Feasibility study of preoperative chemotherapy for patients with advanced esophageal cancer with or without naso-gastric ED tube for enteral feeding.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 184-184
Author(s):  
Takashi Ogata ◽  
Hiroaki Osakabe ◽  
Shinsuke Nagasawa ◽  
Masato Nakazono ◽  
Kentaro Hara ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Preoperative Chemotherapy ◽  
Oral Intake ◽  
Hematologic Toxicity ◽  
Advanced Esophageal Cancer ◽  
Group A ◽  
Grade 3 ◽  
Group B

184 Background: Advanced esophageal cancer patients sometimes have a difficulty to swallow food. On the other hand, standard treatment for resectable advanced esophageal cancer patients is surgery after 2 course preoperative chemotherapy of CDDP-5-FU (JCOG 9907). So we usually use naso-gastric ED tube for patients with difficulty of oral intake during preoperative chemotherapy to administrate adequate nutrition. But there is no report of the safety of this trial. Methods: The aim of this study is to clarify the safety of using ED tube during preoperative chemotherapy and compare the nutritional status between using ED tube or not. From Jan 2012 to June 2017, 122 patients were undergone esophagectomy with 2 course of preoperative chemotherapy, and 14 patients were treated with ED tube for nutrition(Group A) and 108 patients without ED tube(Group B). We evaluated the changes of nutritional status and postoperative complication as an indicator of safety. Results: Changes before and after preoperative chemotherapy(GroupA/B): average of body weight: 53.1→50.8/58.1→57.0, BMI: 20.0→19.2/22.0→21.6, TP: 6.7→6.9/7.3→6.9, alb: 3.5→3.8/4.3→4.2, pre-alb: 20.1→21.7/24.8→23.4, RBP: 2.77→3.33/3.15→3.23. Adverse events during chemotherapy: 1 case of Grade 3 hematologic toxicity and 1 case of Grade 2 non-hematologic toxicity were found at Group A(14.2%), and 11 cases of Grade 3 hematologic toxicity and 8 cases of Grade 2 non-hematologic toxicity were found at Group B(17.61%)(p = 0.758). Postoperative complications (clavien-dindo classification, Grade3 or more): 2 cases were observed at Group A(14.2%), and 21 cases were observed at Group B(19.4%)(p = 0.62). Conclusions: Preoperative chemotherapy with ED tube for nutrition was safe and effective to maintain the preoperative nutritional status.

Exclusive chemoradiation with carboplatin-paclitaxel versus FOLFOX-4 in locally advanced esophageal cancer: A matched-pair analysis.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 145-145
Author(s):  
Joelle Miny ◽  
Aurelie Bertaut ◽  
Jean Francois Bosset ◽  
Jihane Boustani ◽  
Magali Rouffiac ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Locally Advanced ◽  
Stage Iv ◽  
Matched Pair ◽  
Advanced Esophageal Cancer ◽  
Paired Data ◽  
Group A ◽  
The Cross ◽  
Group B ◽  
Locally Advanced Esophageal Cancer

