Clinical nutrition ESPEN · 2026
Prognostic indicators for postoperative complications and prognosis of remnant gastric cancer.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Hoshino Nobuaki, Aoyama Ryuhei, Tsunoda Shigeru, Okamura Ryosuke, Hisamori Shigeo, Yamashita Yoshito, Hata Hiroaki, Kinjo Yosuke, Miki Akira, Kanaya Seiichiro, Yamamoto Michihiro, Matsuo Koichi, Manaka Dai, Tanaka Eiji, Kawada Hironori, Kondo Masato, Itami Atsushi, Ito Tetsuo, Obama Kazutaka, Kyoto Esophageal and Gastric Surgery Study Group
Аннотация
BACKGROUND: Surgery is the primary treatment for remnant gastric cancer, and it is important to predict postoperative complications and prognosis before surgery. However, prognostic indicators for remnant gastric cancer are not fully understood. This study evaluated the relationship between short- and long-term outcomes of remnant gastric cancer and prognostic indicators.
METHODS: This multicenter, retrospective study included patients who underwent curative gastrectomy for remnant gastric cancer between January 2005 and December 2020. We examined the association between short- and long-term outcomes and prognostic indicators. Prognostic indicators included geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), serum albumin level, blood lymphocyte count, and body mass index.
RESULTS: A total of 318 patients were included. None of the prognostic indicators were associated with overall postoperative complications; however, the statistical power to detect these associations was low. GNRI of ≥98, PNI of ≥45, and serum albumin level of ≥4.0 were associated with better overall survival (adjusted hazard ratio [95% confidence interval]: 0.54 [0.33-0.88], 0.51 [0.31-0.84], and 0.43 [0.26-0.71], respectively) and relapse-free survival (adjusted hazard ratio [95% confidence interval]: 0.56 [0.35-0.89], 0.52 [0.32-0.85], and 0.43 [0.27-0.71], respectively). GNRI, PNI, and serum albumin levels were strongly correlated with each other and showed moderate correlations in their associations with prognosis.
CONCLUSION: No prognostic indicators associated with postoperative complications were identified. The GNRI, PNI, and serum albumin levels are useful for predicting the prognosis of remnant gastric cancer.
METHODS: This multicenter, retrospective study included patients who underwent curative gastrectomy for remnant gastric cancer between January 2005 and December 2020. We examined the association between short- and long-term outcomes and prognostic indicators. Prognostic indicators included geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), serum albumin level, blood lymphocyte count, and body mass index.
RESULTS: A total of 318 patients were included. None of the prognostic indicators were associated with overall postoperative complications; however, the statistical power to detect these associations was low. GNRI of ≥98, PNI of ≥45, and serum albumin level of ≥4.0 were associated with better overall survival (adjusted hazard ratio [95% confidence interval]: 0.54 [0.33-0.88], 0.51 [0.31-0.84], and 0.43 [0.26-0.71], respectively) and relapse-free survival (adjusted hazard ratio [95% confidence interval]: 0.56 [0.35-0.89], 0.52 [0.32-0.85], and 0.43 [0.27-0.71], respectively). GNRI, PNI, and serum albumin levels were strongly correlated with each other and showed moderate correlations in their associations with prognosis.
CONCLUSION: No prognostic indicators associated with postoperative complications were identified. The GNRI, PNI, and serum albumin levels are useful for predicting the prognosis of remnant gastric cancer.