ObjectiveTo investigate the prognostic value and consistency of prognostic nutritional index (PNI) and patient-generated subjective global assessment (PG-SGA) in perioperative nutritional status of patients with esophageal cancer.MethodsClinical data of 224 patients, including 186 males and 38 females with an average age of 63.08±8.42 years, who underwent esophageal cancer surgery in our hospital from November 2017 to August 2018 were retrospectively reviewed. The PNI was calculated according to the results of the first time blood and biochemical tests, and the PG-SGA assessment was also performed. According to the PNI value, the patients were divided into a good nutrition group (PNI≥45, 60 patients) and a malnutrition group (PNI<45, 164 patients). According to the PG-SGA score, the patients were divided into a good nutrition group (PG-SGA<4, 75 patients) and a malnutrition group (PG-SGA≥4, 149 patients). Nutrition-related haematological indexes and body mass index (BMI) were compared between the two groups, and the consistency of PNI and PG-SGA for nutritional assessment was analyzed.ResultsThe nutrition-related haematological indexes in different PNI groups were statistically different in the perioperative period (P<0.01). The longitudinal changes of prealbumin in patients of different PG-SGA groups were statistically different (P<0.05); the BMI of patients in different PG-SGA groups was statistically different in the perioperative period (P<0.01). The Kappa coefficient of the two indicators was 0.589 (P<0.001).ConclusionBoth PNI and PG-SGA can predict the nutritional risk of patients with esophageal cancer to some extent. PNI is an objective monitoring indicator, and PG-SGA is a subjective evaluation indicator, the combined use of which can more comprehensively reflect and predict the nutritional status of patients, and provide an important reference to the development of individualized nutrition support programs.
ObjectiveTo analyze the symptom characteristics and influencing factors in order to provide reference for symptom management of patients with esophageal cancer after operation.MethodsA total of 216 esophageal cancer patients, including 180 males and 36 females with an average age of 63.7±8.3 years, who underwent surgical operation in our hospital from March to October 2018 were recruited and investigated with self-designed symptom questionnaire at 1 month after surgery.ResultsThe top five symptoms were acid reflux (48.6%), cough (42.6%), dysphagia (40.7%), hoarseness (12.0%), and diarrhea (11.6%). Women were more prone to acid reflux (OR=2.053), fatigue (OR=1.932), chest pain (OR=3.681), sleep disturbance (OR=2.419), abdominal pain (OR=3.882), nausea (OR=3.014) and vomiting (OR=2.505). Patients over 60 years were more prone to dysphagia (OR=2.274). Patients with lower thoracic esophageal cancer had a higher incidence of dysphagia compared with patients with carcinoma of esophagogastric junction (OR=0.326). Patients who had neoadjuvant chemotherapy were more likely to suffer acid reflux (OR=1.594). Open surgery (OR=3.681) and neoadjuvant radiotherapy (OR=2.495) were the risk factors of chest pain.ConclusionThere are many symptoms in patients with esophageal cancer after operation, and the occurrence of symptoms is closely related to gender, age, tumor location, surgical procedure and neoadjuvant chemoradiotherapy.
ObjectiveTo evaluate the impact of three-field versus two-field lymph node dissection on postoperative complications and survival outcomes in patients with clinically unresectable esophageal squamous cell carcinoma undergoing conversion surgery. MethodsPatients with esophageal squamous cell carcinoma who underwent conversion surgery at Sichuan Cancer Hospital between January 2018 and March 2020 were retrospectively included. Based on the extent of lymph node dissection, patients were divided into a three-field group and a two-field group. Postoperative complications, overall survival (OS), and disease-free survival (DFS) were compared between the two groups. Cox regression and Kaplan-Meier analysis were used to identify prognostic factors. ResultsA total of 58 patients were included, consisting of 51 males and 7 females, with a median age of 61.50 (53.25, 65.00) years. The three-field group comprised 17 patients, and the two-field group comprised 41 patients. The results showed that three-field lymph node dissection did not increase the risk of complications. The OS and DFS in the three-field group tended to be better than those in the two-field group, but the differences were not statistically significant (P=0.228, P=0.342). Cox regression analysis indicated that OS and DFS were not significantly correlated with the extent of lymph node dissection (P=0.234, P=0.347) but were associated with R0 resection status (P=0.027, P=0.069). ConclusionThree-field lymph node dissection demonstrates good safety and may provide survival benefits in specific patient subgroups. R0 resection is a key factor influencing surgical prognosis.