145 Background: The PRODIGE 5 trial has demonstrated the safety and the efficacy of FOLFOX-4 combined with exclusive 50Gy external RT while the CROSS trial showed an improvement in overall survival with Carboplatin-Taxol (C-TAX) when combined with 41.4Gy before surgery. We sought to determine the feasibility and efficacy of exclusive RT with C-TAX compared to FOLFOX-4 regimen. Methods: 46 patients with locally advanced esophageal cancer who were treated with exclusive chemoradiation were matched 1:1 : 23 patients were treated with FOLFOX-4 regimen (group A) and 23 patients with C-TAX (group B). Comparison between the 2 groups was performed using Mac Nemar test for paired data. All tests were two sided and Pvalues were considered significant when less than 0.05. Results: The mean age in group A was 69.4 years (12.5) and 72.4 years (12.6) in group B (p = ns). In each group, 11 patients had a stage III disease at diagnosis (47.8%) with only 2 stage IV in group A (8.7%) vs none in group B. The median delivered RT doses were 50Gy [14-60] in group A while it was 50Gy [20-70] in group B. 6 courses of chemotherapy were delivered in 12 patients in group A (52.2%) and 14 patients in group B (60.9%) (p = 0.51). After chemoradiation, G1 or higher esophagitis was observed in 5 patients (26.3%) in group A and 3 patients (13.0%) in group B of whom 0 vs 2 G3 were observed in group A and B, respectively. Four patients (21.1%) had a pulmonary infection in group A and 3 in group B (13.0%). Two patients (8.7%) vs 4 patients (17.4%) had G3 neutropenia, with only 0 and 2 neutropenic fever in group A and B, respectively. Neither G3 anemia, nor G3 thrombopenia occured. After a median follow-up of 17.7 months [0.0-46.9], 25 patients had died, 14 in group A (60.9%) and 11 in group B (47.8%). The median PFS rates were 14.0 months in group A [7.7-NR] vs 12.1 months [4.4-NR] in group B (p = 0.32). The median OS rates were 20.3 months in group A [6.2-39.3] vs 17.0 months [4.8-NR] in group B (p = 0.82). Conclusions: Exclusive chemoradiation with C-TAX seems feasible with similar toxicity and survival outcomes than FOLFOX-4. The safety and efficacy of the CROSS regimen needs to be tested prospectively with RT doses > 41.4Gy in a phase II or III trial.

Prophylactic fluconazole treatment of mucositis in radiotherapy of head and neck cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6062-6062
Author(s):  
C. Demiroz ◽  
L. Ozkan ◽  
O. Karadag
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Late Toxicity ◽  
Group A ◽  
Fluconazole Prophylaxis ◽  
Grade 3 ◽  
Group B

6062 Background: The aim of the study is to evaluate the preventive role of antifungal fluconazole prophylaxis on mucositis in head and neck cancer patients treated with radiotherapy. Methods: We evaluated 43 head and neck cancer patients treated with radiotherapy with/without chemotherapy. The patients were randomized to two groups: twenty patients (group A) received fluconazole when micotic infections appeared; 23 patients (group B) received fluconazole 200 mg once a week starting from the sixth irradiation session throughout the treatment.The two groups were similar in terms of patients and radiotherapy characteristics. Oral mucositis was recorded according to EORTC/RTOG criteria. Results: The usage of fluconazole 200 mg once a week was well tolerated and no early and late toxicity was observed. Mucositis was appeared in both groups on the third week of radiotherapy. Grade 3 mucositis developed at eight of the patients in group A (40%), three of the patients in group B (13%) and the result was statistically significant (p = 0.044). While grade 3 mucositis was observed the second/third week in group A, it was also observed in group B on third/fourth week in group B (p = 0.043). Conclusions: Weekly fluconazole prophylaxis showed a significant effect on the grade 3 mucositis and improved radiotherapy results. No significant financial relationships to disclose.

Correlation of heart dose with lymphopenia in esophageal cancer patients treated with chemoradiation.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 346-346
Author(s):  
Amber Post ◽  
Stephen R. Bowen ◽  
Bao-Ngoc Nguyen ◽  
William Logan ◽  
Jing Zeng ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Blood Pool ◽  
Hematologic Toxicity ◽  
Characteristic Analysis ◽  
Heart Dose ◽  
Dose Volume ◽  
Vertebral Bodies ◽  
Grade 3 ◽  
The Cost

