nach oben

International Journal of Clinical Oncology

Erschienen in:

30.06.2022 | Original Article

Preoperative nutrition and exercise intervention in frailty patients with gastric cancer undergoing gastrectomy

verfasst von: Yuma Wada, Masaaki Nishi, Kozo Yoshikawa, Chie Takasu, Takuya Tokunaga, Toshihiro Nakao, Hideya Kashihara, Toshiaki Yoshimoto, Mitsuo Shimada

Erschienen in: International Journal of Clinical Oncology | Ausgabe 9/2022

Einloggen, um Zugang zu erhalten

Abstract

Background

The frailty was associated with the worse surgical outcomes and poor prognosis in several cancers. Therefore, we aimed to identify the usefulness of nutrition and exercise intervention (NEI) in frailty patients with GC.

Methods

We analyzed 58 frailty patients with GC who underwent radical surgery. Among these, 15 patients were performed NEI by nutritional and rehabilitation support team. We compared the surgical outcomes between NEI and non-NEI groups with frailty patients and evaluated the nutrition and rehabilitation markers in pre- and post-NEI groups.

Results

The postoperative complication of NEI groups was 6.7% and less than that of non-NEI groups (p = 0.08). The mean postoperative hospital stay of NEI groups was 13.0 ± 1.0 days for NEI groups and significantly shorter than that of non-NEI groups (p = 0.03). The NLR was 4.3 ± 0.6 for pre-NEI and significantly improved by NEI between pre- and post-NEI (p = 0.03).

Conclusion

We identified the clinical importance of NEI for improving the surgical outcomes in frailty patients with GC. Our findings highlight the potential clinical impact of optimizing treatment strategies to select and manage the frailty patients.

Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3):209–249. https://doi.org/10.3322/caac.21660CrossRefPubMed

Sasako M, Sakuramoto S, Katai H et al (2011) Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol 29(33):4387–4393. https://doi.org/10.1200/jco.2011.36.5908CrossRefPubMed

Hogan DB, MacKnight C, Bergman H (2003) Models, definitions, and criteria of frailty. Aging Clin Exp Res 15(3 Suppl):1–29PubMed

Makary MA, Segev DL, Pronovost PJ et al (2010) Frailty as a predictor of surgical outcomes in older patients. J Am Coll Surg 210(6):901–908. https://doi.org/10.1016/j.jamcollsurg.2010.01.028CrossRefPubMed

Rockwood K, Song X, MacKnight C et al (2005) A global clinical measure of fitness and frailty in elderly people. CMAJ 173(5):489–495. https://doi.org/10.1503/cmaj.050051CrossRefPubMedPubMedCentral

Rolfson DB, Majumdar SR, Tsuyuki RT et al (2006) Validity and reliability of the Edmonton Frail Scale. Age Ageing 35(5):526–529. https://doi.org/10.1093/ageing/afl041CrossRefPubMedPubMedCentral

Clavien PA, Barkun J, de Oliveira ML et al (2009) The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196. https://doi.org/10.1097/SLA.0b013e3181b13ca2CrossRefPubMed

Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on sarcopenia in older people. Age Ageing 39(4):412–423. https://doi.org/10.1093/ageing/afq034CrossRefPubMedPubMedCentral

Nakao T, Shimada M, Yoshikawa K et al (2022) The correlation of immunoscore and frailty in colorectal cancer. Int J Clin Oncol 27(3):528–537. https://doi.org/10.1007/s10147-021-02096-3CrossRefPubMed

10.

Yamada S, Shimada M, Morine Y et al (2021) Significance of frailty in prognosis after hepatectomy for elderly patients with hepatocellular carcinoma. Ann Surg Oncol 28(1):439–446. https://doi.org/10.1245/s10434-020-08742-wCrossRefPubMed

11.

Yamada S, Shimada M, Morine Y et al (2021) Significance of frailty in prognosis after surgery in patients with pancreatic ductal adenocarcinoma. World J Surg Oncol 19(1):94. https://doi.org/10.1186/s12957-021-02205-6CrossRefPubMedPubMedCentral

12.

