Risk factors for malnutrition after oesophageal and cardia cancer surgery.
BACKGROUND
Oesophageal cancer surgery is often followed by malnutrition, but the factors causing weight loss are unknown. The aim of this population-based study was to identify such risk factors.


METHODS
Data were collected from a nationwide Swedish organization for research on surgery for oesophageal cancer. A total of 340 patients (75.9 per cent of those eligible) responded to a study-specific questionnaire concerning height and weight, just before and 6 months after surgery. Factors influencing malnutrition, defined as loss of body mass index of at least 15 per cent 6 months after operation, were identified by logistic regression.


RESULTS
Neoadjuvant therapy (received by 10.6 per cent of all patients) and female sex were associated with at least a twofold increased risk of weight loss (odds ratio (OR) 2.41 (95 per cent confidence interval 1.01 to 5.77) and 2.14 (1.07 to 4.28) respectively), whereas preoperative weight loss was associated with a decreased risk (OR 0.13 (0.03 to 0.65)). Age, tumour stage and location, type of oesophageal substitute, suture technique and postoperative complications did not influence the risk.


CONCLUSIONS
Neoadjuvant therapy and female sex appear to be associated with an increased risk of malnutrition after oesophageal cancer surgery.
Unit of Oesophageal and Gastric Research, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden. lena.martin@karolinska.se
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Rouvelas
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Lagergren
D000368:Aged; D002299:Cardia / Q000601:surgery*; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000209:etiology*; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000503:physiopathology / Q000601:surgery*; D015431:Weight Loss / Q000502:physiology*