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Huang S, Song X, Tong Z, Shi Q, Li J. Patent conversion of a novel closed chest drainage device. J Cardiothorac Surg 2024; 19:431. [PMID: 38987804 PMCID: PMC11234601 DOI: 10.1186/s13019-024-02873-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/15/2024] [Indexed: 07/12/2024] Open
Abstract
Closed chest drainage is typically necessary following Lobar and Sublobar resections to evacuate gases and fluids from the thoracic cavity, eliminate residual pleural space for lung expansion, and maintain negative pressure. Currently, three conventional closed chest drainage systems are commonly employed: single-chamber, double-chamber, and triple-chamber systems; each system has its own advantages and disadvantages. Despite the emergence of digital drainage systems in recent years, their high cost hinders their widespread adoption. Based on this premise, our research team has achieved a patent for a micro air pump-integrated chest closed drainage bottle, which has been further developed into a novel device integrating a three-chamber system with negative pressure control and power supply capabilities. This device enables patients undergoing perioperative lung procedures to ambulate freely while simultaneously receiving chest suction therapy-a concept that theoretically promotes rapid postoperative recovery. Moreover, this device offers economic benefits and holds potential for clinical implementation (particularly in economically underdeveloped regions). In this article, we modified the thoracic closed drainage device based on our patent and presented this novel thoracic closed drainage device after 3D printing and assembly.
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Affiliation(s)
- Shaoqing Huang
- Department of Thoracic Surgery, Ningbo No.2 Hospital, 41 Xibei Road, Ningbo, 315010, China.
| | - Xu Song
- Department of Thoracic Surgery, Ningbo No.2 Hospital, 41 Xibei Road, Ningbo, 315010, China
| | - Zhongkai Tong
- Department of Thoracic Surgery, Ningbo No.2 Hospital, 41 Xibei Road, Ningbo, 315010, China
- Department of Respiratory and Critical Care Medicine, Ningbo No.2 Hospital, 41 Xibei Road, Ningbo, 315010, China
| | - Qiang Shi
- Department of Thoracic Surgery, Ningbo No.2 Hospital, 41 Xibei Road, Ningbo, 315010, China
| | - Jie Li
- Department of Thoracic Surgery, Ningbo No.2 Hospital, 41 Xibei Road, Ningbo, 315010, China.
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Takahashi M, Okada H, Kogaki M, Shirokihara R, Kawate Y, Tokumasu H, Aoyama A. Short-term effects of preoperative nutritional intervention in lung surgery for malignant tumors: a single-center prospective study. Gen Thorac Cardiovasc Surg 2024; 72:466-472. [PMID: 38165558 DOI: 10.1007/s11748-023-01998-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/28/2023] [Indexed: 01/04/2024]
Abstract
OBJECTIVES Preoperative malnutrition is a risk factor for postoperative morbidity and mortality in patients with lung cancer. Assessing the preoperative nutritional status should be considered essential for patients scheduled to undergo lung surgery. This prospective study aimed to investigate whether preoperative nutritional intervention improves the nutritional conditions and short-term postoperative outcomes. METHODS The primary endpoints included safety, feasibility and short-term therapeutic efficacy of preoperative nutritional intervention. Patients with clinical stage I-III non-small cell lung cancer (histologically proven or suspected) were screened. Patient enrollment was conducted between January 2021 and December 2022. A total of 15 patients were included in the analysis. Patients with a preoperative prognostic nutritional index of < 45 were considered eligible. All participants received preoperative nutritional intervention. The trajectories of prognostic nutritional index and the incidence of postoperative complication rates in the intervention group were investigated. RESULTS No adverse events were observed during the nutritional intervention. The pre-intervention and post-intervention prognostic nutritional indices were 42.2 (39.8-44.5), and 43.1 (41.4-45.9), respectively (p = 0.04). The postoperative complication rate was 26.7% (n = 15). CONCLUSIONS This is the first prospective study to report the preoperative trajectories of prognostic nutritional index in patients undergoing lung cancer surgery. Our results suggest the safety and feasibility of preoperative nutritional intervention. Further research, such as randomized clinical trials, is warranted to investigate clinical efficacy and optimal nutritional interventions for lung surgery for malignant tumors.
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Affiliation(s)
- Mamoru Takahashi
- Department of Thoracic Surgery, Kyoto Katsura Hospital, 17 Yamada Hirao, Nishikyo, Kyoto, 615-8256, Japan.
| | - Harutaro Okada
- Department of Thoracic Surgery, Kyoto Katsura Hospital, 17 Yamada Hirao, Nishikyo, Kyoto, 615-8256, Japan
| | - Mako Kogaki
- Department of Nutrition, Kyoto Katsura Hospital, Kyoto, Japan
| | - Rio Shirokihara
- Department of Nutrition, Kyoto Katsura Hospital, Kyoto, Japan
| | - Yuka Kawate
- Department of Nutrition, Kyoto Katsura Hospital, Kyoto, Japan
| | - Hironobu Tokumasu
- Department of Clinical Research, Kurashiki Central Hospital, Okayama, Japan
| | - Akihiro Aoyama
- Department of Thoracic Surgery, Kyoto Katsura Hospital, 17 Yamada Hirao, Nishikyo, Kyoto, 615-8256, Japan
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Asakawa A, Ishibashi H, Baba S, Seto K, Wakejima R, Okubo K. Usefulness of the Global Leadership Initiative on malnutrition (GLIM) criteria in preoperative nutritional assessment of patients with primary lung cancer. Clin Nutr ESPEN 2024; 59:135-139. [PMID: 38220366 DOI: 10.1016/j.clnesp.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/25/2023] [Accepted: 11/30/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND AND AIMS The Global Leadership Initiative on Malnutrition (GLIM) developed a new method for evaluating malnutrition; however, no consensus has been reached regarding the use of these criteria. Therefore, this study aimed to investigate the association between nutritional status assessed using the GLIM criteria and outcomes of lung cancer after surgery. METHODS Patients with non-small cell lung cancer who underwent lung resection and bioelectrical impedance analysis to estimate muscle mass before surgery were included. Their background, pathological stage, recurrence, and prognosis were investigated. Patients were divided into two groups according to the GLIM criteria: normal nutrition and malnutrition groups. RESULTS The normal and malnutrition groups comprised 110 and 88 patients, respectively. Malnutrition was significantly associated with poor overall survival after surgery (P = 0.025) but not with disease-free survival. Multivariate analysis showed that malnutrition (hazard ratio [HR]:2.374, P = 0.020), advanced pathological stage of lung cancer (HR: 1.919, P = 0.002), and the presence of postoperative complications (HR: 2.035, P = 0.047) were significantly associated with poor overall survival. CONCLUSION Malnutrition assessed using the GLIM criteria was associated with the prognosis of patients with postoperative non-small cell lung cancer. Preoperative assessment using the GLIM criteria would allow for effective nutritional and rehabilitative interventions to improve prognosis.
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Affiliation(s)
- Ayaka Asakawa
- Department of Thoracic Surgery, Tokyo Medical and Dental University, Japan
| | - Hironori Ishibashi
- Department of Thoracic Surgery, Tokyo Medical and Dental University, Japan
| | - Shunichi Baba
- Department of Thoracic Surgery, Tokyo Medical and Dental University, Japan
| | - Katsutoshi Seto
- Department of Thoracic Surgery, Tokyo Medical and Dental University, Japan
| | - Ryo Wakejima
- Department of Thoracic Surgery, Tokyo Medical and Dental University, Japan
| | - Kenichi Okubo
- Department of Thoracic Surgery, Tokyo Medical and Dental University, Japan.
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Bade BC, Faiz SA, Ha DM, Tan M, Barton-Burke M, Cheville AL, Escalante CP, Gozal D, Granger CL, Presley CJ, Smith SM, Chamberlaine DM, Long JM, Malone DJ, Pirl WF, Robinson HL, Yasufuku K, Rivera MP. Cancer-related Fatigue in Lung Cancer: A Research Agenda: An Official American Thoracic Society Research Statement. Am J Respir Crit Care Med 2023; 207:e6-e28. [PMID: 36856560 PMCID: PMC10870898 DOI: 10.1164/rccm.202210-1963st] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Background: Fatigue is the most common symptom among cancer survivors. Cancer-related fatigue (CRF) may occur at any point in the cancer care continuum. Multiple factors contribute to CRF development and severity, including cancer type, treatments, presence of other symptoms, comorbidities, and medication side effects. Clinically, increasing physical activity, enhancing sleep quality, and recognizing sleep disorders are integral to managing CRF. Unfortunately, CRF is infrequently recognized, evaluated, or treated in lung cancer survivors despite more frequent and severe symptoms than in other cancers. Therefore, increased awareness and understanding of CRF are needed to improve health-related quality of life in lung cancer survivors. Objectives: 1) To identify and prioritize knowledge and research gaps and 2) to develop and prioritize research questions to evaluate mechanistic, diagnostic, and therapeutic approaches to CRF among lung cancer survivors. Methods: We convened a multidisciplinary panel to review the available literature on CRF, focusing on the impacts of physical activity, rehabilitation, and sleep disturbances in lung cancer. We used a three-round modified Delphi process to prioritize research questions. Results: This statement identifies knowledge gaps in the 1) detection and diagnostic evaluation of CRF in lung cancer survivors; 2) timing, goals, and implementation of physical activity and rehabilitation; and 3) evaluation and treatment of sleep disturbances and disorders to reduce CRF. Finally, we present the panel's initial 32 research questions and seven final prioritized questions. Conclusions: This statement offers a prioritized research agenda to 1) advance clinical and research efforts and 2) increase awareness of CRF in lung cancer survivors.
