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Preoperative controlling nutritional status (CONUT) is useful to estimate the prognosis after esophagectomy for esophageal cancer

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Abstract

Purpose

The aim of this study is to confirm the predictive value of controlling nutritional status (CONUT), as a postoperative prognostic marker for esophageal cancer patients undergoing esophagectomy.

Methods

We retrospectively analyzed 373 patients who underwent three-incision esophagectomy with 2- or 3-field lymphadenectomy for esophageal cancer between April 2005 and March 2016. The patients were divided into three groups based on the degree of preoperative malnutrition as assessed by CONUT: normal, light malnutrition, and moderate or severe malnutrition.

Results

The patients with moderate or severe malnutrition experienced a significantly higher frequency of reoperation (normal or light malnutrition, 6.3%; moderate or severe malnutrition, 18.2%; P = 0.033) and a higher tendency for respiratory morbidities (normal or light malnutrition, 14.0%; moderate or severe malnutrition, 27.3%; P = 0.088). Cox regression analysis identified a significantly poor prognosis, in both overall survival (hazard ratio (HR), 3.56; 95% confidence interval (CI), 1.714–7.390; P < 0.001) and cancer-specific survival (HR, 3.41; 95% CI, 1.790–6.516; P = 0.046).

Conclusions

CONUT is convenient and useful for preoperatively assessing malnutrition and prognosis of esophageal cancer patients who underwent surgery.

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Acknowledgements

No funding was received for this study.

Authors’ contributions

Study conception and design: Naoya Yoshida, Kazuto Harada, and Hideo Baba. Acquisition of data: Naoya Yoshida, Yoshifumi Baba, Masaaki Iwatsuki, Keisuke Kosumi, Koichi Kinoshita, Kenichi Nakamura, Yasuo Sakamoto, Yuji Miyamoto, Ryuichi Karashima, Kosuke Mima, Hiroshi Sawayama, Mayuko Ohuchi, and Akira Chikamoto. Analysis and interpretation of data: Naoya Yoshida, Kazuto Harada, and Yu Imamura. Drafting of manuscript: Naoya Yoshida, Masayuki Watanabe, and Hideo Baba. Critical revision of manuscript: Hideo Baba.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan

    Naoya Yoshida, Kazuto Harada, Yoshifumi Baba, Keisuke Kosumi, Masaaki Iwatsuki, Koichi Kinoshita, Kenichi Nakamura, Yasuo Sakamoto, Yuji Miyamoto, Ryuichi Karashima, Kosuke Mima, Hiroshi Sawayama, Mayuko Ohuchi, Akira Chikamoto & Hideo Baba

  2. Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Yu Imamura & Masayuki Watanabe

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  1. Naoya Yoshida
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  2. Kazuto Harada
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  3. Yoshifumi Baba
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  15. Yu Imamura
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  16. Masayuki Watanabe
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  17. Hideo Baba
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Corresponding author

Correspondence to Hideo Baba.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Yoshida, N., Harada, K., Baba, Y. et al. Preoperative controlling nutritional status (CONUT) is useful to estimate the prognosis after esophagectomy for esophageal cancer. Langenbecks Arch Surg 402, 333–341 (2017). https://doi.org/10.1007/s00423-017-1553-1

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  • DOI: https://doi.org/10.1007/s00423-017-1553-1

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