Postoperative complication rate and survival of patients with gastric cancer undergoing immunonutrition: A retrospective study

被引:14
作者
Claudino, Mariana Moreira [1 ]
Lopes, Jessica Rodrigues [1 ]
Rodrigues, Viviane Dias [1 ,2 ]
de Pinho, Nivaldo Barroso [1 ,2 ]
Martucci, Renata Brum [1 ,2 ,3 ]
机构
[1] Natl Canc Inst Jose Alencar Gomes da Silva INCA, Rio De Janeiro, Brazil
[2] Brazilian Soc Oncol Nutr, Rio De Janeiro, Brazil
[3] Univ Estado Rio De Janeiro, Nutr Inst, Rio De Janeiro, Brazil
关键词
Nutritional therapy; Immunomodulation; Gastric neoplasms; Postoperative complications; Survival analysis; ENTERAL IMMUNONUTRITION; PERIOPERATIVE IMMUNONUTRITION; GASTROINTESTINAL SURGERY; SURGICAL-PATIENTS; NUTRITION; GUIDELINES; GASTRECTOMY; MORBIDITY; THERAPY; TRIAL;
D O I
10.1016/j.nut.2019.110590
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Objectives: This study aimed to evaluate the effect of preoperative immunonutrition on the rate of postoperative complication and survival of patients with gastric cancer. Methods: A retrospective cohort was formed after data collection of patients hospitalized with gastric cancer. Postoperative complications classified according to the Clavien-Dindo classification system, length of hospital stay, readmissions, and rates of survival at 6 mo, 1 y, and 5 y were analyzed. A chi(2) or Fisher's exact test, Student or Mann-Whitney t test, and Kaplan-Meier and Cox regressions were used in the statistical analysis. Results: A total of 164 patients were included in the study, with 56 patients assigned to the immunonutrition group and 108 to the conventional group. There were no significant differences in postoperative complications between the immunonutrition and conventional groups (51.8% versus 58.3%; P = 0.423). The most frequent complications were fistula and surgical wound infection. Length of hospital stay did not differ between the groups (median of 7.0 d: P = 0.615) and the presence of readmissions did not differ either (12.5% versus 15.7%; P = 0.648). In the multivariate Cox regression, in a pooled model for group, age, sex, body mass index, Charlson comorbidity index, staging, neoadjuvant chemotherapy, and type of surgery, there was a significant difference in survival rates at 6 mo (P = 0.011), 1 y (P = 0.006), and 5 y (P < 0.001). Conclusions: Preoperative immunonutrition in patients with gastric cancer did not reduce postoperative complications or length of hospital stay. More studies are needed to confirm the benefit of immunonutriton supplementation for overall survival when associated with other protective factors. (C) 2019 Elsevier Inc. All rights reserved.
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页数:7
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