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Yin L, Chong F, Huo Z, Li N, Liu J, Xu H. GLIM-defined malnutrition and overall survival in cancer patients: A meta-analysis. JPEN J Parenter Enteral Nutr 2023; 47:207-219. [PMID: 36371641 PMCID: PMC10107432 DOI: 10.1002/jpen.2463] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/05/2022] [Accepted: 11/06/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Malnutrition defined by the Global Leadership Initiative on Malnutrition (GLIM) has been associated with cancer mortality, but the effect is limited and inconsistent. We performed this meta-analysis aiming to assess this relationship in patients with cancer. METHODS We systematically searched Embase, PubMed, Web of Science, Cochrane, CINAHL, CNKI, Wanfang, and VIP databases from January 1, 2019, to July 1, 2022. Studies evaluating the prognostic effect of GLIM-defined malnutrition on cancer survival were included. A fixed-effect model was fitted to estimate the combined hazard ratio (HR) with a 95% CI. Heterogeneity of studies was analyzed using the I2 statistic. Quality assessment were performed using the Newcastle-Ottawa Scale (NOS) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. RESULTS The search strategy identified 4378 articles in all databases combined. Nine studies (8829 patients) meeting the inclusion criteria were included for quantitative analysis. Meta-analysis revealed significant associations between GLIM-defined pooled malnutrition (HR = 1.75; 95% CI, 1.43-2.15), moderate malnutrition (HR = 1.44; 95% CI, 1.29-1.62), and severe malnutrition (HR = 1.79; 95% CI, 1.58-2.02) with all-cause mortality. Sensitivity analysis supported the robustness of these associations. The between-study heterogeneity was low (all I2 < 50%), and study quality assessed with NOS was high (all scores > 6). The evidence quality according to the GRADE tool was very low. CONCLUSIONS Our meta-analysis suggests a significant negative association of malnutrition, as defined by the GLIM, with overall survival in patients with cancer. However, definitive conclusions cannot be made, owing to the low quality of the source data.
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Affiliation(s)
- Liangyu Yin
- Institute of Hepatopancreatobiliary Surgery, Southwest HospitalArmy Medical University (Third Military Medical University)ChongqingChina
- Department of Clinical Nutrition, Daping HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Feifei Chong
- Department of Clinical Nutrition, Daping HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Zhenyu Huo
- Department of Clinical Nutrition, Daping HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Na Li
- Department of Clinical Nutrition, Daping HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Jie Liu
- Department of Clinical Nutrition, Daping HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Hongxia Xu
- Department of Clinical Nutrition, Daping HospitalArmy Medical University (Third Military Medical University)ChongqingChina
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[KINE PREOP pilot study: Prehabilitation in fast-track thoracic surgery protocol]. Rev Mal Respir 2023; 40:3-16. [PMID: 36604191 DOI: 10.1016/j.rmr.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/06/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Prehabilitation preceding oncological thoracic surgery according to a fast-track enhanced recovery after surgery (ERAS) protocol is in full expansion. Many recent studies have demonstrated the benefits of preoperative pulmonary rehabilitation as a means of reducing postoperative pulmonary complications. Unfortunately, it is rarely carried out by independent physiotherapists, and questions arise: is it feasible in private practice? Can it yield results similar to those achieved in institutional settings? DESIGN The study was non-interventional. The patients included had to be able to practice physical activities according to a standard ERAS approach. The endpoints were: postoperative pulmonary complications, physical condition (VO2max), and impact on the quality of life (SF-36 questionnaire). A statistical study was conducted to analyze the results with parametric and non-parametric tests. RESULTS Between June 2018 and January 2019, nine patients were included. From two to fifteen pulmonary rehabilitation sessions were carried out by six volunteering independent physiotherapists. Only two minor postoperative complications ensued. VO2max post rehabilitation increased on average by 2.4mL.kg -1.min-1. The SF-36 physical score increased significantly (+17.9%). The physical functioning (PF) (+28.9), physical restrictions (PR) (+11.1) and vitality (VT) (+16.7) sub-scores likewise improved. CONCLUSION Based on a literature review and on comparisons, our results seem promising. While further investigations are needed, it would seem that prehabilitation by independent physiotherapists leads to results similar to those achieved in inpatient prehabilitation.
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Déniz C, Raba-Parodi C, García-Raimundo E, Macía I, Rivas F, Ureña A, Muñoz A, Moreno C, Serratosa I, Masuet-Aumatell C, Escobar I, Ramos R. Preoperative Omega-6/Omega-3 Fatty Acid Ratio Could Predict Postoperative Outcomes in Patients with Surgically Resected Non-Small-Cell Lung Cancer. Curr Oncol 2022; 29:7086-7098. [PMID: 36290833 PMCID: PMC9600895 DOI: 10.3390/curroncol29100556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction: The aim of this study was to determine whether preoperative nutritional status and inflammatory status, specifically polyunsaturated acids and the omega 6/3 ratio, would affect postoperative outcomes and complications in patients with lung cancer undergoing lung resection. Methods: This prospective observational study included 68 patients with early-stage non-small-cell lung cancer who were candidates for radical surgery. A complete nutritional assessment was performed. The primary study variable was postoperative complications and mortality in the first 30 days. Descriptive, bivariate, and logistic regression analyses were carried out. Results: A total of 50 men (73.53%) and 18 women (26.47%) underwent surgery, with a median age of 64.2 (±9.74) years. The mean omega 6/3 ratio was 17.39 (±9.45). A complication occurred in 39.7% of the study sample (n = 27), the most common being persistent air leak in 23.53% (n = 16). After performing the bivariate analysis, the only variable that remained significant was the omega 6/3 ratio; we observed that it had a prognostic value for persistent air leak (p = 0.001) independent of age, sex, comorbidity, preoperative respiratory function, and approach or type of surgery. The remaining nutritional and inflammatory markers did not have a statistically significant association (p > 0.05) with postoperative complications. However, this significance was not maintained in the multivariate analysis by a small margin (p = 0.052; 95% CI: 0.77-1.41). Conclusions: Omega 6/3 ratio may be a prognostic factor for air leak, independent of the patient's clinical and pathological characteristics.
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Affiliation(s)
- Carlos Déniz
- Thoracic Surgery Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Carla Raba-Parodi
- Preventive Medicine and Public Health Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Eva García-Raimundo
- Endocrinology and Nutrition Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Iván Macía
- Thoracic Surgery Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Francisco Rivas
- Thoracic Surgery Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Anna Ureña
- Thoracic Surgery Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Anna Muñoz
- Thoracic Surgery Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Camilo Moreno
- Thoracic Surgery Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Ines Serratosa
- Thoracic Surgery Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Cristina Masuet-Aumatell
- Preventive Medicine and Public Health Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Ignacio Escobar
- Thoracic Surgery Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Ricard Ramos
- Thoracic Surgery Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Correspondence: ; Tel.: +34-3357011
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Doose M, Verhoeven D, Sanchez JI, Livinski AA, Mollica M, Chollette V, Weaver SJ. Team-Based Care for Cancer Survivors With Comorbidities: A Systematic Review. J Healthc Qual 2022; 44:255-268. [PMID: 36036776 PMCID: PMC9429049 DOI: 10.1097/jhq.0000000000000354] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Coordination of quality care for the growing population of cancer survivors with comorbidities remains poorly understood, especially among health disparity populations who are more likely to have comorbidities at the time of cancer diagnosis. This systematic review synthesized the literature from 2000 to 2022 on team-based care for cancer survivors with comorbidities and assessed team-based care conceptualization, teamwork processes, and outcomes. Six databases were searched for original articles on adults with cancer and comorbidity, which defined care team composition and comparison group, and assessed clinical or teamwork processes or outcomes. We identified 1,821 articles of which 13 met the inclusion criteria. Most studies occurred during active cancer treatment and nine focused on depression management. Four studies focused on Hispanic or Black cancer survivors and one recruited rural residents. The conceptualization of team-based care varied across articles. Teamwork processes were not explicitly measured, but teamwork concepts such as communication and mental models were mentioned. Despite team-based care being a cornerstone of quality cancer care, studies that simultaneously assessed care delivery and outcomes for cancer and comorbidities were largely absent. Improving care coordination will be key to addressing disparities and promoting health equity for cancer survivors with comorbidities.
