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Esophageal cancer patients of heavier weight have more nutritional risk of inadequate calorie intake immediately after esophagectomy: a retrospective study

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Abstract

Background

Perioperative malnutrition is common in patients undergoing esophagectomy, and nutritional support is critical for postoperative recovery in these patients. But few studies reported which characteristics of these patients were associated with post-esophagectomy inadequate calorie intake. This study aimed to explore which patients were more likely to have inadequate calories immediately after esophagectomy and the impact on clinical outcomes.

Methods

From January 2018 to June 2019, patients undergoing esophagectomy were retrospectively divided into the “adequate calorie group” and the “inadequate calorie group” according to whether they met daily calorie requirements in a week after esophagectomy. Caloric requirements met rate and clinical outcomes were compared between patients with and without complications, and with weight > 70 kg or ≤ 70 kg.

Results

Patients in the inadequate calorie group (n = 104) had significantly higher weight (p < 0.001), lean body mass (p = 0.028), and BMI (p = 0.001) than the adequate calorie group (n = 46). Weight loss after esophagectomy was reduced (p = 0.043) in the adequate calorie group. Patients with complications had lower rate of adequate calorie intake (72.8% vs. 63.8%). The caloric requirements met rate in patients with weigh ≤ 70 kg was significantly higher than those weight > 70 kg (80.2% vs. 43.2%, p < 0.001).

Conclusion

The weights of patients having inadequate calories in a week after esophagectomy were significantly heavier than those having adequate calories. Heavier patients after esophagectomy should attract more attention to their nutrition support.

Trial registration

This trial was registered (ChiCTR1900025557).

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Acknowledgments

We thank Feng Jiang, Jianfeng Huang, Zhi Zhang, Hui Jia, and Xiaojun Wang for providing clinical cases in this study.

Funding

This research was financially supported by the National Natural Science Foundation of China (No.81672869), Jiangsu Provincial Science Foundation (BK20161596), Jiangsu Provincial Medical Youth Talent (QNRC2016657), Jiangsu Provincial Key Research Development Program (BE2017759), and AOSAIKANG Clinical Pharmacy Foundation of Jiangsu Pharmaceutical Association (A201806).

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Author notes

  1. Kaichao Liu, Saisai Sun and Xiaolin Liu contributed equally to this work.

Authors and Affiliations

  1. Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Cancer Institute of Jiangsu Province, Nanjing, China

    Kaichao Liu, Saisai Sun, Jing Luo, Xiang Gao, Zhiyun Xu, Qin Zhang & Binhui Ren

  2. Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China

    Kaichao Liu & Jing Luo

  3. Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Nanjing, China

    Kaichao Liu, Saisai Sun, Jing Luo, Xiang Gao, Zhiyun Xu, Qin Zhang & Binhui Ren

  4. Department of Clinical Pharmacy, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Cancer Institute of Jiangsu Province, Nanjing, China

    Xiaolin Liu & Jun Bao

Authors
  1. Kaichao Liu
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  2. Saisai Sun
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Contributions

Study conception and design: Kaichao Liu, Saisai Sun, Xiaolin Liu, Qin Zhang, Jun Bao, and Binhui Ren. Acquisition of data: Xiaolin Liu, Saisai Sun, Xiang Gao, and Zhiyun Xu. Analysis and interpretation of data: Kaichao Liu, Jing Luo, Qin Zhang, Jun Bao, and Binhui Ren. Drafting of manuscript: Kaichao Liu, Saisai Sun, Xiang Gao, Zhiyun Xu, and Binhui Ren. Critical revision: Jing Luo, Xiaolin Liu, Qin Zhang, and Jun Bao. Final approval of the article: All authors.

Corresponding authors

Correspondence to Qin Zhang, Jun Bao or Binhui Ren.

Ethics declarations

This trial was approved by the Institutional Review Board of Jiangsu Cancer Hospital, and conducted in accordance with the Declaration of Helsinki. Informed consents were waived due to the retrospective nature of this study.

Conflict of interest

The authors declare that they have n conflicts of interest.

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Qin Zhang, Jun Bao and Binhui Ren these authors share co-corresponding authorship.

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Liu, K., Sun, S., Liu, X. et al. Esophageal cancer patients of heavier weight have more nutritional risk of inadequate calorie intake immediately after esophagectomy: a retrospective study. Support Care Cancer 29, 1265–1274 (2021). https://doi.org/10.1007/s00520-020-05538-2

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  • DOI: https://doi.org/10.1007/s00520-020-05538-2

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