Abstract
Abstract Background Esophageal cancer patients often suffer from malnutrition. Older people constitute a group of patients more susceptible to nutritional status deterioration. The aim of this study is to investigate the differences in nutritional status between elderly patients and patients younger than 65 years of age with esophageal and gastroesophageal junction cancer. Methods The study sample consisted of 73 patients with esophageal (n = 11) and gastroesophageal junction cancer (n = 62) who were admitted for surgery in the First Department of Surgery, Laikon General Hospital, Athens, Greece, between September 2015 and December 2017. Patients were divided into 2 groups according to their age, those younger than 65 years (n = 39) and those older than 65 years (n = 34). The preoperative assessment of nutritional status was based on Patient Generated Subjective Global Assessment (PG-SGA), laboratory tests, anthropometric measurements, handgrip strength, unintentional weight loss during the last six months and Skeletal Muscle Index (SMI) derived from analysis of CT scans. Results Malnutrition and sarcopenia were more prevalent in the group of older patients compared to the group of younger ones (73.5% vs 41%, P < 0.05 and 60% vs 35.3%, P < 0.05). PG-SGA was significantly higher in elderly patients (12.35 vs 8.23, P < 0.05), while SMI and handgrip strength were significantly lower in elderly patients (48.47 cm2/m2 vs 55.5 cm2/m2, P < 0.05 and 31 kg vs 39.1 kg, P < 0.05 respectively). Among the laboratory tests, albumin, hemoglobin and hematocrit were lower in the group of older patients (3.86 g/dL vs 4.15 g/dL, P < 0.05, 12.25 g/dL vs 13.17 g/dL, P < 0.05 and 36.5 vs 39.5, P < 0.05, respectively), whereas platelet-to-lymphocyte ratio was higher (205.4 vs 156.2, P < 0.05). Concerning anthropometric measurements, corrected mid arm muscle area and calf circumference were lower in older patients (42.15 cm2 vs 49.26 cm2, P < 0.05 and 34.86 cm vs 36.89 cm, P < 0.05, respectively), whereas no significant differences were observed in Body Mass Index values and unintentional weight loss between the two groups. Conclusion Geriatric patients with esophageal and gastroesophageal junction cancer have more compromised nutritional status compared to their younger counterparts. Preoperative nutritional assessment should be performed in all such patients in order to detect those who will benefit from perioperative nutritional support. Disclosure All authors have declared no conflicts of interest.
Published Version
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