Yamamoto K, Nagatsuma Y, Fukuda Y et al (2017) Effectiveness of a preoperative exercise and nutritional support program for elderly sarcopenic patients with gastric cancer. Gastric Cancer 20(5):913–918. https://doi.org/10.1007/s10120-016-0683-4CrossRefPubMed

13.

Kimber DE, Kehler DS, Lytwyn J et al (2018) Pre-operative frailty status is associated with cardiac rehabilitation completion: a retrospective cohort study. J Clin Med. https://doi.org/10.3390/jcm7120560CrossRefPubMedPubMedCentral

14.

Bruixola G, Caballero J, Papaccio F et al (2018) Prognostic nutritional index as an independent prognostic factor in locoregionally advanced squamous cell head and neck cancer. ESMO Open 3(6):e000425. https://doi.org/10.1136/esmoopen-2018-000425CrossRefPubMedPubMedCentral

15.

Grenader T, Waddell T, Peckitt C et al (2016) Prognostic value of neutrophil-to-lymphocyte ratio in advanced oesophago-gastric cancer: exploratory analysis of the REAL-2 trial. Ann Oncol 27(4):687–692. https://doi.org/10.1093/annonc/mdw012CrossRefPubMed

16.

Okugawa Y, Toiyama Y, Yamamoto A et al (2020) Lymphocyte-C-reactive protein ratio as promising new marker for predicting surgical and oncological outcomes in colorectal cancer. Ann Surg 272(2):342–351. https://doi.org/10.1097/sla.0000000000003239CrossRefPubMed

17.

Ensrud KE, Ewing SK, Taylor BC et al (2008) Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Arch Intern Med 168(4):382–389. https://doi.org/10.1001/archinternmed.2007.113CrossRefPubMed

18.

Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56(3):M146-156. https://doi.org/10.1093/gerona/56.3.m146CrossRefPubMed

19.

Chow WB, Rosenthal RA, Merkow RP et al (2012) Optimal preoperative assessment of the geriatric surgical patient: a best practices guideline from the American College of Surgeons National Surgical Quality Improvement Program and the American Geriatrics Society. J Am Coll Surg 215(4):453–466. https://doi.org/10.1016/j.jamcollsurg.2012.06.017CrossRefPubMed

20.

Morley JE, Malmstrom TK, Miller DK (2012) A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging 16(7):601–608. https://doi.org/10.1007/s12603-012-0084-2CrossRefPubMedPubMedCentral

21.

Peterson MD, Sen A, Gordon PM (2011) Influence of resistance exercise on lean body mass in aging adults: a meta-analysis. Med Sci Sports Exerc 43(2):249–258. https://doi.org/10.1249/MSS.0b013e3181eb6265CrossRefPubMedPubMedCentral

22.

Morley JE, Argiles JM, Evans WJ et al (2010) Nutritional recommendations for the management of sarcopenia. J Am Med Dir Assoc 11(6):391–396. https://doi.org/10.1016/j.jamda.2010.04.014CrossRefPubMedPubMedCentral

23.

Ngo-Huang A, Holmes HM, des Bordes JKA et al (2019) Association between frailty syndrome and survival in patients with pancreatic adenocarcinoma. Cancer Med 8(6):2867–2876. https://doi.org/10.1002/cam4.2157CrossRefPubMedPubMedCentral

24.

Clough-Gorr KM, Thwin SS, Stuck AE et al (2012) Examining five- and ten-year survival in older women with breast cancer using cancer-specific geriatric assessment. Eur J Cancer 48(6):805–812. https://doi.org/10.1016/j.ejca.2011.06.016CrossRefPubMed

25.

Lu J, Cao LL, Zheng CH et al (2017) The preoperative frailty versus inflammation-based prognostic score: which is better as an objective predictor for gastric cancer patients 80 years and older? Ann Surg Oncol 24(3):754–762. https://doi.org/10.1245/s10434-016-5656-7CrossRefPubMed

26.

