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Nutritional changes and factors contributing to postoperative weight recovery after esophagectomy

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Abstract

Background

In patients treated surgically for esophageal cancer, time-dependent data on nutritional status from the perioperative to postoperative period are questionable. We investigated time-dependent data on weight, body composition, and nutritional indices of patients with esophageal cancer from the preoperative period through the 12-month postoperative period.

Methods

Eighty patients with esophageal cancer were enrolled and subsequently underwent esophagectomy. Forty out of eighty patients were completed the 12-month follow-up survey period and analyzed. We assessed clinical, anthropometric measurement, laboratory data, and nutritional status data preoperatively and at 1, 3, 6, and 12 months postoperatively.

Results

Patients with esophageal cancer had 7.2% weight loss in the preoperative period compared with the usual body weight (UBW) before morbidity and 9.3% weight loss from preoperative to 12-month postoperative period. Weight gain in the postoperative survey period was not significant. Conversely, there was a time lag in the time-dependent changes in the postoperative nutritional status; this was considered to coincide with internal organ protein, body protein, and body fat levels, in that order. Multivariate analysis identified a ≥ 10% preoperative weight loss compared with UBW as the only independent factor negatively contributing to ≥ 85% weight recovery at 12 months postoperatively (OR 6.54, 95% CI 1.14–37.60, p = 0.036).

Conclusions

For sufficient nutritional status recovery in patients treated with esophagectomy, minimizing weight loss preoperatively is important. Regardless of neoadjuvant therapy or age, preoperative nutritional treatment should be promptly administered for all patients.

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Acknowledgements

The authors are grateful to J. Nadai, T. Hattori, S. Tsukada, and T. Fujii for constructive comments and warm encouragement. The authors would like to thank Enago (http://www.enago.jp) for the English language review.

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Authors and Affiliations

  1. Department of Health Science, Prefectural University of Hiroshima, 1-1-71 Ujina-higashi, Minami-ku, Hiroshima, 734-8558, Japan

    Genya Okada

  2. Department of Nutritional Medicine, Graduate School of Human Life Science, Osaka City University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka, 558-8585, Japan

    Genya Okada, Yoshinari Matsumoto, Yoshihiro Nakamura, Fumikazu Hayashi, Kumiko Kato, Chika Momoki, Yoko Yasui & Daiki Habu

  3. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi, Abeno-ku, Osaka, 545-8585, Japan

    Eijiro Edagawa, Yasunori Matsuda, Satoru Kishida, Shigeru Lee & Harushi Osugi

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  1. Genya Okada
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  2. Yoshinari Matsumoto
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  13. Harushi Osugi
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Corresponding author

Correspondence to Genya Okada.

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Ethical Statement

All patients signed informed consent to participate in the study; the study received the approval of the Ethics Committee of Osaka City University Medical School (No. 1611). 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.

Conflict of interest

Genya Okada, Yoshinari Matsumoto, Yoshihiro Nakamura, Fumikazu Hayashi, Kumiko Kato, Chika Momoki, Yoko Yasui, Daiki Habu, Eijiro Edagawa, Yasunori Matsuda, Satoru Kishida, Shigeru Lee, and Harushi Osugi declare that they have no conflicts of interest.

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Okada, G., Matsumoto, Y., Nakamura, Y. et al. Nutritional changes and factors contributing to postoperative weight recovery after esophagectomy. Esophagus 14, 343–350 (2017). https://doi.org/10.1007/s10388-017-0584-6

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  • DOI: https://doi.org/10.1007/s10388-017-0584-6

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