346 Background: Lymphopenia has been associated with survival and disease progression in esophageal cancer patients treated with chemoradiation (cRT). We previously published on our posterior-only proton therapy approach that maximally spares the heart and lungs, but at the cost of increased dose to the bone marrow in the vertebral bodies (VBs). We assessed hematologic toxicity in proton (PT) and IMRT treated patients and studied dosimetric parameters associated with hematologic toxicity. Methods: 35 patients treated with PT and 46 patients treated with IMRT for esophageal cancer between 2011-2018 were analyzed. Most patients were treated concurrently with carboplatin/paclitaxel to a median dose of 50.4 Gy. Lymphocyte, neutrophil and total leukocyte values while under treatment were recorded and graded per the CTCAE v4.03 toxicity scale, and the neutrophil-to-lymphocyte ratio (NLR) was computed. Mean dose and volumes (cc) receiving 5-50 Gy were calculated for the heart and VBs. A receiver-operator characteristic analysis was performed for univariate correlation between incidence of grade ≥3 hematotoxicity and dose-volume parameters. Results: Median follow-up was 36.1 months for all patients and the overall survival at 3 years was 57.5%. The rates of grade 3 or 4 hematologic toxicity in the PT group were 37.1% (leukopenia), 22.9% (neutropenia), and 80.0% (lymphopenia) versus 41.3%, 15.2% and 87.2%, respectively, for IMRT patients. There was a significant correlation between grade 4 lymphopenia and the heart V5, V10 and V20, but no significant correlation between VB doses with any hematotoxicity. Median NLR values and heart dose were higher in the IMRT group (9.17 vs 3.86 with PT, p = 0.0048; 10.5 vs 23.5Gy, p< 0.0001, respectively). There was a correlation between survival and NLR with a hazard ratio of 1.025 (CI 1.006 - 1.044). Conclusions: Low doses to the heart mediate severe lymphopenia in esophageal cancer patients treated with cRT. These data confirm the safety of the posterior-only proton approach without concern for increased hematologic toxicity despite higher vertebral body doses compared to IMRT. They also suggest that the blood pool is more important as a source of severe lymphopenia.

PS02.072: ESTIMATION OF DOWN STAGING AFTER CHEMORADIOTHERAPY FOR T4 ESOPHAGEAL CANCER BY QUALITATIVE RESPONSE EVALUATION USING RENDERED MD-CT AND THE OUTCOME OF CURATIVE RESECTION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 140-141
Author(s):  
Shinichi Okazumi ◽  
Hideaki Shimada ◽  
Hisahiro Matsubara
Keyword(s):  
Esophageal Cancer ◽  
Curative Resection ◽  
Pathological Examination ◽  
Cancer Tissue ◽  
Slice Thickness ◽  
Histological Response ◽  
Advanced Esophageal Cancer ◽  
Diagnostic Image ◽  
Group A ◽  
Group B

Abstract Background A new qualitative diagnostic image which represented the histological responses was developed using 3D-volume rendered MD-CT, and which was applied for the estimation of down staging after chemoradiotherapy (CRT) followed curative resection for T4 advanced esophageal cancer. Methods 95 cases of T4 advanced esophageal cancer which underwent CRT were enrolled CRT protocol: 40–60Gy dose of irradiation were done and concurrently CDDP 15(mg/mm2) and 5-FU 500(mg/mm2) were administered in day 1–5 i.v.. Down staging estimation by MD-CT rendering: Contrast media (300mg iodine/ml, 3ml/kg) was administrated intravenously (3ml/sec). CT (GE: Light Speed 16) scans were performed (slice thickness: 1.3 mm) at 50 seconds delay before and after CRT. A workstation Virtual Place(AZE) was used for rendering the diagnostic image which represented histological response with specially selected colors and opacities. Down staging was diagnosed by the fibrotic change(CT value < 50HU) of the cancer tissue in the border area to the adjacent organs. The first estimation were done at 40Gy and the down staging cases were examined for resection and no down staging cases were continued to 60Gy. Results Down staging ratio were 48% in T4 aorta, 17% in trachea,35.7% in bronchus, and 44.4% in pulmonary vein. In the irradiation dose of 41.3 ± 2.5Gy, 24cases (25.3%) (Group A) and in 61.8 ± 3.15Gy,12 cases (12.6%) obtained down staging. 30 days after CRT, 13 cases of Group A and 10 of Group B underwent curative esophagectomy. In the pathological examination, response rate were 60.8% in group A and 80% in group B. The outcome after resection was 40% in the five year survival (n = 23). Conclusion The qualitative diagnostic image rendered by 3D-enhanced MD-CT was useful for the down staging evaluation after CRT to estimate curability of followed resection for T4 advanced esophageal cancer. Early estimation of the down staging at the dose of 40Gy seemed to be necessary to plan the followed resection safely and survival benefit were obtained in the curatively resected case with histological response. Disclosure All authors have declared no conflicts of interest.

