Long-term weight change after oesophageal cancer surgery.
BACKGROUND
Malnutrition is common after oesophageal cancer surgery. This study investigated weight changes and the risk of malnutrition among long-term survivors.


METHODS
A nationwide cohort study was conducted in Sweden in 2001-2004, with follow-up to 2008. Weight was assessed before oesophagectomy, after 6 months and at 3 years. Logistic regression was performed with adjustment for confounders. Odds ratios (ORs) for postoperative weight loss of at least 15 per cent were estimated.


RESULTS
Some 203 patients survived at least 3 years after oesophagectomy. Continuous weight loss occurred for up to 3 years. Women and men had a similar risk of malnutrition after 3 years (OR 0.85 (95 per cent confidence interval 0.24 to 2.98)). In overweight patients (preoperative body mass index at least 25 kg/m(2)) the risk of malnutrition was increased almost fivefold at 6 months (OR 4.90 (2.27 to 10.59)) and 3 years (OR 4.60 (1.80 to 11.78)). There was no difference in weight loss at 6 months between survivors and those who died between 6 months and 3 years after surgery (OR 1.11 (0.64 to 1.94)).


CONCLUSIONS
Weight loss can be long lasting after oesophagectomy; overweight patients are at particularly increased risk of malnutrition.
Unit of Oesophageal and Gastric Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. lena.martin@karolinska.se
L
L
Martin
P
P
Lagergren
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004812:Epidemiologic Methods; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000209:etiology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D013274:Stomach Neoplasms / Q000601:surgery*; D017741:Survivors / Q000706:statistics & numerical data*; D015431:Weight Loss