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Affiliation(s)
- Michelle Doose
- Division of Clinical and Health Services Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Dana Verhoeven
- Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Janeth I. Sanchez
- Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Alicia A. Livinski
- National Institutes of Health Library, Office of Research Services, OD, National Institutes of Health, Bethesda, MD, USA
| | - Michelle Mollica
- Outcomes Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Veronica Chollette
- Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Sallie J. Weaver
- Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
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The Prognostic Role of Chronic Obstructive Pulmonary Disease for Lung Cancer After Pulmonary Resection. J Surg Res 2022; 275:137-148. [DOI: 10.1016/j.jss.2022.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 01/10/2022] [Accepted: 01/25/2022] [Indexed: 11/20/2022]
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Tsubokawa N, Mimura T, Tadokoro K, Yamashita Y. Classification based on skeletal muscle mass and the severity of lung emphysema impacts on clinical outcomes after anatomical resection for lung cancer. Jpn J Clin Oncol 2022; 52:917-924. [PMID: 35438159 DOI: 10.1093/jjco/hyac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/02/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Both sarcopenia and lung emphysema are prognostic factors in lung cancer and can be easily assessed using the psoas muscle index and Goddard score, respectively. We investigated the clinical significance of the classification based on psoas muscle index and Goddard score in non-small cell lung cancer. METHODS A total of 303 consecutive patients who underwent anatomical resection for non-small cell lung cancer were retrospectively analyzed. The psoas muscle at the level of the third lumbar vertebrae and Goddard score were measured on preoperative computed tomography. The psoas muscle was adjusted by height as the psoas muscle index (cm2/m2). We divided patients into three groups: low-, middle- and high-risk, using cut-off values of psoas muscle index < 6.36 cm2/m2 for males and 3.92 cm2/m2 for females and Goddard score higher than 7. The predictors of postoperative complications and prognosis were examined. RESULTS High-, middle- and low-risk were present in 30 (10%), 164 (54%) and 109 (36%) patients, respectively. High risk was significantly associated with male sex, low pulmonary function, more comorbidities and increased postoperative complications. High-risk patients showed poorer overall survival than middle- and low-risk patients (P < 0.001). Multivariable analysis revealed that high risk was an independent risk factor for postoperative complications and unfavorable prognostic factors (P = 0.011, P = 0.014, respectively). CONCLUSIONS Classification based on psoas muscle index and Goddard score is significantly associated with short- and long-term outcomes in patients with lung cancer. This method can be easily assessed for patients and may help select patients for nutritional support and rehabilitation before surgery.
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Affiliation(s)
- Norifumi Tsubokawa
- Department of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure city, Hiroshima, Japan
| | - Takeshi Mimura
- Department of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure city, Hiroshima, Japan
| | - Kazuki Tadokoro
- Department of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure city, Hiroshima, Japan
| | - Yoshinori Yamashita
- Department of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure city, Hiroshima, Japan
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Yin L, Song C, Cui J, Lin X, Li N, Fan Y, Zhang L, Liu J, Chong F, Wang C, Liang T, Liu X, Deng L, Yang M, Yu J, Wang X, Liu X, Yang S, Zuo Z, Yuan K, Yu M, Cong M, Li Z, Weng M, Yao Q, Jia P, Li S, Guo Z, Li W, Shi H, Xu H. De novo Creation and Assessment of a Prognostic Fat-Age-Inflammation Index “FAIN” in Patients With Cancer: A Multicenter Cohort Study. Front Nutr 2022; 9:860285. [PMID: 35495957 PMCID: PMC9043856 DOI: 10.3389/fnut.2022.860285] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Aims Malnutrition is highly prevalent and is related to multiple impaired clinical outcomes in cancer patients. This study aimed to de novo create an objective, nutrition-related index specially for prognostic purposes in oncology populations. Methods We performed a multicenter cohort study including 14,134 cancer patients. The prognostic impact for each baseline characteristic was estimated by calculating Harrell's C-index. The optimal parameters reflecting the nutritional and inflammatory impact on patients' overall survival were selected to develop the fat-age-inflammation (FAIN) index. The associations of the FAIN with the nutritional status, physical performance, quality of life, short-term outcomes and mortality of patients were comprehensively evaluated. Independent external validation was performed to further assess the prognostic value of the FAIN. Results The study enrolled 7,468 men and 6,666 women with a median age of 57 years and a median follow-up of 42 months. The FAIN index was defined as: (triceps skinfold thickness + albumin) / [age + 5 × (neutrophil count/lymphocyte count)]. There were significant associations of the FAIN with the nutritional status, physical performance, quality of life and short-term outcomes. The FAIN also showed better discrimination performance than the Nutritional Risk Index, the Prognostic Nutritional Index and the Controlling Nutritional Status index (all P < 0.05). In multivariable-adjusted models, the FAIN was independently associated with a reduced death hazard both as a continuous variable (HR = 0.57, 95%CI = 0.47–0.68) and per one standard deviation (HR = 0.83, 95%CI = 0.78–0.88). External validation in a multicenter lung cancer cohort (n = 227) further confirmed the prognostic value of the FAIN. Conclusions This study created and assessed the prognostic FAIN index, which might act as a feasible option to monitor the nutritional status and help develop intervention strategies to optimize the survival outcomes of cancer patients.
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Affiliation(s)
- Liangyu Yin
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Institute of Hepatopancreatobiliary Surgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chunhua Song
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jiuwei Cui
- Cancer Center, The First Hospital, Jilin University, Changchun, China
| | - Xin Lin
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Na Li
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yang Fan
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ling Zhang
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jie Liu
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Feifei Chong
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chang Wang
- Cancer Center, The First Hospital, Jilin University, Changchun, China
| | - Tingting Liang
- Cancer Center, The First Hospital, Jilin University, Changchun, China
| | - Xiangliang Liu
- Cancer Center, The First Hospital, Jilin University, Changchun, China
| | - Li Deng
- Cancer Center, The First Hospital, Jilin University, Changchun, China
| | - Mei Yang
- Department of Medical Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Jiami Yu
- Department of Medical Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Xiaojie Wang
- Department of Medical Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Xing Liu
- Department of Nutrition and Metabolism of Oncology, The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Cancer Hospital), Hefei, China
| | - Shoumei Yang
- Department of Nutrition and Metabolism of Oncology, The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Cancer Hospital), Hefei, China
| | - Zheng Zuo
- Department of Nutrition and Metabolism of Oncology, The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Cancer Hospital), Hefei, China
| | - Kaitao Yuan
- Center of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Miao Yu
- Center of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Minghua Cong
- Department of Comprehensive Oncology, National Cancer Center or Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zengning Li
- Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Min Weng
- Department of Clinical Nutrition, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qinghua Yao
- Department of Integrated Chinese and Western Medicine, Cancer Hospital of the University of Chinese Academy of Science (Zhejiang Cancer Hospital), Hangzhou, China
| | - Pingping Jia
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Suyi Li
- Department of Nutrition and Metabolism of Oncology, The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Cancer Hospital), Hefei, China
| | - Zengqing Guo
- Department of Medical Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Wei Li
- Cancer Center, The First Hospital, Jilin University, Changchun, China
- *Correspondence: Wei Li
| | - Hanping Shi
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Hanping Shi
| | - Hongxia Xu
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Hongxia Xu
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Şahin H, Naz İ, Aksel N, Güldaval F, Gayaf M, Yazgan S, Ceylan KC. Outcomes of pulmonary rehabilitation after lung resection in patients with lung cancer. TURK GOGUS KALP DAMAR CERRAHISI DERGISI 2022; 30:227-234. [PMID: 36168581 PMCID: PMC9473605 DOI: 10.5606/tgkdc.dergisi.2022.21595] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/27/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND In this study, we aimed to examine the effectiveness of pulmonary rehabilitation applied after resection in patients with lung cancer. METHODS Between October 2017 and December 2019, a total of 66 patients (53 males, 13 females; median age: 65 years; range, 58 to 70 years) who underwent lung resection for non-small cell lung cancer and who were not administered any chemotherapy or radiotherapy regimen were included in the study. An eight-week comprehensive outpatient pulmonary rehabilitation program was applied to half of the patients, while the other half received respiratory exercise training. After the intervention, the results of both groups were compared. RESULTS In the pulmonary rehabilitation group, forced vital capacity value (p=0.011), six-minute walking distance (p<0.001), and Short Form-36 physical function, mental health, vitality scores increased significantly, while all scores of St. George's Respiratory Questionnaire, dyspnea (p<0.001) and anxiety score (p=0.041) significantly decreased. In the group given breathing exercise training, only dyspnea (p=0.046) and St. George's Respiratory Questionnaire symptom scores (p=0.038) were decreased. When the changes in the groups after pulmonary rehabilitation were compared, the decrease in dyspnea perception was significantly higher in the pulmonary rehabilitation group (p<0.001). CONCLUSION Pulmonary rehabilitation program applied after lung resection in patients with non-small cell lung cancer reduces dyspnea and psychological symptoms, increases exercise capacity, and improves quality of life. It should be ensured that patients with lung cancer who have undergone lung resection are directed to the pulmonary rehabilitation program and benefit from this program.
