This study aimed to examine the effect of preoperative nutritional status on short- and long-term outcomes in patients who underwent radical gastrectomy. It also explored the role of preoperative correction of hypoalbuminemia (PCH) in malnourished patients with gastric cancer.
We prospectively reviewed data from patients with gastric cancer who were treated in our department between January 2009 and December 2014. The effect of preoperative nutritional status on short- and long-term outcomes in patients who underwent radical gastrectomy was investigated. We explored whether PCH could improve the short- and long-term outcomes of these patients.
A total of 1,976 patients were analyzed, including 412 in the malnourished group and 1,564 in the well-nourished group. The overall incidence of complications in the malnourished group was significantly higher than that of the well-nourished group (21.4% vs 15.5%, p = 0.005). Except for incision infection (3.2% vs 1.6%, p = 0.041), there were no significant differences for other complications. In the malnourished group, 98 cases of preoperative hypoproteinemia were corrected (PCH group), whereas 314 cases were not (NPCH group). The incidence of incision infection in the PCH group was significantly lower than that in the NPCH group (0% vs 4.1%, p = 0.041). The median follow-up time was 39 months (1.0–88.0 months). The 3-year overall survival (OS; 59.1% vs 75%, p
The incidence of incision infection was significantly higher in patients with malnutrition than in well-nourished patients. The 3-year OS and RFS were significantly lower in malnourished patients than in well-nourished patients. PCH can both reduce the incidence of incisional infection in patients with malnutrition and significantly improve the 3-year OS and RFS for malnourished patients with stage II/III gastric cancer.
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All authors have declared no conflicts of interest.