Nutritional changes and factors contributing to postoperative weight recovery after esophagectomy

Abstract

Background

In patients treated surgically for esophageal cancer, time-dependent data on nutritional status from the perioperative to postoperative period are questionable. We investigated time-dependent data on weight, body composition, and nutritional indices of patients with esophageal cancer from the preoperative period through the 12-month postoperative period.

Methods

Eighty patients with esophageal cancer were enrolled and subsequently underwent esophagectomy. Forty out of eighty patients were completed the 12-month follow-up survey period and analyzed. We assessed clinical, anthropometric measurement, laboratory data, and nutritional status data preoperatively and at 1, 3, 6, and 12 months postoperatively.

Results

Patients with esophageal cancer had 7.2% weight loss in the preoperative period compared with the usual body weight (UBW) before morbidity and 9.3% weight loss from preoperative to 12-month postoperative period. Weight gain in the postoperative survey period was not significant. Conversely, there was a time lag in the time-dependent changes in the postoperative nutritional status; this was considered to coincide with internal organ protein, body protein, and body fat levels, in that order. Multivariate analysis identified a ≥ 10% preoperative weight loss compared with UBW as the only independent factor negatively contributing to ≥ 85% weight recovery at 12 months postoperatively (OR 6.54, 95% CI 1.14–37.60, p = 0.036).

Conclusions

For sufficient nutritional status recovery in patients treated with esophagectomy, minimizing weight loss preoperatively is important. Regardless of neoadjuvant therapy or age, preoperative nutritional treatment should be promptly administered for all patients.

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