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Affiliation(s)
- Hülya Şahin
- Department of Chest Diseases, University of Health Sciences, Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, Izmir, Türkiye
| | - İlknur Naz
- Physiotherapy and Rehabilitation Unit, Katip Çelebi University, Faculty of Health Sciences, Izmir, Türkiye
| | - Nimet Aksel
- Department of Chest Diseases, University of Health Sciences, Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, Izmir, Türkiye
| | - Filiz Güldaval
- Department of Chest Diseases, University of Health Sciences, Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, Izmir, Türkiye
| | - Mine Gayaf
- Department of Chest Diseases, University of Health Sciences, Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, Izmir, Türkiye
| | - Serkan Yazgan
- Department of Thoracic Surgery, University of Health Sciences, Dr. Suat Seren Chest Diseases And Chest Surgery Training and Research Hospital, Izmir, Türkiye
| | - Kenan Can Ceylan
- Department of Thoracic Surgery, University of Health Sciences, Dr. Suat Seren Chest Diseases And Chest Surgery Training and Research Hospital, Izmir, Türkiye
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13
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Kamigaichi A, Harada H, Shibata S. Muscle Quality Predicts Outcomes after Surgery for Early-Stage Non-Small-Cell Lung Cancer. Ann Thorac Cardiovasc Surg 2022; 28:262-270. [PMID: 35296583 PMCID: PMC9433886 DOI: 10.5761/atcs.oa.21-00274] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose: This study investigated the impact of skeletal muscle quality on the outcomes of patients undergoing surgery for early-stage non–small-cell lung cancer (NSCLC). Methods: A total of 98 patients with pathological stage I–II NSCLC who underwent lobectomy or segmentectomy were retrospectively analyzed. Along with skeletal muscle quantity, muscle quality was evaluated by intramuscular adipose tissue content (IMAC) at the first lumbar vertebral level; a higher IMAC indicates lower skeletal muscle quality. Patients were divided into two groups according to the gender-specific quartiles of IMAC, and the prognostic impact of IMAC was investigated. Results: No significant differences in the body and skeletal mass indices, which indicate skeletal muscle quantity, were observed between patients with high and those with normal IMAC. Patients with high IMAC (n = 23) showed a significantly poorer prognosis in overall and disease-specific survivals than those with normal IMAC (n = 75; P <0.001 and P = 0.048, respectively). In a bivariate analysis that included other clinicopathological factors, a high IMAC was independently associated with worse overall survival. Conclusion: The skeletal muscle quality evaluated by IMAC could be used to predict survival risk after surgery for early-stage NSCLC.
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Affiliation(s)
- Atsushi Kamigaichi
- Department of Thoracic Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Hiroshima, Japan
| | - Hiroaki Harada
- Department of Thoracic Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Hiroshima, Japan
| | - Satoshi Shibata
- Department of Thoracic Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Hiroshima, Japan
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14
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Zou H, Qin Y, Gong F, Liu J, Zhang J, Zhang L. ABCDEF pulmonary rehabilitation program can improve the mid-term lung function of lung cancer patients after thoracoscopic surgery: A randomized controlled study. Geriatr Nurs 2022; 44:76-83. [DOI: 10.1016/j.gerinurse.2021.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 11/28/2022]
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15
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Zhou T, Sun C. Effect of physical manipulation pulmonary rehabilitation on lung cancer patients after thoracoscopic lobectomy. Thorac Cancer 2021; 13:308-315. [PMID: 34882313 PMCID: PMC8807280 DOI: 10.1111/1759-7714.14225] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/21/2021] [Accepted: 10/23/2021] [Indexed: 11/27/2022] Open
Abstract
Background To introduce a new postoperative pulmonary rehabilitation program named physical manipulation pulmonary rehabilitation (PMPR) and to explore the effect of perioperative management, including PMPR, on patients with non‐small cell lung cancer (NSCLC) after thoracoscopic lobectomy. Methods A randomized controlled trial was conducted between April and June 2021 at the Department of Thoracic Surgery, Beijing Hospital. Adult patients with NSCLC who had undergone thoracoscopic lobectomy were allocated to the treatment and control groups using a random number table. The treatment group received both conventional pulmonary rehabilitation (CVPR) and 14 days of PMPR after surgery; the control group patients received CVPR only. PMPR included relaxing and exercising the intercostal muscles, thoracic costal joint and abdominal breathing muscles. Pulmonary function tests and the 6‐min walk test were conducted preoperatively and 7, 14, 21 and 28 days postoperatively. The postoperative length of hospital stay, chest tube retention time and postoperative pulmonary complications were recorded. The baseline data, pulmonary function parameters and prognosis were compared with t‐ and chi‐square tests between the two groups. Results A total of 86 patients were enrolled, and 44 patients were allocated to the treatment group. There were no significant differences in the baseline data for age, sex, body mass index, basic disease, surgical plan or preoperative pulmonary function between the two groups (all p > 0.05). The peak expiratory flow of patients in the treatment group was higher than that of those in the control group 21 days after surgery (316 ± 95 vs. 272 ± 103 l/min, respectively, p = 0.043), and forced expiratory volume in the first second on day 28 after surgery was greater than that in the control group (2.1 ± 0.2 vs. 1.9 ± 0.3 L, respectively, p < 0.001). There were no significant differences in forced vital capacity or 6‐min walk test scores (both p > 0.05). There were no significant differences in the incidences of pneumonia and atelectasis between the two groups (both p > 0.05). The postoperative length of hospital stay (3.3 ± 1.3 vs. 3.9 ± 1.5 days, p = 0.043) and chest tube retention time (66 ± 30 vs. 81 ± 35 h, p = 0.036) in the treatment group were shorter than those in the control group. Conclusions We determined that PMPR could improve early lung function in patients with NSCLC after thoracoscopic lobectomy, and that chest tube retention time and length of hospital stay were shortened.
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Affiliation(s)
- Ting Zhou
- Thoracic surgery Department, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Chao Sun
- Nursing Department, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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16
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Ferreira V, Lawson C, Carli F, Scheede-Bergdahl C, Chevalier S. Feasibility of a novel mixed-nutrient supplement in a multimodal prehabilitation intervention for lung cancer patients awaiting surgery: A randomized controlled pilot trial. Int J Surg 2021; 93:106079. [PMID: 34464752 DOI: 10.1016/j.ijsu.2021.106079] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/20/2021] [Accepted: 08/26/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate, in lung cancer patients awaiting elective surgery, the feasibility of delivering a novel four-week multimodal prehabilitation intervention and its effects on preoperative functional capacity and health-related quality of life (HRQoL), compared to standard hospital care. METHODS Adult patients awaiting elective thoracotomy for lung cancer stages I, II or IIIa, were approached to participate in an open-label, randomized controlled trial of two parallel arms: multimodal prehabilitation combining a mixed-nutrient supplement with structured supervised and home-based exercise training, and relaxation-strategies (Prehab) or standard hospital care (Control). Feasibility was assessed based on recruitment and adherence rates to the intervention and study outcome assessment. Functional capacity, measured by the 6-min walk test (6MWT), and HRQoL were measured at baseline and after four weeks (preoperative). RESULTS Within 5 months, 34 patients were enrolled and randomized (2:1) to Prehab (n = 24; median age = 67 years) or Control (n = 10; median age = 69 years); recruitment rate of 58.6%. The study was interrupted by the COVID-19 pandemic. Adherence to the prescribed intensity of the supervised exercise program was 84.1% (SD 23.1). Self-reported adherence to the home-based exercise program was 88.2% (SD 21) and to the nutritional supplement, 93.2% (SD 14.2). Adherence to patients' preoperative assessment was 82% and 88% in Prehab and Control, respectively. The mean adjusted difference in 4-week preoperative 6MWT between groups was 37.7 m (95% CI, -6.1 to 81.4), p = 0.089. There were no differences in HRQoL between groups. CONCLUSION Within a preoperative timeframe, it was feasible to deliver this novel multimodal prehabilitation intervention in lung cancer patients awaiting surgery.