scholarly journals Supplemental enteral tube feeding nutrition after hospital discharge of esophageal cancer patients who have undergone esophagectomy

Esophagus ◽  
2021 ◽  
Author(s):  
Masahiro Niihara ◽  
Yasuhiro Tsubosa ◽  
Aiko Yamashita ◽  
Keita Mori ◽  
Hiromi Tsumaki ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Hospital Discharge ◽  
Tube Feeding ◽  
Oral Intake ◽  
Nutritional Intervention ◽  
Nutrition Intervention ◽  
Enteral Tube Feeding ◽  
Grade 3 ◽  
Intervention Procedure

Abstract Background After undergoing esophagectomy to treat esophageal cancer, there are changes in the normal intake patterns in most patients, with more than half found to have an inadequate oral intake at the time of their hospital discharge. However, the use of home supplemental enteral tube feeding nutrition after hospital discharge in esophagectomy patients has yet to be established. The aim of this study was to evaluate the feasibility of 90-day home supplemental enteral tube feeding nutrition in esophagectomy patients. Methods This single-center, prospective, and single-arm study evaluated the feasibility of using supplemental tube feeding nutrition intervention for 90 days in esophageal cancer patients who have undergone esophagectomy. Results This study enrolled 24 post-esophagectomy patients between February 2015 and September 2016. Twenty patients were administered 70% or more of the planned nutrient, with 83% of the patients completing the nutritional intervention procedure. There were no grade 3/4 adverse events observed, with a mean body weight change of − 7.6 ± 6.0%. Conclusions Our results showed that routine use of 90-day home supplemental enteral tube feeding nutrition after hospital discharge for esophagectomy patients was both feasible and acceptable. Trial registration UMIN000016286.

PS02.114: CLINICAL SIGNIFICANCE OF PREOPERATIVE CHEMORADIOTHERAPY FOR RESECTABLE ESOPHAGEAL CANCER PATIENTS USING PROPENSITY SCORE

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 153-153
Author(s):  
Yoshinori Fujiwara ◽  
Hisako Kubota ◽  
Masaharu Higashida ◽  
Yusaku Watanabe ◽  
Toshimasa Okada ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Factors ◽  
Propensity Score ◽  
Cancer Patients ◽  
Preoperative Chemoradiotherapy ◽  
Resectable Esophageal ◽  
Resectable Esophageal Cancer ◽  
Group A ◽  
Group B ◽  
Cox Analysis

Abstract Background Preoperative chemoradiotherapy(CRT) for advanced resectable esophageal cancer patients is controversial in Japan, and it is different from other countries. We examine the clinical significance of it using propensity score(PS). Methods 142 patients in resectable cStageII/III/IV(TNM 6th edition) esophageal cancer patients were studied. There were 55 preoperative CRT cases (Group A), 87 patients with surgery alone(Group B). The survival was analyzed between the two groups. PS was calculated by Logistic analysis and the background factor was adjusted by the PS matching and IPTW(Inverse probability of treatment weighting) method for the preoperative CRT (Group A) vs surgery alone group (GroupB), Cox model was used to analyzed the prognostic factors. Results 1, Unmatched situation: In OS(Overall survival), no difference was found between the two groups. In DFS(Disease free survival), the prognosis of group A was better than that of group B (5 years DFS: 52.2% vs 34.55%, P < 0.05). 2, After PS matching: OS, GroupA was tended to be better(P = 0.097). DFS: the prognosis of the Group A was better (5 years DFS: 57.2 vs 28.1%, P < 0.01). With Cox analysis, the presence or absence of preoperative CRT was a significant prognostic factor. 3, After IPTW: Prognosis of group A in both OS and DFS was better (5 years OS: 77.25 vs 41.13%, P < 0.05, 5 years DFS: 76.7 vs 32.14%, P < 0.01). In Cox analysis, preoperative CRT and TNM stages were independent prognostic factors. Conclusion 1, Preoperative CRT for resectable advanced esophageal cancer is a recommended treatment by analyzing the PS. 2, IPTW and PS matching are different methods for evaluating PS, and since there is a possibility that different results may be occurred when evaluated between two groups by PS, the evaluation of it should be done more carefully. Disclosure All authors have declared no conflicts of interest.

