Prognostic Nutritional Index Predicts Treatment Outcomes following Palliative Surgery for Colorectal Adenocarcinoma
Objectives: Palliative surgeries such as stoma creation and bypass are effective for relieving symptoms related to incurable abdominal malignancies; however, these methods are controversial in patients with severe metastatic disease or poor pre-surgical health. The aim of this study was to examine t...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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The Japan Society of Coloproctology
2017-10-01
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| Series: | Journal of the Anus, Rectum and Colon |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/jarc/1/4/1_2017-016/_pdf/-char/en |
| _version_ | 1818151721102213120 |
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| author | Manabu Shimomura Kazuhiro Toyota Nozomi Karakuchi Kosuke Ono Naofumi Tsukiyama Masayuki Shishida Koichi Oishi Kazuaki Miyamoto Masahiro Ikeda Seiji Sadamoto Tadateru Takahashi |
| author_facet | Manabu Shimomura Kazuhiro Toyota Nozomi Karakuchi Kosuke Ono Naofumi Tsukiyama Masayuki Shishida Koichi Oishi Kazuaki Miyamoto Masahiro Ikeda Seiji Sadamoto Tadateru Takahashi |
| author_sort | Manabu Shimomura |
| collection | DOAJ |
| description | Objectives: Palliative surgeries such as stoma creation and bypass are effective for relieving symptoms related to incurable abdominal malignancies; however, these methods are controversial in patients with severe metastatic disease or poor pre-surgical health. The aim of this study was to examine the clinical significance of the prognostic nutritional index (PNI) in evaluations for palliative surgery. Methods: We retrospectively analyzed data from 37 patients who underwent palliative surgery for histologically-proven colorectal adenocarcinoma from 2009 to 2015. We investigated both risk factors for postoperative complications and prognostic factors. We used a PNI cutoff value of 40, as defined by previous studies. Results: The reason for surgery was stenosis in 18 patients, obstruction in 12, fistula in 5, and bleeding in 2. Bypass was performed in 10 cases, ileostomy in 5, and colostomy in 22. Postoperative morbidity and mortality occurred in 9 and 2 patients, respectively. Median overall survival time was 8.9 months. Only low PNI correlated with postoperative complications at trend-level (p=0.07), and the 2 patients with mortality were classified as PNI-low. The presence of ascites (p=0.003) and PNI (p=0.02) were identified as independent prognostic factors. Conclusions: PNI could be used as an objective marker for deciding whether to proceed with palliative surgery, independent of the extent of metastatic disease. |
| first_indexed | 2024-12-11T13:43:19Z |
| format | Article |
| id | doaj.art-81e705090ec9407b8f16404c7fe8791b |
| institution | Directory Open Access Journal |
| issn | 2432-3853 |
| language | English |
| last_indexed | 2024-12-11T13:43:19Z |
| publishDate | 2017-10-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj.art-81e705090ec9407b8f16404c7fe8791b2022-12-22T01:04:40ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532017-10-011411812410.23922/jarc.2017-0162017-016Prognostic Nutritional Index Predicts Treatment Outcomes following Palliative Surgery for Colorectal AdenocarcinomaManabu Shimomura0Kazuhiro Toyota1Nozomi Karakuchi2Kosuke Ono3Naofumi Tsukiyama4Masayuki Shishida5Koichi Oishi6Kazuaki Miyamoto7Masahiro Ikeda8Seiji Sadamoto9Tadateru Takahashi10Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, HiroshimaDepartment of Surgery, National Hospital Organization Higashihiroshima Medical Center, HiroshimaDepartment of Surgery, National Hospital Organization Higashihiroshima Medical Center, HiroshimaDepartment of Surgery, National Hospital Organization Higashihiroshima Medical Center, HiroshimaDepartment of Surgery, National Hospital Organization Higashihiroshima Medical Center, HiroshimaDepartment of Surgery, National Hospital Organization Higashihiroshima Medical Center, HiroshimaDepartment of Surgery, National Hospital Organization Higashihiroshima Medical Center, HiroshimaDepartment of Surgery, National Hospital Organization Higashihiroshima Medical Center, HiroshimaDepartment of Surgery, National Hospital Organization Higashihiroshima Medical Center, HiroshimaDepartment of Surgery, National Hospital Organization Higashihiroshima Medical Center, HiroshimaDepartment of Surgery, National Hospital Organization Higashihiroshima Medical Center, HiroshimaObjectives: Palliative surgeries such as stoma creation and bypass are effective for relieving symptoms related to incurable abdominal malignancies; however, these methods are controversial in patients with severe metastatic disease or poor pre-surgical health. The aim of this study was to examine the clinical significance of the prognostic nutritional index (PNI) in evaluations for palliative surgery. Methods: We retrospectively analyzed data from 37 patients who underwent palliative surgery for histologically-proven colorectal adenocarcinoma from 2009 to 2015. We investigated both risk factors for postoperative complications and prognostic factors. We used a PNI cutoff value of 40, as defined by previous studies. Results: The reason for surgery was stenosis in 18 patients, obstruction in 12, fistula in 5, and bleeding in 2. Bypass was performed in 10 cases, ileostomy in 5, and colostomy in 22. Postoperative morbidity and mortality occurred in 9 and 2 patients, respectively. Median overall survival time was 8.9 months. Only low PNI correlated with postoperative complications at trend-level (p=0.07), and the 2 patients with mortality were classified as PNI-low. The presence of ascites (p=0.003) and PNI (p=0.02) were identified as independent prognostic factors. Conclusions: PNI could be used as an objective marker for deciding whether to proceed with palliative surgery, independent of the extent of metastatic disease.https://www.jstage.jst.go.jp/article/jarc/1/4/1_2017-016/_pdf/-char/encolorectal adenocarcinomapalliative surgeryprognostic nutritional index |
| spellingShingle | Manabu Shimomura Kazuhiro Toyota Nozomi Karakuchi Kosuke Ono Naofumi Tsukiyama Masayuki Shishida Koichi Oishi Kazuaki Miyamoto Masahiro Ikeda Seiji Sadamoto Tadateru Takahashi Prognostic Nutritional Index Predicts Treatment Outcomes following Palliative Surgery for Colorectal Adenocarcinoma Journal of the Anus, Rectum and Colon colorectal adenocarcinoma palliative surgery prognostic nutritional index |
| title | Prognostic Nutritional Index Predicts Treatment Outcomes following Palliative Surgery for Colorectal Adenocarcinoma |
| title_full | Prognostic Nutritional Index Predicts Treatment Outcomes following Palliative Surgery for Colorectal Adenocarcinoma |
| title_fullStr | Prognostic Nutritional Index Predicts Treatment Outcomes following Palliative Surgery for Colorectal Adenocarcinoma |
| title_full_unstemmed | Prognostic Nutritional Index Predicts Treatment Outcomes following Palliative Surgery for Colorectal Adenocarcinoma |
| title_short | Prognostic Nutritional Index Predicts Treatment Outcomes following Palliative Surgery for Colorectal Adenocarcinoma |
| title_sort | prognostic nutritional index predicts treatment outcomes following palliative surgery for colorectal adenocarcinoma |
| topic | colorectal adenocarcinoma palliative surgery prognostic nutritional index |
| url | https://www.jstage.jst.go.jp/article/jarc/1/4/1_2017-016/_pdf/-char/en |
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