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Affiliation(s)
- Vanessa Ferreira
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada; Department of Anesthesia, McGill University Health Centre, Montreal, QC, Canada
| | - Claire Lawson
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Francesco Carli
- Department of Anesthesia, McGill University Health Centre, Montreal, QC, Canada
| | - Celena Scheede-Bergdahl
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada; Department of Anesthesia, McGill University Health Centre, Montreal, QC, Canada
| | - Stéphanie Chevalier
- School of Human Nutrition, McGill University, Montreal, QC, Canada; Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
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17
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Zhou C, Li S, Liu J, Chu Q, Miao L, Cai L, Cai X, Chen Y, Cui F, Dong Y, Dong W, Fang W, He Y, Li W, Li M, Liang W, Lin G, Lin J, Lin X, Liu H, Liu M, Mu X, Hu Y, Hu J, Jin Y, Li Z, Qin Y, Ren S, Sun G, Shen Y, Su C, Tang K, Wu L, Wang M, Wang H, Wang K, Wang Y, Wang P, Wang H, Wang Q, Wang Z, Xie X, Xie Z, Xu X, Xu F, Yang M, Yang B, Yi X, Ye X, Ye F, Yu Z, Yue D, Zhang B, Zhang J, Zhang J, Zhang X, Zhang W, Zhao W, Zhu B, Zhu Z, Zhong W, Bai C, Chen L, Han B, Hu C, Lu S, Li W, Song Y, Wang J, Zhou C, Zhou J, Zhou Y, Saito Y, Ichiki Y, Igai H, Watanabe S, Bravaccini S, Fiorelli A, Petrella F, Nakada T, Solli P, Tsoukalas N, Kataoka Y, Goto T, Berardi R, He J, Zhong N. International consensus on severe lung cancer-the first edition. Transl Lung Cancer Res 2021; 10:2633-2666. [PMID: 34295668 PMCID: PMC8264326 DOI: 10.21037/tlcr-21-467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/17/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Chengzhi Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Shiyue Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Jun Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Qian Chu
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Liyun Miao
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Linbo Cai
- Department of Oncology, Guangdong Sanjiu Brain Hospital, Guangzhou, China
| | - Xiuyu Cai
- Department of General Internal Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yu Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Fei Cui
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yuchao Dong
- Department of Pulmonary and Critical Care Medicine, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Wen Dong
- Department of Oncology, Hainan Cancer Hospital, Haikou, China
| | - Wenfeng Fang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yong He
- Department of Respiratory Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Weifeng Li
- Department of Respiratory Medicine, General Hospital of Guangzhou Military Command of PLA, Guangzhou, China
| | - Min Li
- Department of Respiratory Medicine, Xiangya Cancer Center, Xiangya Hospital, Central South University, Changsha, China
| | - Wenhua Liang
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Gen Lin
- Department of Thoracic Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Jie Lin
- Department of Medical Oncology, the Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xinqing Lin
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Hongbing Liu
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Ming Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xinlin Mu
- Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Yi Hu
- Department of Medical Oncology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Jie Hu
- Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yang Jin
- Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ziming Li
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yinyin Qin
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Shengxiang Ren
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, China
| | - Gengyun Sun
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yihong Shen
- Department of Respiratory Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chunxia Su
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Kejing Tang
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, China
| | - Lin Wu
- Thoracic Medicine Department II, Hunan Cancer Hospital, Changsha, China
| | - Mengzhao Wang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Beijing, China
| | - Huijuan Wang
- Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Kai Wang
- Department of Respiratory Medicine, Fourth Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Yuehong Wang
- Department of Respiratory Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ping Wang
- Department of Respiratory and Critical Care Medicine, the Eighth Medical Center of PLA General Hospital, Beijing, China
| | - Hongmei Wang
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qi Wang
- Department of Respiratory Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhijie Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohong Xie
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Zhanhong Xie
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xin Xu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Fei Xu
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Meng Yang
- Department of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
| | - Boyan Yang
- Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangjun Yi
- Department of Medical Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoqun Ye
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Feng Ye
- Department of Medical Oncology, The first affiliated hospital of Xiamen University, Xiamen, China
| | - Zongyang Yu
- Department of Pulmonary and Critical Care Medicine, The th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China
| | - Dongsheng Yue
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Bicheng Zhang
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jian Zhang
- Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jianqing Zhang
- Second Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiaoju Zhang
- Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Wei Zhang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wei Zhao
- Department of Pulmonary and Critical Care Medicine, The General Hospital of People's Liberation Army, Beijing, China
| | - Bo Zhu
- Institute of Cancer, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Zhengfei Zhu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Wenzhao Zhong
- Guangdong Lung Cancer Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chunxue Bai
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Liangan Chen
- Department of Respiratory, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Baohui Han
- Department of Pulmonology, Shanghai Chest Hospital, Shanghai, China
| | - Chengping Hu
- Department of Pulmonary Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Shun Lu
- Department of Oncology, Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Song
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing, China
| | - Jie Wang
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Caicun Zhou
- Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jianying Zhou
- Department of Respiratory Diseases, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, China
| | - Yanbin Zhou
- Department of Internal Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuichi Saito
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Yoshinobu Ichiki
- Department of General Thoracic Surgery, National Hospital Organization, Saitama Hospital, Wako, Japan
| | - Hitoshi Igai
- Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan
| | - Satoshi Watanabe
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Sara Bravaccini
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, Universitàdella Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Petrella
- Division of Thoracic Surgery, IRCCS European Institute of Oncology, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Takeo Nakada
- Division of Thoracic Surgery, Department of Surgery, the Jikei University School of Medicine, Tokyo, Japan
| | - Piergiorgio Solli
- Department of Cardio-Thoracic Surgery and Hearth & Lung Transplantation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Yuki Kataoka
- Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Kyoto, Japan
| | - Taichiro Goto
- Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, Yamanashi, Japan
| | - Rossana Berardi
- Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi di Ancona, Italy
| | - Jianxing He
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Nanshan Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
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18
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Effects of preoperative nutrition and multimodal prehabilitation on functional capacity and postoperative complications in surgical lung cancer patients: a systematic review. Support Care Cancer 2021; 29:5597-5610. [PMID: 33768372 DOI: 10.1007/s00520-021-06161-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/16/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine the effect of preoperative nutrition and multimodal prehabilitation on clinical and functional outcomes in surgical lung cancer patients. METHODS We searched MEDLINE, Cochrane Library and CENTRAL, EMBASE, Scopus, and clinical trial registries ( clinicaltrials.gov , International Clinical Trials Registry Platform and Google Scholar) to identify studies involving a preoperative nutrition-based intervention or multimodal prehabilitation (nutrition with exercise) of at least 7 days, in lung cancer patients awaiting surgery. Studies must have reported results on at least one of the following outcomes: functional capacity, pulmonary function, postoperative complications, and length of hospital stay. The quality of included studies was assessed using the Cochrane risk of bias assessment tool for randomized trials and the modified Newcastle-Ottawa scale for non-controlled trials. RESULTS Five studies were included (1 nutrition-only and 4 multimodal prehabilitation studies). Due to substantial heterogeneity in the interventions across studies, a meta-analysis was not conducted. Findings suggest that multimodal prehabilitation, compared with standard hospital care, is associated with improvements in both functional walking capacity and pulmonary function during the preoperative period; however it does not appear to have an effect on postoperative outcomes. Rather, the finding of significantly lower rates of postoperative complications in the intervention group was unique to the nutrition-only study. CONCLUSION Multimodal prehabilitation programs that combine nutrition and exercise may have beneficial effects on various physical function outcomes in patients with lung cancer awaiting surgery. Optimizing preoperative nutrition may have postoperative benefits which remain to be confirmed.
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Avancini A, Cavallo A, Trestini I, Tregnago D, Belluomini L, Crisafulli E, Micheletto C, Milella M, Pilotto S, Lanza M, Infante MV. Exercise prehabilitation in lung cancer: Getting stronger to recover faster. Eur J Surg Oncol 2021; 47:1847-1855. [PMID: 33757650 DOI: 10.1016/j.ejso.2021.03.231] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/10/2021] [Accepted: 03/05/2021] [Indexed: 02/07/2023] Open
Abstract
Despite several recent advances, lung cancer surgery is still associated with potentially severe postoperative complications. It has been suggested that preoperative exercise training could render patients with borderline functional parameters eligible for surgery, improve perioperative outcomes and that these benefits might reduce healthcare costs. Nevertheless, given the substantial heterogeneity of the available studies, no specific guidelines for preoperative exercise training have been released so far. This narrative review aims to provide an overview of the potential benefits of exercise training in the preoperative period as a central intervention for lung cancer patients. In detail, the effects of exercise (with different regimens) were evaluated in terms of physical functions, patients' eligibility for curative surgery, postoperative complications and length of stay, with an exploratory focus on healthcare costs and long-term outcomes. Furthermore, a feasible approach for every-day clinical practice is proposed in order to increase the expected benefit deriving from a more extensive and methodical application of prehabilitation exercise, ideally in the context of a comprehensive approach to lung cancer patients, including nutritional and psychological support.
