261. THE PROGNOSTIC IMPACT OF PRE-OPERATIVE NUTRITIONAL INDICATORS OF THE PATIENTS WITH ESOPHAGEAL CANCER
Chia-Cheng Kao, Ke-Cheng Chen, Pei-Ming Huang, Mong-Wei Lin, Shuenn-Wen Kuo, Chia-Hsien Cheng, Feng-Ming Hsu, Ta-Chen Huang, Hsao-Hsun Hsu, Jang-Ming Lee- Gastroenterology
- General Medicine
Abstract
Background
Esophagectomy with or without concurrent chemoradiotherapy had been the treatment of choice for the patients with clinically operable esophageal cancer. In addition to the standard TNM status of the disease, it is unknown about whether pre-operative nutrition indicators, inclusive of hemoglobin value and albumin level before treatment, will have impact on post-operative survival outcome of these patients.
Methods
This is a retrospective study from a single medical center. We retrospectively reviewed and analyze the survival impact of various pre-operative nutritional indicators of esophageal cancer patients who received esophagectomy. Pre-operative indicators included age, gender, receiving concurrent chemoradiotherapy or not, alcohol, betel nuts and cigarette usage or not, lung function test, Hemoglobin value, Albumin level and white blood cell level. The survival impact of these parameters was evaluated with univariate as well as multi-variate analysis.
Results
Our study had totally retrospectively reviewed 1213 patients, which received esophagectomy between 1996 to 2022. Ratio of Male to Female is 1112 to 111, and 325 patients are older than 65 years old. Before operation, 746 among 1213 patients had received concurrent chemoradiotherapy. In univariate analysis, we found that Pre-operative Hemoglobin value (cut-off point 11.9) and Albumin level (cut-off point 4.1) had statistically significant difference on overall survival, with increased risk of mortality by the presence of lower level of Hb and albumin with P-value <0.001. The survival difference persisted after adjusted with TNM status under multi-variate analysis.
Conclusion
Our study showed that Pre-operative Hemoglobin value and Albumin level can be a significant prognosis factor of esophageal cancer patients who received esophagectomy. This significant result highlight the importance of nutritional status in caring the patients of esophageal cancer and suggested the possibility of improvement of survival by intervention of malnutrition during the course of treatment for esophageal cancer.