Preoperative nutritional status is associated with the prognosis for lung cancer.

Abstract

We investigated whether preoperative nutritional indicators predicted the prognosis for patients with early-stage non-small cell lung cancer. Data for stage I or stage IIA non-small cell lung cancer without lymph node metastasis patients who received anatomical lung resection and were followed-up at least five years after surgery (n=286) were analyzed. We calculated geriatric nutritional risk index, prognostic nutritional index, controlling nutritional status score, and modified Glasgow prognostic score. Multivariate Cox proportional hazard model adjusting for age, BMI, complication, pathological stage, histology of squamous cell carcinoma, T factor, diffusing capacity for carbon monoxide, surgery and smoking status was fitted to evaluate the association between these nutritional indicators and mortality and recurrence within five years. After adjusted for covariates other than type of surgery and diffusing capacity for carbon monoxide, controlling nutritional status of ≥3 was significantly associated with mortality (hazard ratio (HR) = 2.68, 95% confidence interval (CI) = 1.02, 7.01). The association remained marginally significant by adjusting for type of surgery and diffusing capacity for carbon monoxide (HR = 2.44, 95% CI = 0.92, 6.45). controlling nutritional status of ≥3 was significantly associated with recurrence (HR = 2.60; 95% CI: 1.20, 5.61) after adjusting for all covariates. Other nutritional indices did not predict the prognosis in multivariate analysis. Preoperative high controlling nutritional status score was marginally and significantly associated with mortality and recurrence of non-small cell lung cancer patients after lung resection.