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Affiliation(s)
- Alice Avancini
- Biomedical, Clinical and Experimental Sciences, Department of Medicine, University of Verona, Verona, Italy.
| | - Alessandro Cavallo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Ilaria Trestini
- Section of Oncology, Department of Medicine, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Daniela Tregnago
- Section of Oncology, Department of Medicine, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Lorenzo Belluomini
- Section of Oncology, Department of Medicine, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Ernesto Crisafulli
- Respiratory Medicine Unit, Department of Medicine, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Claudio Micheletto
- Department of Cardiovascular and Thoracic, Pneumology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Michele Milella
- Section of Oncology, Department of Medicine, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Sara Pilotto
- Section of Oncology, Department of Medicine, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Massimo Lanza
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Maurizio Valentino Infante
- Thoracic Surgery Department, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
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Yin L, Liu J, Lin X, Li N, Shi M, Zhang H, Guo J, Chen X, Wang C, Wang X, Liang T, Liu X, Deng L, Li W, Fu Z, Song C, Cui J, Shi H, Xu H. Development and validation of a rapid-decision pathway to diagnose malnutrition in patients with lung cancer. Nutrition 2020; 84:111102. [PMID: 33453621 DOI: 10.1016/j.nut.2020.111102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/25/2020] [Accepted: 11/25/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Malnutrition is frequently developed and outcome-related in patients with lung cancer (LC). Making a rapid and accurate diagnosis of malnutrition is the major concern for dietitians and clinicians. METHODS We performed a multicenter, observational cohort study including 1219 patients with LC. Malnutrition was diagnosed using the Global Leadership Initiative on Malnutrition criteria, and the study population was randomly divided into a training group (n = 914) and a validation group (n = 305). A nomogram (to diagnose malnutrition) and two decision trees (to diagnose and grade malnutrition, respectively) were independently developed and tested. A random forest algorithm was used to calculate relative variable importance. RESULTS The Global Leadership Initiative on Malnutrition criteria identified 292 patients with malnutrition (24%). Sex, body mass index, weight loss within 6 mo, weight loss beyond 6 mo, calf circumference, and handgrip strength to weight ratio were screened for model development. The nomogram showed good discrimination with an area under the curve (AUC) of 0.982 (95% confidence interval, 0.969-0.995) and good calibration in the validation group. A decision curve analysis demonstrated that the nomogram was clinically useful. The diagnostic tree showed an accuracy of 0.98 (Kappa = 0.942; AUC = 0.978; 95% confidence interval, 0.964-0.992), and the classification tree showed an accuracy of 0.98 (Kappa = 0.955; AUC = 0.987) in the validation group. Weight loss within 6 mo contributed the largest importance to both trees. CONCLUSIONS This study presents a rapid-decision pathway, including a set of tools that can be conveniently used to facilitate the diagnosis and severity grading of malnutrition in patients with LC.
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Affiliation(s)
- Liangyu Yin
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Institute of Hepatopancreatobiliary Surgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jie Liu
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xin Lin
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Na Li
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Muli Shi
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Hongmei Zhang
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jing Guo
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xiao Chen
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, China
| | - Chang Wang
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, China
| | - Xu Wang
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, China
| | - Tingting Liang
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiangliang Liu
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, China
| | - Li Deng
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, China
| | - Wei Li
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, China
| | - Zhenming Fu
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Chunhua Song
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Jiuwei Cui
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, China.
| | - Hanping Shi
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
| | - Hongxia Xu
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
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21
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Siddiq MAB, Rathore FA, Clegg D, Rasker JJ. Pulmonary Rehabilitation in COVID-19 patients: A scoping review of current practice and its application during the pandemic. Turk J Phys Med Rehabil 2020. [PMID: 33364571 DOI: 10.5606/tfrd.2020.6889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
The novel coronavirus-2019 (COVID-19) pandemic primarily affects the respiratory system. Elderly individuals with comorbidity are severely affected. Survivors weaned from mechanical ventilation are at a higher risk of developing post-intensive care syndrome (PICS). This scoping review, based on 40 recent publications, highlights pulmonary rehabilitation (PR) in COVID-19. There is a paucity of high-quality research on this topic. However, rehabilitation societies including the Turkish Society of Physical Medicine and Rehabilitation have issued PR recommendations in COVID-19 pneumonia with productive cough can benefit from diaphragmatic breathing, pursed-lip breathing, and resistance-breathing training. Besides, those in mechanical ventilation and post-PICS COVID-19 cases, oxygen therapy, early mobilization, airway clearance, aerobic exercise, gradual-graded limb muscle resistance exercise, nutritional and psychological interventions should be consideration. During PR, careful evaluation of vital signs and exercise-induced symptoms is also required. When in-person PR is not possible, telerehabilitation should be explored. However, the long-term effects of PR in COVID-19 need further evaluation.
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Affiliation(s)
- Md Abu Bakar Siddiq
- Department of Physical Medicine and Rehabilitation, Brahmanbaria Medical College, Brahmanbaria, Bangladesh
- School of Health Sports and Professional Practice, University of South Wales, Pontypridd, United Kingdom
| | - Farooq Azam Rathore
- Department of Rehabilitation Medicine, PNS Shifa Hospital, Karachi, Pakistan
| | - Danny Clegg
- School of Health and Social Care, London South Bank University, London, United Kingdom
| | - Johannes J Rasker
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, the Netherlands
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22
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Siddiq MAB, Rathore FA, Clegg D, Rasker JJ. Pulmonary Rehabilitation in COVID-19 patients: A scoping review of current practice and its application during the pandemic. Turk J Phys Med Rehabil 2020; 66:480-494. [PMID: 33364571 PMCID: PMC7756838 DOI: 10.5606/tftrd.2020.6889] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/31/2020] [Indexed: 02/06/2023] Open
Abstract
The novel coronavirus-2019 (COVID-19) pandemic primarily affects the respiratory system. Elderly individuals with comorbidity are severely affected. Survivors weaned from mechanical ventilation are at a higher risk of developing post-intensive care syndrome (PICS). This scoping review, based on 40 recent publications, highlights pulmonary rehabilitation (PR) in COVID-19. There is a paucity of high-quality research on this topic. However, rehabilitation societies including the Turkish Society of Physical Medicine and Rehabilitation have issued PR recommendations in COVID-19 pneumonia with productive cough can benefit from diaphragmatic breathing, pursed-lip breathing, and resistance-breathing training. Besides, those in mechanical ventilation and post-PICS COVID-19 cases, oxygen therapy, early mobilization, airway clearance, aerobic exercise, gradual-graded limb muscle resistance exercise, nutritional and psychological interventions should be consideration. During PR, careful evaluation of vital signs and exercise-induced symptoms is also required. When in-person PR is not possible, telerehabilitation should be explored. However, the long-term effects of PR in COVID-19 need further evaluation.
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Affiliation(s)
- Md Abu Bakar Siddiq
- Department of Physical Medicine and Rehabilitation, Brahmanbaria Medical College, Brahmanbaria, Bangladesh
- School of Health Sports and Professional Practice, University of South Wales, Pontypridd, United Kingdom
| | - Farooq Azam Rathore
- Department of Rehabilitation Medicine, PNS Shifa Hospital, Karachi, Pakistan
| | - Danny Clegg
- School of Health and Social Care, London South Bank University, London, United Kingdom
| | - Johannes J. Rasker
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, the Netherlands
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23
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Yin L, Lin X, Li N, Zhang M, He X, Liu J, Kang J, Chen X, Wang C, Wang X, Liang T, Liu X, Deng L, Li W, Song C, Cui J, Shi H, Xu H. Evaluation of the Global Leadership Initiative on Malnutrition Criteria Using Different Muscle Mass Indices for Diagnosing Malnutrition and Predicting Survival in Lung Cancer Patients. JPEN J Parenter Enteral Nutr 2020; 45:607-617. [PMID: 32386328 DOI: 10.1002/jpen.1873] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/21/2020] [Accepted: 05/04/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Liangyu Yin
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
- Institute of Hepatopancreatobiliary Surgery, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Xin Lin
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Na Li
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Mengyuan Zhang
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Xiumei He
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Jie Liu
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Jun Kang
- Department of Respiratory and Critical Medicine, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Xiao Chen
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Chang Wang
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Xu Wang
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Tingting Liang
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Xiangliang Liu
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Li Deng
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Wei Li
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Chunhua Song
- Department of Epidemiology, College of Public Health Zhengzhou University Zhengzhou Henan China
| | - Jiuwei Cui
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Hanping Shi
- Department of Gastrointestinal Surgery Department of Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University Beijing China
| | - Hongxia Xu
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
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24
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Blanch A, Costescu F, Slinger P. Preoperative Evaluation for Lung Resection Surgery. CURRENT ANESTHESIOLOGY REPORTS 2020. [DOI: 10.1007/s40140-020-00376-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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25
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Borloni B, Huettner H, Schuerholz T. Preoperative Nutritional Conditioning: Why, When and How. Visc Med 2019; 35:299-304. [PMID: 31768393 PMCID: PMC6873024 DOI: 10.1159/000503041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 08/29/2019] [Indexed: 12/10/2023] Open
Abstract
BACKGROUND Malnutrition is a frequent finding in patients undergoing cancer surgery, especially in the elderly. The decreased nutritional status leads to increased complications and to delayed recovery after the surgical procedure. While established concepts of enhanced recovery after surgery and rehabilitation aim at improving the patient after surgery, the concept of prehabilitation is targeting the phase before surgery. This multimodal concept incorporates preoperative nutritional support. SUMMARY Nutritional conditioning targets an increase in the functional reserve preoperatively to optimize recovery in the postoperative period. Routinely, it is combined with an exercise program according to the patient's state. Individualized meal plans help to meet the patient's requirements and should start approximately 4 weeks prior to surgery. An important part of the nutritional conditioning is to guarantee a daily protein intake of at least 1.2 g/kg body weight. This may be realized by commercially available whey proteins in particular or milk proteins in general. KEY MESSAGES All specialists involved in the care of cancer patients should recognize the care continuum that starts when the need for surgery is identified and aims at increasing the functional capacity throughout the pre-, peri- and postoperative phase by means of prehabilitation, enhanced recovery programs and rehabilitation.
