Predictive value of prognostic nutritional index in complications after thoracoscopy-assisted esophagectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

DILIMULATI Maimaiti , JULAITI Ainiwaer , KAWULI Jumai ,  ILYAR Sheyhidin

Department of Thoracic Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, P. R. China;

Corresponding?author：

ILYAR Sheyhidin, Email: iyarsc@163.com

Keywords：

Esophageal neoplasms; prognostic nutritional index; postoperative complications

DOI：

10.7507/1007-4848.202102044

Video：

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Objective To investigate the predictive value of prognostic nutritional index (PNI) in complications after thoracoscopy-assisted radical resection of esophageal cancer.Methods We collected the clinical data of patients who underwent thoracoscopy-assisted esophagectomy in the First Affiliated Hospital of Xinjiang Medical University from January 2015 to June 2020. The predictive value of PNI for postoperative complications was evaluated by establishing receiver operating characteristic (ROC) curve and the optimal cut-off point was determined. The patients were divided into a high PNI group and a low PNI group according to the cut-off point. The differences of baseline data and perioperative complications-related indicators between the two groups were compared and analyzed. Univariate and multivariate analyses were used to investigate the influence of PNI and other related indexes on postoperative complications.Results A total of 116 patients were enrolled in this study, including 75 males and 41 females, aged 65 (58-69) years. The area under ROC curve was 0.647, and the optimal cut-off point was 51.9. According to the cut-off point, there were 45 patients in the high PNI group and 71 patients in the low PNI group. The overall complication rate (χ²=10.437, P=0.001) and the incidence of postoperative pulmonary infection (χ²=10.811, P=0.001) were statistically different between the two groups. The results of univariate analysis showed that the duration of ventilator use (Z=–3.136, P=0.002), serum albumin value (t=2.961, P=0.004), and PNI value (χ²=10.437, P=0.001) were the possible risk factors for postoperative complications after thoracoscopy-assisted esophagectomy. The results of multivariate analysis suggested that the duration of ventilator use (OR=1.015, P=0.002) and the history of drinking (OR=5.231, P=0.013) were independent risk factors for postoperative complications, and high PNI was the protective factor for postoperative complications (OR=0.243, P=0.047).Conclusion PNI index has a certain value in predicting postoperative complications, which can quantify the preoperative nutritional and immune status of patients. Drinking history and duration of ventilator use are independent risk factors for postoperative complications of thoracoscopy-assisted esophagectomy, and high PNI is a protective factor for postoperative complications.

Citation： DILIMULATI Maimaiti, JULAITI Ainiwaer, KAWULI Jumai, ILYAR Sheyhidin. Predictive value of prognostic nutritional index in complications after thoracoscopy-assisted esophagectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(1): 89-94. doi: 10.7507/1007-4848.202102044 Copy

