Nutritional risk factors in planned oncologic surgery: what clinical and biological parameters should be routinely used?
BACKGROUND
Screening for malnutrition is recommended in hospitalized and planned surgical patients. The aim of this study was to analyze the feasibility and routine prognostic value of using the principal recommended nutritional screening and evaluation tools for cancer patients undergoing major surgery.


METHODS
This study is a prospective, 3-month, multicenter observational trial recording weight loss, body mass index, albumin, transthyretin, and PG-SGA. The morbidity rate was assessed on the basis of major complications (MC), whether of an infectious (MIC) or noninfectious (MNIC) nature.


RESULTS
Two hundred seventy-five patients were recruited at nine centers. The following percentages were recorded with respect to morbidity: 28.4% MC, 12.7% MIC, and 22.2% MNIC. Univariate analysis revealed a statistical association only between weight loss greater than 10% and MIC and hospital stay. A weight loss of 15% is required to demonstrate an association with either MC, MIC, or MNIC. Body mass index (BMI) was associated only with MNIC, PG-SGA with MC, and albumin <30 g/l was strongly associated with all types of morbidity (MC, MIC, MNIC). Multivariate analysis indicated that only albumin <30 g/l and an operating time of more than 4 h are significantly associated with morbidity.


CONCLUSIONS
In this study, the best nutritional factor for detecting the risk of MC is albumin levels below 30 g/l. A weight loss greater than 15% is required to obtain a statistically significant correlation with the existence of MC.
Antoun
Sami
S
CLAN Institut Gustave Roussy, Inter CLAN Centres Recherche Lutte Contre Cancer, 39 Rue Camille Desmoulins, 94805, Villejuif, France. sami.antoun@igr.fr
Rey
Annie
A
Béal
Jacqueline
J
Montange
Fabienne
F
Pressoir
Martine
M
Vasson
Marie-Paule
MP
Dupoiron
Denis
D
Gourdiat-Borye
Anne
A
Guillaume
Alain
A
Maget
Brigitte
B
Nitenberg
Gérard
G
Raynard
Bruno
B
Bachmann
Patrick
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000032:analysis; D015992:Body Mass Index; D016009:Chi-Square Distribution; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007239:Infections / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011228:Prealbumin / Q000032:analysis; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D015431:Weight Loss
D000418:Albumins; D011228:Prealbumin