Prognostic impact of immunonutritional status changes during preoperative chemoradiation in patients with rectal cancer

Yong Joon Lee, Woo Ram Kim, Jeonghee Han, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Nam Kyu Kim, Byung Soh Min

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5 Citations (Scopus)

Abstract

Purpose: Previous studies have demonstrated the prognostic impact of the prognostic nutritional index (PNI), a proposed indicator of immunonutritional statuses of surgical patients, on patients with various gastrointestinal cancers. Although the prognostic impact of the PNI on patients with colorectal cancer has been well established, its value has not been studied in patients treated with preoperative chemoradiation (pCRT). This study aimed to evaluate the prognostic impact of PNI on patients receiving pCRT for locally advanced rectal cancer (LARC). Methods: Patients with LARC who underwent curative pCRT followed by surgical resection were enrolled. The PNI was measured in all patients before and after pCRT, and the difference in values was calculated as the PNI difference (dPNI). Patients were classified according to dPNI (<5, 5-10, and >10). Clinicopathologic parameters and long-term oncologic outcomes were assessed according to dPNI classification. Results: No significant intergroup differences were observed in clinicopathologic parameters such as age, histologic grade, tumor location, tumor-node-metastasis stage, and postoperative complications. Approximately 53% of the patients had a mild dPNI (<5); only 15% had a high dPNI (>10). Univariate and multivariate analyses identified the dPNI as an independent prognostic factor for disease-free status (P < 0.01; hazard ratio [HR], 2.792; 95% confidence interval [CI], 1.577-4.942) and for cancer-specific survival (P = 0.012; HR, 2.469; 95%CI, 1.225-4.978). Conclusion: The dPNI is predictive of long-term outcomes in pCRT-treated patients with LARC. Further prospective studies should investigate whether immune-nutritional status correction during pCRT would improve oncologic outcomes.

Original languageEnglish
Pages (from-to)208-214
Number of pages7
JournalAnnals of Coloproctology
Volume32
Issue number6
DOIs
Publication statusPublished - 2016 Dec

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Rectal Neoplasms
Nutrition Assessment
Confidence Intervals
Neoplasms
Gastrointestinal Neoplasms
Nutritional Status
Colorectal Neoplasms
Multivariate Analysis
Prospective Studies
Neoplasm Metastasis
Survival

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Lee, Yong Joon ; Kim, Woo Ram ; Han, Jeonghee ; Han, Yoon Dae ; Cho, Min Soo ; Hur, Hyuk ; Lee, Kang Young ; Kim, Nam Kyu ; Min, Byung Soh. / Prognostic impact of immunonutritional status changes during preoperative chemoradiation in patients with rectal cancer. In: Annals of Coloproctology. 2016 ; Vol. 32, No. 6. pp. 208-214.
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title = "Prognostic impact of immunonutritional status changes during preoperative chemoradiation in patients with rectal cancer",
abstract = "Purpose: Previous studies have demonstrated the prognostic impact of the prognostic nutritional index (PNI), a proposed indicator of immunonutritional statuses of surgical patients, on patients with various gastrointestinal cancers. Although the prognostic impact of the PNI on patients with colorectal cancer has been well established, its value has not been studied in patients treated with preoperative chemoradiation (pCRT). This study aimed to evaluate the prognostic impact of PNI on patients receiving pCRT for locally advanced rectal cancer (LARC). Methods: Patients with LARC who underwent curative pCRT followed by surgical resection were enrolled. The PNI was measured in all patients before and after pCRT, and the difference in values was calculated as the PNI difference (dPNI). Patients were classified according to dPNI (<5, 5-10, and >10). Clinicopathologic parameters and long-term oncologic outcomes were assessed according to dPNI classification. Results: No significant intergroup differences were observed in clinicopathologic parameters such as age, histologic grade, tumor location, tumor-node-metastasis stage, and postoperative complications. Approximately 53{\%} of the patients had a mild dPNI (<5); only 15{\%} had a high dPNI (>10). Univariate and multivariate analyses identified the dPNI as an independent prognostic factor for disease-free status (P < 0.01; hazard ratio [HR], 2.792; 95{\%} confidence interval [CI], 1.577-4.942) and for cancer-specific survival (P = 0.012; HR, 2.469; 95{\%}CI, 1.225-4.978). Conclusion: The dPNI is predictive of long-term outcomes in pCRT-treated patients with LARC. Further prospective studies should investigate whether immune-nutritional status correction during pCRT would improve oncologic outcomes.",
author = "Lee, {Yong Joon} and Kim, {Woo Ram} and Jeonghee Han and Han, {Yoon Dae} and Cho, {Min Soo} and Hyuk Hur and Lee, {Kang Young} and Kim, {Nam Kyu} and Min, {Byung Soh}",
year = "2016",
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doi = "10.3393/ac.2016.32.6.208",
language = "English",
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Prognostic impact of immunonutritional status changes during preoperative chemoradiation in patients with rectal cancer. / Lee, Yong Joon; Kim, Woo Ram; Han, Jeonghee; Han, Yoon Dae; Cho, Min Soo; Hur, Hyuk; Lee, Kang Young; Kim, Nam Kyu; Min, Byung Soh.