Yuan P, Wu Z, Li Z et al (2019) Impact of postoperative major complications on long-term survival after radical resection of gastric cancer. BMC Cancer 19(1):833. https://doi.org/10.1186/s12885-019-6024-3CrossRefPubMedPubMedCentral

27.

Minnella EM, Awasthi R, Loiselle SE et al (2018) Effect of exercise and nutrition prehabilitation on functional capacity in esophagogastric cancer surgery: a randomized clinical trial. JAMA Surg 153(12):1081–1089. https://doi.org/10.1001/jamasurg.2018.1645CrossRefPubMedPubMedCentral

28.

Cao Y, Han D, Zhou X et al (2022) Effects of preoperative nutrition on postoperative outcomes in esophageal cancer: a systematic review and meta-analysis. Dis Esophagus. https://doi.org/10.1093/dote/doab028CrossRefPubMed

29.

Furukawa K, Irino T, Makuuchi R et al (2019) Impact of preoperative wait time on survival in patients with clinical stage II/III gastric cancer. Gastric Cancer 22(4):864–872. https://doi.org/10.1007/s10120-018-00910-yCrossRefPubMed

30.

Stotz M, Gerger A, Eisner F et al (2013) Increased neutrophil-lymphocyte ratio is a poor prognostic factor in patients with primary operable and inoperable pancreatic cancer. Br J Cancer 109(2):416–421. https://doi.org/10.1038/bjc.2013.332CrossRefPubMedPubMedCentral

31.

Teramukai S, Kitano T, Kishida Y et al (2009) Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: an analysis of Japan Multinational Trial Organisation LC00-03. Eur J Cancer 45(11):1950–1958. https://doi.org/10.1016/j.ejca.2009.01.023CrossRefPubMed

32.

Li MX, Liu XM, Zhang XF et al (2014) Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: a systematic review and meta-analysis. Int J Cancer 134(10):2403–2413. https://doi.org/10.1002/ijc.28536CrossRefPubMed

33.

Lee S, Oh SY, Kim SH et al (2013) Prognostic significance of neutrophil lymphocyte ratio and platelet lymphocyte ratio in advanced gastric cancer patients treated with FOLFOX chemotherapy. BMC Cancer 13:350. https://doi.org/10.1186/1471-2407-13-350CrossRefPubMedPubMedCentral

34.

Cheng CB, Zhang QX, Zhuang LP et al (2020) Prognostic value of lymphocyte-to-C-reactive protein ratio in patients with gastric cancer after surgery: a multicentre study. Jpn J Clin Oncol 50(10):1141–1149. https://doi.org/10.1093/jjco/hyaa099CrossRefPubMed

35.

Okugawa Y, Toiyama Y, Yamamoto A et al (2020) Lymphocyte-to-C-reactive protein ratio and score are clinically feasible nutrition-inflammation markers of outcome in patients with gastric cancer. Clin Nutr 39(4):1209–1217. https://doi.org/10.1016/j.clnu.2019.05.009CrossRefPubMed

36.

Hirahara N, Tajima Y, Fujii Y et al (2018) Prognostic nutritional index as a predictor of survival in resectable gastric cancer patients with normal preoperative serum carcinoembryonic antigen levels: a propensity score matching analysis. BMC Cancer 18(1):285. https://doi.org/10.1186/s12885-018-4201-4CrossRefPubMedPubMedCentral

37.

Migita K, Takayama T, Saeki K et al (2013) The prognostic nutritional index predicts long-term outcomes of gastric cancer patients independent of tumor stage. Ann Surg Oncol 20(8):2647–2654. https://doi.org/10.1245/s10434-013-2926-5CrossRefPubMed

38.

Xishan Z, Ye Z, Feiyan M et al (2020) The role of prognostic nutritional index for clinical outcomes of gastric cancer after total gastrectomy. Sci Rep 10(1):17373. https://doi.org/10.1038/s41598-020-74525-8CrossRefPubMedPubMedCentral

39.

