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Research in Review

Nutritional Status an Indicator of Survival in Patients With Esophageal Cancer

Nutritional status may be a prominent indicator of survival in elderly patients with esophageal cancer, claims a recently published study.

Esophageal cancer is one of the leading causes of cancer-related death worldwide, and, while new research has propelled the treatment and understanding of the disease, the influence of nutritional status on survival is still relatively unclear. Therefore, researchers led by Yaccong Bo, Zhengzhou University, China, conducted a retrospective cohort study of patients aged 60 years and older treated for esophageal cancer at an academic treatment facility in China, where the disease has a particularly high prevalence and mortality rate.

A total of 239 patients were included in the study, each of whom underwent nutritional screening using the geriatric nutritional risk index (GNRI), a screening index of nutritional-related risk based on a patient’s body weight and serum albumin, and followed for the occurrence of lymphatic node metastasis, radiation complications, and mortality. Follow-up was performed every 3 months for the first year, every 6 months for the second year, and then once every year thereafter until patient death or October 2015, which was the cut-off date for the study. Statistical analysis models were used to estimate survival associated with different risk groups.

Of the 239 patients analyzed for the study, 184 (74.9%) had no nutritional risk, 32 patients (13.4%) had a moderate risk of malnutrition, and 23 patients (9.7%) had a high risk of malnutrition.

Overall, the median survival of the group with no nutritional risk was nearly twice as long as what was found in the high-risk group (38 months vs 20 months). And, in patients with intermediate nutritional risk, the risk of death increased by more than 66% compared with patients who had no nutritional risk.

“The present study suggests that the GNRI is a simple and effective tool to predict the overall survival time in elderly [esophageal squamous cell carcinoma] patients treated with radiotherapy,” researchers concluded. “Compared with the non-nutritional risk group, the risk of death had increased by 68.8% for moderate risk group and 169.9% for high risk group, respectively.”