60% non-complete response; p = .02). Conclusions: Our results suggest that baseline malnutrition is a risk factor for poor survival and negatively impacts the efficacy of neoadjuvant therapy in EC patients. Poor response to NAT in malnourished patients may stem from impaired immune function. Future prospective studies should evaluate other parameters for nutritional assessment to further assess the impact of malnutrition on tumor regression and survival after NAT.


2014 ◽  
Vol 146 (5) ◽  
pp. S-1086
Author(s):  
Masaki Nakamura ◽  
Mikihito Nakamori ◽  
Toshiyasu Ojima ◽  
Masahiro Katsuda ◽  
Takeshi Iida ◽  
...  

2016 ◽  
Vol 9 (6) ◽  
pp. 806-814 ◽  
Author(s):  
James L. Araujo ◽  
Nasser K. Altorki ◽  
Joshua R. Sonett ◽  
Adriana Rodriguez ◽  
Kivilcim Sungur-Stasik ◽  
...  

2020 ◽  
Vol 5 (2) ◽  
pp. 137-146
Author(s):  
Jia Hua Lyu ◽  
Tao Li ◽  
Yong Tao Han ◽  
Lei Wu ◽  
Lin Peng ◽  
...  

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 289
Author(s):  
Binh Pham Van ◽  
Hoa Nguyen Thi Thanh ◽  
Huong Le Thi ◽  
Anh Nguyen Le Tuan ◽  
Hang Dang Thi Thu ◽  
...  

Background: Esophagus cancer patients are at high risk of malnutrition. This study was performed to assess the nutritional status and dietary intake of newly diagnosed esophageal cancer patients in Vietnam National Cancer Hospital (NCH). Methods: A cross-sectional study was conducted on 206 early esophageal cancer inpatients after gastrostomy from September 2017 to June 2018. The chi-squared test, Fisher exact test, and Mann–Whitney test were performed. The software of the Vietnam National Institute of Nutrition was used to evaluate the dietary intake of patients. Results: All the participants were male with a mean age of 57.1 ± 8.5 years. Overall, 87.4% of patients had dysphagia. Furthermore, 82.5% and 90.8% of patients reported weight loss one and six months pre-diagnosis, respectively. Moreover, 52.9% of patients suffered from mild/moderate malnutrition and 29.6% of patients had severe malnutrition according to the Patient-Generated Subjective Global Assessment (PG-SGA). The body mass index (BMI) and mid upper arm circumference (MUAC) measurement revealed 47.6% and 50% of undernourished patients, respectively. The proportions of patients having malnutrition were 10.7%, 55.8%, and 27.2% according to albumin, prealbumin, and total lymphocyte counts, respectively. The means of energy, protein, lipid, and carbohydrate in the patients’ 24 h preoperative diets were 973.6 ± 443.0 kcal/day, 42.4 ± 21.6 g/day, 31.0 ± 15.5 g/day, and 130.0 ± 64.5 g/day. The total energy, total protein, animal protein, total lipid, and plant lipid in the dietary intake of patients were strongly correlated with age, economic classification, and PG-SGA (each p < 0.05). The total energy intake increased day by day, with the average energy intake of 1343.9 ± 521.3 kcal on the seventh day. Energy and protein response rates increased day by day and were highest at 7 days post-operation at 18.0% and 19.4%. Conclusion: Malnutrition and insufficient intake are noteworthy in esophageal cancer patients. The PG-SGA is strongly correlated with the dietary intake of patients. The results from this study will help medical staff to prevent malnutrition and improve the nutritional status of esophageal cancer inpatients. Furthermore, public awareness should be raised on recognizing weight loss as an early symptom of esophageal cancer and the utilization of preoperative assessment tools for nutritional assessment and malnutrition management.


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