Prognostic Nutritional Index Predicts Morbidity After Curative Surgery for Colorectal Cancer

Colorectal cancer (CRC) is a major health concern and it is associated with significant morbidity and mortality. Over the last decades, the relationship between cancer and nutritional and inflammatory status in oncologic patients was studied thoroughly and multiple immunonutritional scores were deve...

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Published in:Cirugia española (English ed.) 2019-02, Vol.97 (2), p.71-80
Main Authors: Bailón-Cuadrado, Martín, Pérez-Saborido, Baltasar, Sánchez-González, Javier, Rodríguez-López, Mario, Velasco-López, Rosalía, Sarmentero-Prieto, José C., Blanco-Álvarez, José I., Pacheco-Sánchez, David
Format: Article
Language:English
Subjects:
Aged
Colorectal cancer
Colorectal Neoplasms - complications
Colorectal Neoplasms - surgery
Complicaciones postoperatorias
Cáncer colorrectal
Estado inflamatorio
Estado nutricional
Female
Humans
Inflammation - complications
Inflammatory status
Male
Morbidity
Nutrition Assessment
Nutritional status
Postoperative complications
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Prognosis
Prognostic Nutritional Index
Prospective Studies
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Summary:Colorectal cancer (CRC) is a major health concern and it is associated with significant morbidity and mortality. Over the last decades, the relationship between cancer and nutritional and inflammatory status in oncologic patients was studied thoroughly and multiple immunonutritional scores were developed. These scores have been mainly related to the prognosis of several cancers. An interaction between the tumour and the host is generated, triggering a systemic inflammatory reaction leading to several neuroendocrine changes. This situation favours a tendency towards anorexia and catabolism. Our hypothesis is that nutritional and inflammatory status of oncologic patients is correlated to postoperative morbidity. This is a prospective observational cohort study with those patients undergoing curative surgery for CRC at our institution between September 2015 and March 2017. Nutritional and inflammatory status was established using Onodera's Prognostic Nutritional Index (PNI). Complications (overall, severe, infectious and anastomotic leakage) were carefully collected during the first 30 days of the postoperative period. After carrying out the multivariate analysis, PNI turned out to be a great predictive and protective factor for overall complications (RR: 0.279; 95% CI: 0.141–0.552), severe complications (RR: 0.355; 95% CI: 0.130–0.965), infectious complications (RR: 0.220; 95% CI: 0.099–0.489) and anastomotic leakage (RR: 0.151; 95% CI: 0.036–0.640). Our work reports that PNI is an independent predictive factor for the development of postoperative complications following curative surgery for CRC. El cáncer colorrectal (CCR) constituye un problema sanitario relevante, asociado a una morbimortalidad significativa. A lo largo de las últimas décadas se ha estudiado en profundidad el vínculo que existe entre el cáncer y el estado nutricional e inflamatorio de los pacientes oncológicos, y se han desarrollado múltiples escalas inmunonutricionales, relacionadas principalmente con el pronóstico oncológico de varios tipos de cáncer. Al generarse una interacción entre el tumor y el huésped, se desencadena una reacción inflamatoria sistémica que conduce a una serie de alteraciones neuroendocrinas. Dicha situación favorece una tendencia hacia la anorexia y el catabolismo. Nuestra hipótesis es que el estado nutricional e inflamatorio de los pacientes oncológicos se correlaciona con la morbilidad postoperatoria. Este es un estudio observacional y prospectivo de cohortes, c
ISSN:2173-5077
2173-5077
DOI:10.1016/j.cireng.2019.01.003