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Affiliation(s)
| | | | - Tobias Schuerholz
- Department of Anesthesiology and Intensive Care, University Hospital Rostock, Rostock, Germany
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26
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Abstract
Enhancing the recovery of patients undergoing Thoracic Surgery is the raison d'être of a pulmonary rehabilitation (PR) process. Benefits of a PR program have been shown to include reduced postoperative complications, hospital length of stay (LOS) and improved exercise and lung function parameters. Identifying which groups of patients benefit most and the constituency of the perfect PR program is subject to ongoing research. Providing PR to patients in a manner acceptable to their lifestyle and disease timeline within economic limitations is the challenge.
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Affiliation(s)
- Kajan Mahendran
- Thoracic Surgery Department, Birmingham Heartlands Hospital, Birmingham, UK
| | - Babu Naidu
- Thoracic Surgery Department, Birmingham Heartlands Hospital, Birmingham, UK.,Birmingham Medical School, University of Birmingham, Birmingham, UK
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27
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Rankin NM, Lai M, Miller D, Beale P, Spigelman A, Prest G, Turley K, Simes J. Cancer multidisciplinary team meetings in practice: Results from a multi-institutional quantitative survey and implications for policy change. Asia Pac J Clin Oncol 2017; 14:74-83. [PMID: 28949100 DOI: 10.1111/ajco.12765] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/25/2017] [Indexed: 11/30/2022]
Abstract
AIM Multidisciplinary care is advocated as best practice in cancer care. Relatively little is documented about multidisciplinary team (MDT) meeting functioning, decision making and the use of evidence to support decision making in Australia. This descriptive study aimed to examine team functioning, the role of team meetings and evidence use in MDTs whose institutions are members of Sydney Catalyst Translational Cancer Research Centre. METHODS We designed a structured 40-item survey instrument about topics that included meeting purpose, organization, resources and documentation; caseload estimates; use of evidence and quality assurance; patient involvement and supportive care needs; and open-ended items about the MDTs strengths and weaknesses. Participants were invited to participate via email and the survey was administered online. Data were analyzed using descriptive and comparative statistics. RESULTS Thirty-seven MDTs from seven hospitals participated (100% response) and represented common (70%) and rare tumor groups (30%). MDT meeting purpose was reported as treatment (100%) or diagnostic decision making (88%), or for education purposes (70%). Most MDTs based treatment decisions on group consensus (92%), adherence to clinical practice guidelines (57%) or other evidence-based medicine sources (33%). The majority of MDTs discussed only a proportion of new patients at each meeting emphasizing the importance of educational aspects for other cases. Barriers exist in the availability of data to enable audit and reflection on evidence-based practice. MDT strengths included collaboration and quality discussion about patients. CONCLUSIONS MDT meetings focus on treatment decision making, with group consensus playing a significant role in translating research evidence from guidelines into clinical decision making. With a varying proportion of patients discussed in each MDT meeting, a wider audit of multidisciplinary care would enable more accurate assessments of whether treatment recommendations are in accordance with best-practice evidence.
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Affiliation(s)
- Nicole M Rankin
- Sydney Catalyst Translational Cancer Research Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Michelle Lai
- Sydney Catalyst Translational Cancer Research Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Danielle Miller
- Sydney Catalyst Translational Cancer Research Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Philip Beale
- Sydney Catalyst Translational Cancer Research Centre, University of Sydney, Camperdown, New South Wales, Australia.,Cancer Services, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Allan Spigelman
- The Kinghorn Cancer Centre and St Vincent's Hospital, Darlinghurst, New South Wales, Australia.,University of New South Wales, St Vincent's Hospital Clinical School, Sydney, New South Wales, Australia
| | - Gabrielle Prest
- The Kinghorn Cancer Centre and St Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Kim Turley
- Dubbo Base Hospital, Western NSW Local Health District, Dubbo, New South Wales, Australia
| | - John Simes
- Sydney Catalyst Translational Cancer Research Centre, University of Sydney, Camperdown, New South Wales, Australia.,NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
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28
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An international review and meta-analysis of prehabilitation compared to usual care for cancer patients. J Cancer Surviv 2017; 12:64-73. [DOI: 10.1007/s11764-017-0645-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 08/30/2017] [Indexed: 10/18/2022]
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29
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Postmus PE, Kerr KM, Oudkerk M, Senan S, Waller DA, Vansteenkiste J, Escriu C, Peters S. Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2017; 28:iv1-iv21. [PMID: 28881918 DOI: 10.1093/annonc/mdx222] [Citation(s) in RCA: 1203] [Impact Index Per Article: 171.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Affiliation(s)
- P E Postmus
- The Clatterbridge Cancer Centre and Liverpool Heart and Chest Hospital, Liverpool
| | - K M Kerr
- University of Aberdeen, Aberdeen, UK
| | - M Oudkerk
- Center for Medical Imaging, University of Groningen, Groningen
| | - S Senan
- Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands
| | - D A Waller
- Department of Thoracic Surgery, University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | - C Escriu
- The Clatterbridge Cancer Centre and Liverpool Heart and Chest Hospital, Liverpool
| | - S Peters
- Oncology Department, Service d'Oncologie Médicale, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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30
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Sebio Garcia R, Yáñez Brage MI, Giménez Moolhuyzen E, Granger CL, Denehy L. Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg 2016; 23:486-97. [PMID: 27226400 DOI: 10.1093/icvts/ivw152] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 03/21/2016] [Indexed: 12/13/2022] Open
Abstract
Lung cancer is the leading cause of cancer-related death worldwide. For early stages of the disease, lung resection surgery remains the best treatment with curative intent, but significant morbidity is associated, especially among patients with poor pulmonary function and cardiorespiratory fitness. In those cases, the implementation of a preoperative exercise-based intervention could optimize patient's functional status before surgery and improve postoperative outcomes and enhance recovery. The aim of this systematic review is to provide the current body of knowledge regarding the effectiveness of a preoperative exercise-based intervention on postoperative and functional outcomes in patients with lung cancer submitted to lung resection surgery. A systematic review of the literature using CINAHL, EMBASE, MEDLINE, Pubmed, PEDro and SCOPUS was undertaken in September 2015 yielding a total of 1656 references. Two independent reviewers performed the assessment of the potentially eligible records against the inclusion criteria and finally, 21 articles were included in the review. Articles were included if they examined the effects of an exercise-based intervention on at least one of the selected outcomes: pulmonary function, (functional) exercise capacity, health-related quality of life (HRQoL) and postoperative outcomes (length of stay and postoperative complications). Fourteen studies were further selected for a meta-analysis to quantify the mean effect of the intervention and generate 95% confidence intervals (CIs) using the Cochrane Review Manager 5.0.25. For two of the outcomes included (exercise capacity and HRQoL), studies showed large heterogeneity and thus, a meta-analysis was considered inappropriate. Pulmonary function (forced vital capacity and forced expiratory volume in 1 s) was significantly enhanced after the intervention [standardized mean difference (SMD) = 0.38; 95% CI 0.14, 0.63 and SMD = 0.27, 95% CI 0.11, 0.42, respectively]. In comparison with the patients in the control groups, patients in the experimental groups spent less days in the hospital (mean difference = -4.83, 95% CI -5.9, -3.76) and had a significantly reduced risk for developing postoperative complications (risk ratios = 0.45; 95% CI 0.28, 0.74). In conclusion, preoperative exercise-based training improves pulmonary function before surgery and reduces in-hospital length of stay and postoperative complications after lung resection surgery for lung cancer.