Perioperative management of esophageal cancer surgery based on a modified ERAS protocol.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 99-99
Author(s):  
Takashi Ogata ◽  
Yousuke Makuuchi ◽  
Kenki Segami ◽  
Taiichi Kawabe ◽  
Shigeya Hayashi ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Enteral Feeding ◽  
Perioperative Management ◽  
Oral Intake ◽  
Length Of Hospital Stay ◽  
Hospital Death ◽  
Group A ◽  
Group B ◽  
Eras Protocol ◽  
Start Dates

99 Background: We have performed perioperative management using modified ERAS protocol after esophageal cancer surgery. Our protocol includes plaque control in collaboration with dental clinic, breathing training, nutrition support for low-nutrition, preoperative oral rehydration, pain control, early mobilization, early enteral nutrition and intestinal peristalsis monitoring by abdominal Xp with contrast agents after surgery, and so on. Methods: The aim of the study is to clarify the safety of our modified ERAS protocol as perioperative management of esohphageal surgery. 136 cases of thoracic esophageal cancer patients were performed with 3 field lymph node dissection between January 2011 and July 2014 using modified ERAS protocol(group A). 29 cases were performed classical postoperative management between September 2008 and November 2009(group B). We compared ventilator weaning dates, start dates of postoperative ambulation, start dates of enteral feeding, start dates of oral intake, length of hospital stay, the number of hospital death between group A and group B. Results: In group A, except two cases was extubated in POD1, start dates of postoperative ambulation was POD1(median), start dates of enteral feeding was POD1(median), start dates of oral intake was POD6(median), length of hospital stay was 15days(median), and the number of hospital death was 1case. On the other hand, in group B, dates of extubation was POD4(median), start dates of postoperative ambulation was POD2(median), enteral feeding was not sued for postoperative management, start dates of oral intake was POD15(median), length of hospital stay was 29days(median), and the number of hospital death was 2case. After introduction of this protocol, all these values were significantly reduced in group A rather than in group B. Walking distance were 130m(POD1), 322m(POD2), 509m(POD3), completion rate of enteral feeding was 90%, and the safety of enteral nutrition was also confirmed by peristalsis monitor using abdominal Xp with contrast agents or defecation state. Conclusions: It was considered that perioperative management of esophageal cancer surgery based on modified ERAS protocol is contribute to the early recover of postoperative status.

scholarly journals Prospective study of hair recovery after (neo)adjuvant chemotherapy with scalp cooling in Japanese breast cancer patients

2021 ◽  
Author(s):  
Shozo Ohsumi ◽  
Sachiko Kiyoto ◽  
Mina Takahashi ◽  
Seiki Takashima ◽  
Kenjiro Aogi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Prospective Study ◽  
Cancer Patients ◽  
Scalp Cooling ◽  
Breast Cancer Patients ◽  
Chemotherapy Infusion ◽  
Group A ◽  
Neo Adjuvant Chemotherapy ◽  
Group B

Abstract Purpose Scalp cooling during chemotherapy infusion to mitigate alopecia for breast cancer patients is becoming widespread; however, studies regarding hair recovery after chemotherapy with scalp cooling are limited. We conducted a prospective study of hair recovery after chemotherapy with scalp cooling. Patients and methods One hundred and seventeen Japanese female breast cancer patients who completed planned (neo)adjuvant chemotherapy using the Paxman Scalp Cooling System for alopecia prevention were evaluated for alopecia prevention in our prospective study. We evaluated their hair recovery 1, 4, 7, 10, and 13 months after chemotherapy. Primary outcomes were grades of alopecia judged by two investigators (objective grades) and patients’ answers to the questionnaire regarding the use of a wig or hat (subjective grades). Results Of 117 patients, 75 completed scalp cooling during the planned chemotherapy cycles (Group A), but 42 discontinued it mostly after the first cycle (Group B). Objective and subjective grades were significantly better in Group A than in Group B throughout 1 year, and at 4 and 7 months after chemotherapy. When we restricted patients to those with objective Grade 3 (hair loss of > 50%) at 1 month, Group A exhibited slightly faster hair recovery based on the objective grades than Group B. There was less persistent alopecia in Group A than in Group B. Conclusions Scalp cooling during chemotherapy infusion for Japanese breast cancer patients increased the rate of hair recovery and had preventive effects against persistent alopecia.