In: Annals of Coloproctology, Vol. 32, No. 6, 12.2016, p. 208-214.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic impact of immunonutritional status changes during preoperative chemoradiation in patients with rectal cancer

AU - Lee, Yong Joon

AU - Kim, Woo Ram

AU - Han, Jeonghee

AU - Han, Yoon Dae

AU - Cho, Min Soo

AU - Hur, Hyuk

AU - Lee, Kang Young

AU - Kim, Nam Kyu

AU - Min, Byung Soh

PY - 2016/12

Y1 - 2016/12

N2 - Purpose: Previous studies have demonstrated the prognostic impact of the prognostic nutritional index (PNI), a proposed indicator of immunonutritional statuses of surgical patients, on patients with various gastrointestinal cancers. Although the prognostic impact of the PNI on patients with colorectal cancer has been well established, its value has not been studied in patients treated with preoperative chemoradiation (pCRT). This study aimed to evaluate the prognostic impact of PNI on patients receiving pCRT for locally advanced rectal cancer (LARC). Methods: Patients with LARC who underwent curative pCRT followed by surgical resection were enrolled. The PNI was measured in all patients before and after pCRT, and the difference in values was calculated as the PNI difference (dPNI). Patients were classified according to dPNI (<5, 5-10, and >10). Clinicopathologic parameters and long-term oncologic outcomes were assessed according to dPNI classification. Results: No significant intergroup differences were observed in clinicopathologic parameters such as age, histologic grade, tumor location, tumor-node-metastasis stage, and postoperative complications. Approximately 53% of the patients had a mild dPNI (<5); only 15% had a high dPNI (>10). Univariate and multivariate analyses identified the dPNI as an independent prognostic factor for disease-free status (P < 0.01; hazard ratio [HR], 2.792; 95% confidence interval [CI], 1.577-4.942) and for cancer-specific survival (P = 0.012; HR, 2.469; 95%CI, 1.225-4.978). Conclusion: The dPNI is predictive of long-term outcomes in pCRT-treated patients with LARC. Further prospective studies should investigate whether immune-nutritional status correction during pCRT would improve oncologic outcomes.

AB - Purpose: Previous studies have demonstrated the prognostic impact of the prognostic nutritional index (PNI), a proposed indicator of immunonutritional statuses of surgical patients, on patients with various gastrointestinal cancers. Although the prognostic impact of the PNI on patients with colorectal cancer has been well established, its value has not been studied in patients treated with preoperative chemoradiation (pCRT). This study aimed to evaluate the prognostic impact of PNI on patients receiving pCRT for locally advanced rectal cancer (LARC). Methods: Patients with LARC who underwent curative pCRT followed by surgical resection were enrolled. The PNI was measured in all patients before and after pCRT, and the difference in values was calculated as the PNI difference (dPNI). Patients were classified according to dPNI (<5, 5-10, and >10). Clinicopathologic parameters and long-term oncologic outcomes were assessed according to dPNI classification. Results: No significant intergroup differences were observed in clinicopathologic parameters such as age, histologic grade, tumor location, tumor-node-metastasis stage, and postoperative complications. Approximately 53% of the patients had a mild dPNI (<5); only 15% had a high dPNI (>10). Univariate and multivariate analyses identified the dPNI as an independent prognostic factor for disease-free status (P < 0.01; hazard ratio [HR], 2.792; 95% confidence interval [CI], 1.577-4.942) and for cancer-specific survival (P = 0.012; HR, 2.469; 95%CI, 1.225-4.978). Conclusion: The dPNI is predictive of long-term outcomes in pCRT-treated patients with LARC. Further prospective studies should investigate whether immune-nutritional status correction during pCRT would improve oncologic outcomes.

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