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Affiliation(s)
- Raquel Sebio Garcia
- Faculty of Physiotherapy, University of A Coruña, Research Group in Psychological Wellbeing and Functional Rehabilitation, A Coruña, Spain
| | | | | | | | - Linda Denehy
- School of Health Sciences, University of Melbourne, Melbourne, Australia
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31
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Kaya SO, Akcam TI, Ceylan KC, Samancılar O, Ozturk O, Usluer O. Is preoperative protein-rich nutrition effective on postoperative outcome in non-small cell lung cancer surgery? A prospective randomized study. J Cardiothorac Surg 2016; 11:14. [PMID: 26782276 PMCID: PMC4717613 DOI: 10.1186/s13019-016-0407-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 01/12/2016] [Indexed: 01/22/2023] Open
Abstract
Objective Protein-rich nutrition is necessary for wound healing after surgery. In this study, the benefit of preoperative nutritional support was investigated for non-small cell lung cancer patients who underwent anatomic resection. Methods A prospective study was planned with the approval of our institutional review board. Fifty-eight patients who underwent anatomic resection in our department between January 2014 and December 2014 were randomized. Thirty-one patients were applied a preoperative nutrition program with immune modulating formulae (enriched with arginine, omega-3 fatty acids and nucleotides) for ten days. There were 27 patients in the control group who were fed with only normal diet. Patients who were malnourished, diabetic or who had undergone bronchoplastic procedures or neoadjuvant therapy were excluded from the study. Patients’ baseline serum albumin levels, defined as the serum albumin level before any nutrition program, and the serum albumin levels on the postoperative third day were calculated and recorded with the other data. Results Anatomic resection was performed by thoracotomy in 20 patients, and 11 patients were operated by videothoracoscopy in the nutrition program group. On the other hand 16 patients were operated by thoracotomy and 11 patients were operated by videothoracoscopy in the control group. In the control group, the patients’ albumin levels decreased to 25.71 % of the baseline on the postoperative third day, but this reduction was only 14.69 % for nutrition program group patients and the difference was statistically significant (p < 0.001). Complications developed in 12 patients (44.4 %) in the control group compared to 6 patients in the nutrition group (p = 0.049). The mean chest tube drainage time was 6 (1–42) days in the control group against 4 (2–15) days for the nutrition program group (p = 0.019). Conclusions Our study showed that preoperative nutrition is beneficial in decreasing the complications and chest tube removal time in non-small cell lung cancer patients that were applied anatomic resection with a reduction of 25 % in the postoperative albumin levels of non-malnourished patients who underwent resection.
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Affiliation(s)
- Seyda Ors Kaya
- Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey
| | - Tevfik Ilker Akcam
- Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
| | - Kenan Can Ceylan
- Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey
| | - Ozgur Samancılar
- Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey
| | - Ozgur Ozturk
- Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey
| | - Ozan Usluer
- Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey
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Deepak JA, Ng X, Feliciano J, Mao L, Davidoff AJ. Pulmonologist involvement, stage-specific treatment, and survival in adults with non-small cell lung cancer and chronic obstructive pulmonary disease. Ann Am Thorac Soc 2015; 12:742-51. [PMID: 25760983 PMCID: PMC4418342 DOI: 10.1513/annalsats.201406-230oc] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 03/11/2015] [Indexed: 12/12/2022] Open
Abstract
RATIONALE Up to 80% of patients with lung cancer have comorbid chronic obstructive pulmonary disease (COPD). Many of them are poor candidates for stage-specific lung cancer treatment due to diminished lung function and poor functional status, and many forego treatment. The negative effect of COPD may be moderated by pulmonologist-guided management. OBJECTIVES This study examined the association between pulmonologist management and the probability of receiving the recommended stage-specific treatment modality and overall survival among patients with non-small cell lung cancer (NSCLC) with preexisting COPD. METHODS Early- and advanced-stage NSCLC cases diagnosed between 2002 and 2005 with a prior COPD diagnosis (3-24 months before NSCLC diagnosis) were identified in Surveillance, Epidemiology, and End Results tumor registry data linked to Medicare claims. Study outcomes included receipt of recommended stage-specific treatment (surgical resection for early-stage NSCLC and chemotherapy for advanced-stage NSCLC [advNSCLC]) and overall survival. Pulmonologist management was considered present if one or more Evaluation and Management visit claims with pulmonologist specialty were observed within 6 months after NSCLC diagnosis. Stage-specific multivariate logistic regression tested association between pulmonologist management and treatment received. Cox proportional hazard models examined the independent association between pulmonologist care and mortality. Two-stage residual inclusion instrumental variable (2SRI-IV) analyses tested and adjusted for potential confounding based on unobserved factors or measurement error. MEASUREMENTS AND MAIN RESULTS The cohorts included 5,488 patients with early-stage NSCLC and 6,426 patients with advNSCLC disease with preexisting COPD. Pulmonologist management was recorded for 54.9% of patients with early stage NSCLC and 35.7% of patients with advNSCLC. Of those patients with pulmonologist involvement, 58.5% of patients with early NSCLC received surgical resection, and 43.6% of patients with advNSCLC received chemotherapy. Pulmonologist management post NSCLC diagnosis was associated with increased surgical resection rates (odds ratio, 1.26; 95% confidence interval, 1.11-1.45) for early NSCLC and increased chemotherapy rates (odds ratio, 1.88; 95% confidence interval, 1.67-2.10) for advNSCLC. Pulmonologist management was also associated with reduced mortality risk for patients with early-stage NSCLC but not AdvNSCLC. CONCLUSIONS Pulmonologist management had a positive association with rates of stage-specific treatment in both groups and overall survival in early-stage NSCLC. These results provide preliminary support for the recently published guidelines emphasizing the role of pulmonologists in lung cancer management.
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Affiliation(s)
- Janaki A Deepak
- 1 Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
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Mortensen K, Nilsson M, Slim K, Schäfer M, Mariette C, Braga M, Carli F, Demartines N, Griffin SM, Lassen K, Fearon KCF, Ljungqvist O, Lobo DN, Revhaug A. Consensus guidelines for enhanced recovery after gastrectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Br J Surg 2014; 101:1209-29. [PMID: 25047143 DOI: 10.1002/bjs.9582] [Citation(s) in RCA: 460] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 01/20/2014] [Accepted: 05/08/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Application of evidence-based perioperative care protocols reduces complication rates, accelerates recovery and shortens hospital stay. Presently, there are no comprehensive guidelines for perioperative care for gastrectomy. METHODS An international working group within the Enhanced Recovery After Surgery (ERAS®) Society assembled an evidence-based comprehensive framework for optimal perioperative care for patients undergoing gastrectomy. Data were retrieved from standard databases and personal archives. Evidence and recommendations were classified according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system and were discussed until consensus was reached within the group. The quality of evidence was rated 'high', 'moderate', 'low' or 'very low'. Recommendations were graded as 'strong' or 'weak'. RESULTS The available evidence has been summarized and recommendations are given for 25 items, eight of which contain procedure-specific evidence. The quality of evidence varies substantially and further research is needed for many issues to improve the strength of evidence and grade of recommendations. CONCLUSION The present evidence-based framework provides comprehensive advice on optimal perioperative care for the patient undergoing gastrectomy and facilitates multi-institutional prospective cohort registries and adequately powered randomized trials for further research.
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Affiliation(s)
- K Mortensen
- Department of Gastrointestinal and Hepatobiliary Surgery, University Hospital of Northern Norway, Tromsø, Norway
| | | | | | | | | | | | | | | | | | | | | | - K C F Fearon
- Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, UK
| | - O Ljungqvist
- Department of Surgery, Örebro University Hospital, Örebro and Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - D N Lobo
- Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre National Institute for Health Research, Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK
| | - A Revhaug
- Department of Gastrointestinal and Hepatopancreaticobiliary Surgery, University Hospital of Northern Norway, Tromsø, Norway
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Rodriguez-Larrad A, Lascurain-Aguirrebena I, Abecia-Inchaurregui LC, Seco J. Perioperative physiotherapy in patients undergoing lung cancer resection. Interact Cardiovasc Thorac Surg 2014; 19:269-81. [DOI: 10.1093/icvts/ivu126] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Thomas PA, Berbis J, Falcoz PE, Le Pimpec-Barthes F, Bernard A, Jougon J, Porte H, Alifano M, Dahan M, Alauzen M, Andro JF, Aubert M, Avaro JP, Azorin J, Bagan P, Bellenot F, Blin V, Boitet P, Bordigoni L, Borrelly J, Brichon PY, Cardot G, Carrie JM, Clement F, Corbi P, Debaert M, Debrueres B, Dubrez J, Ducrocq X, Dujon A, Dumont P, Fernoux P, Filaire M, Frassinetti E, Frey G, Gossot D, Grosdidier G, Guibert B, Hagry O, Jaillard S, Jarry JM, Kaczmarek D, Laborde Y, Lenot B, Levy F, Lombart L, Marcade E, Marcade JP, Marzelle J, Massard G, Mazeres F, Mensier E, Metois D, Michaud J, Paris E, Mondine P, Monteau M, Moreau JM, Mouroux J, Mugniot A, Mulsant P, Naffaa N, Neveu P, Pavy G, Peillon C, Pons F, Porte H, Regnard JF, Riquet M, Looyeh BS, Thomas P, Tiffet O, Tremblay B, Valla J, Velly JF, Wack B, Wagner JD, Woelffe D. National perioperative outcomes of pulmonary lobectomy for cancer: the influence of nutritional status. Eur J Cardiothorac Surg 2013; 45:652-9; discussion 659. [DOI: 10.1093/ejcts/ezt452] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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