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Hand grip strength as a predictor of postoperative complications in esophageal cancer patients undergoing esophagectomy

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Abstract

Background

Radical esophagectomy remains the primary treatment option for resectable esophageal cancer. However, it sometimes induces postoperative complications due to its invasive nature. Recently, the impact of loss of muscle mass on postoperative complications and survival among cancer patients has been highlighted. This study aimed to identify the impact of low hand grip strength (HGS) on postoperative complications after esophagectomy.

Methods

A total of 188 patients (male: 166, female: 22) who underwent radical esophagectomy with gastric tube reconstruction between 2008 and 2014 were included. The correlation between HGS and age was analyzed using Pearson’s correlation coefficient. Due to the small patient numbers, only male patients were stratified into two groups according to age (<70 years: non-elderly group, ≥70 years: elderly group). Receiver operating characteristic curve analysis was performed for each group using postoperative complication occurrence as the endpoint to determine an optimal HGS cutoff value.

Results

Postoperative complications occurred in 60.9% of the elderly group and 47.4% of the non-elderly group. When the cutoff values were set at 30.5 and 37 kg for the elderly and non-elderly group, respectively, low HGS was an independent predictive factor of postoperative complications on multivariate analysis only in the elderly group (p = 0.008). In the elderly group, the incidence of postoperative pneumonia was 39.5% among patients with low HGS vs. 3.8% among patients with high HGS.

Conclusion

Preoperative HGS is an independent predictive factor of postoperative complications, especially postoperative pneumonia, for elderly male patients with esophageal cancer treated with radical esophagectomy.

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Acknowledgements

This work was supported in part by Grants-in-Aid for medical research from Shizuoka Prefectural Hospital Organization.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan

    Shinsuke Sato, Erina Nagai, Yusuke Taki, Masaya Watanabe & Masakazu Takagi

  2. Department of Rehabilitation, Shizuoka General Hospital, Shizuoka, Japan

    Yuki Watanabe, Kiyokaze Nakano, Hiroyuki Yamada, Takuya Chiba, Yuichiro Ishii & Hiroshi Ogiso

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  1. Shinsuke Sato
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  2. Erina Nagai
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Correspondence to Shinsuke Sato.

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Ethical Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was waived due to the retrospective nature of the study.

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All authors have no conflict of interest.

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Sato, S., Nagai, E., Taki, Y. et al. Hand grip strength as a predictor of postoperative complications in esophageal cancer patients undergoing esophagectomy. Esophagus 15, 10–18 (2018). https://doi.org/10.1007/s10388-017-0587-3

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  • DOI: https://doi.org/10.1007/s10388-017-0587-3

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