1.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2.	徐建峰, 周軍慶, 魏德勝, 等. 食管癌術后肺部并發癥的預測與對策. 中華胸部外科電子雜志, 2020, 7(4): 224-232.
3.	中國抗癌協會腫瘤營養專業委員會, 中華醫學會腸外腸內營養分會, 中國醫師協會放射腫瘤治療醫師分會營養與支持治療學組. 食管癌患者營養治療指南. 中國腫瘤臨床, 2020, 47(1): 1-10.
4.	Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi, 1984, 85(9): 1001-1005.
5.	Xue Y, Zhou X, Xue L, et al. The role of pretreatment prognostic nutritional index in esophageal cancer: A meta-analysis. J Cell Physiol, 2019, 234(11): 19655-19662.
6.	陳云開. 營養預后指數評估術前營養狀態對食管癌術后并發癥的預測價值. 臨床合理用藥雜志, 2020, 13(16): 139-140.
7.	Kubo N, Ohira M, Tamura T, et al. Prognostic significance of baseline nutritional index for patients with esophageal squamous cell carcinoma after radical esophagectomy. Esophagus, 2017, 14: 84-90.
8.	Hirahara N, Tajima Y, Fujii Y, et al. Preoperative prognostic nutritional index predicts long-term surgical outcomes in patients with esophageal squamous cell carcinoma. World J Surg, 2018, 42(7): 2199-2208.
9.	徐世斌, 徐美青, 孫效輝, 等. 預后營養指數與食管鱗癌患者術后并發癥和遠期預后的相關性研究. 中國腫瘤臨床, 2018, 45(15): 789-794.
10.	Filip B, Scarpa M, Cavallin F, et al. Postoperative outcome after oesophagectomy for cancer: Nutritional status is the missing ring in the current prognostic scores. Eur J Surg Oncol, 2015, 41(6): 787-794.
11.	李美端, 張娟, 楊勝生, 等. 營養預后指數評估術前營養狀態對食管癌術后并發癥的預測價值. 臨床與病理雜志, 2018, 38(6): 1267-1273.
12.	馬明全, 姜宏景, 弓磊, 等. 胸腔鏡與開放食管癌根治術后并發癥及應激反應的比較研究. 中華胃腸外科雜志, 2016, 19(4): 401-405.
13.	洪松銘. 術前營養評估指標對食管癌術后并發癥的預測價值. 福建醫科大學, 2019.
14.	Nozoe T, Kimura Y, Ishida M, et al. Correlation of pre-operative nutritional condition with post-operative complications in surgical treatment for oesophageal carcinoma. Eur J Surg Oncol, 2002, 28(4): 396-400.
15.	王青亮. 食管癌根治術后頸部吻合口瘺發生的影響因素分析. 淮海醫藥, 2020, 38(3): 287-289.
16.	劉超. 長期飲酒對食管癌患者圍手術期影響的初步研究. 泰山醫學院, 2018.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. 徐建峰, 周軍慶, 魏德勝, 等. 食管癌術后肺部并發癥的預測與對策. 中華胸部外科電子雜志, 2020, 7(4): 224-232.
3. 中國抗癌協會腫瘤營養專業委員會, 中華醫學會腸外腸內營養分會, 中國醫師協會放射腫瘤治療醫師分會營養與支持治療學組. 食管癌患者營養治療指南. 中國腫瘤臨床, 2020, 47(1): 1-10.
4. Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi, 1984, 85(9): 1001-1005.
5. Xue Y, Zhou X, Xue L, et al. The role of pretreatment prognostic nutritional index in esophageal cancer: A meta-analysis. J Cell Physiol, 2019, 234(11): 19655-19662.
6. 陳云開. 營養預后指數評估術前營養狀態對食管癌術后并發癥的預測價值. 臨床合理用藥雜志, 2020, 13(16): 139-140.
7. Kubo N, Ohira M, Tamura T, et al. Prognostic significance of baseline nutritional index for patients with esophageal squamous cell carcinoma after radical esophagectomy. Esophagus, 2017, 14: 84-90.
8. Hirahara N, Tajima Y, Fujii Y, et al. Preoperative prognostic nutritional index predicts long-term surgical outcomes in patients with esophageal squamous cell carcinoma. World J Surg, 2018, 42(7): 2199-2208.
9. 徐世斌, 徐美青, 孫效輝, 等. 預后營養指數與食管鱗癌患者術后并發癥和遠期預后的相關性研究. 中國腫瘤臨床, 2018, 45(15): 789-794.
10. Filip B, Scarpa M, Cavallin F, et al. Postoperative outcome after oesophagectomy for cancer: Nutritional status is the missing ring in the current prognostic scores. Eur J Surg Oncol, 2015, 41(6): 787-794.
11. 李美端, 張娟, 楊勝生, 等. 營養預后指數評估術前營養狀態對食管癌術后并發癥的預測價值. 臨床與病理雜志, 2018, 38(6): 1267-1273.
12. 馬明全, 姜宏景, 弓磊, 等. 胸腔鏡與開放食管癌根治術后并發癥及應激反應的比較研究. 中華胃腸外科雜志, 2016, 19(4): 401-405.
13. 洪松銘. 術前營養評估指標對食管癌術后并發癥的預測價值. 福建醫科大學, 2019.
14. Nozoe T, Kimura Y, Ishida M, et al. Correlation of pre-operative nutritional condition with post-operative complications in surgical treatment for oesophageal carcinoma. Eur J Surg Oncol, 2002, 28(4): 396-400.
15. 王青亮. 食管癌根治術后頸部吻合口瘺發生的影響因素分析. 淮海醫藥, 2020, 38(3): 287-289.
16. 劉超. 長期飲酒對食管癌患者圍手術期影響的初步研究. 泰山醫學院, 2018.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Predictive value of prognostic nutritional index in complications after thoracoscopy-assisted esophagectomy

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