scholarly journals 439 Conservative Versus Surgical Management of Complicated Diverticulitis - A Retrospective Study of Long-Term Outcomes

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Durity ◽  
G Elliott ◽  
T Gana
Keyword(s):  
Complicated Diverticulitis ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Female Ratio ◽  
Stoma Reversal ◽  
Group A ◽  
Grade 3 ◽  
Group B

Abstract Introduction Management of complicated diverticulitis has shifted towards a conservative approach over time. This study evaluates the feasibility and long-term outcomes of conservative management. Method We retrospectively evaluated a consecutive series of patients managed with perforated colonic diverticulitis from 2013-2017. Results Seventy-three (73) patients were included with a male to female ratio of 1:2. Thirty-one (31) underwent Hartmann’s procedure (Group A) and 42 patients were managed with antibiotics +/- radiological drainage (Group B). Mean follow-up was 64.9 months (range 3-7 years). CT Grade 3 and 4 disease was observed in 64.5% and 40.4% of Group A and Group B patients, respectively. During follow-up, 9 (21.4%) Group B patients required Hartmann’s. Group A had longer median length of stay compared to Group B (25.1 vs 9.2 days). Post-operative complications occurred in 80.6% with 40% being Clavien-Dindo grade III or higher in group A. Stoma reversal was performed in 8 patients (25.8%). Conclusions In carefully selected cases, complicated diverticulitis including CT grade 3 and 4 disease, can be managed conservatively with acceptable recurrence rates (16.7% at 30 days, 4.8% at 90 days, 19.0% at 5 years). Surgical intervention on the other hand, carries high post-operative complication rates and low stoma reversal rates.

Changes in the palliative performance scale may be as important as the initial palliative performance scale for predicting survival in terminal cancer patients

2021 ◽  
pp. 1-5
Author(s):  
Guk Jin Lee ◽  
Ji Hyun Gwak ◽  
Myoung Sim Kim ◽  
Mi Yeong Lee ◽  
Seo Ree Kim ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Gastrointestinal Cancer ◽  
Poor Prognosis ◽  
Accurate Estimation ◽  
Terminal Cancer ◽  
Hospice Patients ◽  
Terminal Cancer Patients ◽  
Group A ◽  
Group B ◽  
Performance Scale

Abstract Objective The accurate estimation of expected survival in terminal cancer patients is important. The palliative performance scale (PPS) is an important factor in predicting survival of hospice patients. The purpose of this study was to examine how initial status of PPS and changes in PPS affect the survival of hospice patients in Korea. Method We retrospectively examined 315 patients who were admitted to our hospice unit between January 2017 and December 2018. The patients were divided based on the PPS of ≥50% (group A) and ≤40% (group B). We performed survival analysis for factors associated with the length of survival (LOS) in group A. Based on the hospice team's weekly evaluation of PPS, we examined the effect of initial levels and changes in group A on the prognosis of patients who survived for 2 weeks or more. Results At the time of admission to hospice, 265 (84.1%) patients were PPS ≥50%, and 50 (15.9%) were PPS ≤40%. The median LOS of PPS ≥50% and PPS ≤40% were 15 (2–158 days) and 9 (2–43 days), respectively. Male, gastrointestinal cancer, and lower initial PPS all predicted poor prognosis in group A. Male, gastrointestinal cancer, and a PPS change of 10% or greater, compared with initial status 1 week and 2 weeks of hospitalization, were all predictors of poor prognosis in group A patients who survived for 2 weeks or longer. Significance of results Our research demonstrates the significance of PPS change at 1 week and 2 weeks, suggesting the importance of evaluating not only initial PPS but also change in PPS.

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