Yang J, Guo X, Wang M et al (2017) Pre-treatment inflammatory indexes as predictors of survival and cetuximab efficacy in metastatic colorectal cancer patients with wild-type RAS. Sci Rep 7(1):17166. https://doi.org/10.1038/s41598-017-17130-6CrossRefPubMedPubMedCentral

40.

Proctor MJ, Morrison DS, Talwar D et al (2011) A comparison of inflammation-based prognostic scores in patients with cancer. A glasgow inflammation outcome study. Eur J Cancer 47(17):2633–2641. https://doi.org/10.1016/j.ejca.2011.03.028CrossRefPubMed

41.

Li Y, Jia H, Yu W et al (2016) Nomograms for predicting prognostic value of inflammatory biomarkers in colorectal cancer patients after radical resection. Int J Cancer 139(1):220–231. https://doi.org/10.1002/ijc.30071CrossRefPubMed

Titel: Preoperative nutrition and exercise intervention in frailty patients with gastric cancer undergoing gastrectomy
verfasst von: Yuma Wada
Masaaki Nishi
Kozo Yoshikawa
Chie Takasu
Takuya Tokunaga
Toshihiro Nakao
Hideya Kashihara
Toshiaki Yoshimoto
Mitsuo Shimada
Publikationsdatum: 30.06.2022
Verlag: Springer Nature Singapore
Erschienen in: International Journal of Clinical Oncology / Ausgabe 9/2022
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-022-02202-z

Neu im Fachgebiet Onkologie

Hodgkin Lymphom: BrECADD-Regime übertrifft die Erwartungen

05.06.2024 ASCO 2024 Kongressbericht

Das Kombinationsregime BrECADD mit Brentuximab vedotin ermöglichte in der Studie HD21 beim fortgeschrittenen klassischen Hodgkin-Lymphom eine unerwartet hohe progressionsfreie Überlebensrate von 94,3% nach vier Jahren. Gleichzeitig war das Regime besser tolerabel als der bisherige Standard eBEACOPP.

Antikörper-Drug-Konjugat verdoppelt PFS bei Multiplem Myelom

05.06.2024 ASCO 2024 Nachrichten

Zwei Phase-3-Studien deuten auf erhebliche Vorteile des Antikörper-Wirkstoff-Konjugats Belantamab-Mafodotin bei vorbehandelten Personen mit Multiplem Myelom: Im Vergleich mit einer Standard-Tripeltherapie wurde das progressionsfreie Überleben teilweise mehr als verdoppelt.

Neuer TKI gegen CML: Höhere Wirksamkeit, seltener Nebenwirkungen

05.06.2024 Chronische myeloische Leukämie Nachrichten

Der Tyrosinkinasehemmer (TKI) Asciminib ist älteren Vertretern dieser Gruppe bei CML offenbar überlegen: Personen mit frisch diagnostizierter CML entwickelten damit in einer Phase-3-Studie häufiger eine gut molekulare Response, aber seltener ernste Nebenwirkungen.

Brustkrebs-Prävention wird neu gedacht

04.06.2024 ASCO 2024 Kongressbericht

Zurzeit untersuchen Forschende verschiedene neue Ansätze zur Prävention von Brustkrebs bei Personen mit hohem Risiko. Darunter Denosumab, die prophylaktische Bestrahlung der Brust – und Impfungen.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Background

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 9/2022

Survival benefit of using pemetrexed for EGFR mutation-positive advanced non-small-cell lung cancer in a randomized phase III study comparing gefitinib to cisplatin plus docetaxel (WJTOG3405)

Indocyanine green-guided sentinel lymph node mapping during laparoscopic surgery with vaginal cuff closure but no uterine manipulator for cervical cancer

Incidence, trend and risk factors associated with suicide among patients with malignant intracranial tumors: a surveillance, epidemiology, and end results analysis

Development of a national health policy logic model to accelerate the integration of oncology and palliative care: a nationwide Delphi survey in Japan