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Ishak NS, Abdul Rahman H, Lee SHF, Lu SK, Naing L. Incidence, Survival and Prognostic Factors of Oesophagogastric Cancer. J Gastrointest Cancer 2021; 53:130-143. [PMID: 33392958 DOI: 10.1007/s12029-020-00559-w] [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] [Accepted: 11/25/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Oesophagogastric cancer is one of the leading causes of cancer death worldwide due to its aggressive nature. Despite the high mortality rate, there is limited information regarding this cancer in Brunei. AIM To estimate the incidence and survival duration of oesophagogastric cancer patients, to identify prognostic factors of oesophagogastric cancer and associated factors for late-stage oesophagogastric cancer detection. METHODS A retrospective study on all oesophagogastric cancer patients registered in the population-based national cancer registry in Brunei from January 2010 to December 2018. Kaplan-Meier and Cox proportional hazard regression survival analyses and multiple logistic regression were applied. RESULTS Sixty-eight oesophagogastric cancer patients' data were retrieved from the registry. The incidence was 2.75 cases per 100,000 adults per year. Median survival time was 1.18 years (95% CI: 0.77, 1.80) and the 3-year survival rate was 26.3%. Age (61-70 years) (adjusted HR = 0.38; 95% CI: 0.17, 0.89; p = 0.025) and those who have undergone chemotherapy (adj. HR = 0.40; 95% CI: 0.18, 0.90; p = 0.026) have a significantly lower mortality risk. Obesity (adj. HR = 11.94; 95% CI: 1.94, 73.36; p = 0.007), and stage 4 (advanced stage) cancer (adj. HR=4.11; 95% CI: 1.97, 8.58; p< 0.001) have a significantly higher mortality risk. Females have 3-time odds (adj. OR = 3.05; 95% CI: 1.09, 9.02; p = 0.038) of presenting with stage 4 cancer. Smokers have 13-time odds (Adj. OR=12.99; 95% CI: 1.92, 262.0; p = 0.025) of presenting with stage 4 cancer. CONCLUSION Prognosis of oesophagogastric cancer remains poor. Addressing late detection and improve endoscopic surveillance and awareness of symptoms may help improve prognosis and mortality.
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Affiliation(s)
- Nurul Syuhada Ishak
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, BE1410, Brunei Darussalam
| | - Hanif Abdul Rahman
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, BE1410, Brunei Darussalam.
| | - Shirley H F Lee
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, BE1410, Brunei Darussalam
| | - Shir Kiong Lu
- The Brunei Cancer Centre, Pantai Jerudong Specialist Centre, Bandar Seri Begawan, Brunei
| | - Lin Naing
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, BE1410, Brunei Darussalam
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Cheng Y, Liu J, Liao Q, Hu X, Lv H, Ding P, Nie S, Tan L. Population-Based Incidence, Mortality, And Survival For Gastrointestinal Cancers During 2006-2016 In Wuhan, Central China. Cancer Manag Res 2019; 11:9233-9241. [PMID: 31754312 PMCID: PMC6825471 DOI: 10.2147/cmar.s209925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 09/28/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Incidence and mortality rates of malignant tumors in China are higher than global averages, especially for gastrointestinal (GI) cancers. To advance understanding of the epidemiology of GI cancers and to seek clues for cancer control, this study compared the incidence, mortality, and survival for GI cancers among residents of Wuhan (central China) and Chinese Americans. METHODS A population-based study of cancer epidemiology was carried out on Wuhan residents and Chinese Americans. Data were collected from the Cancer Registry of Jiang'an District in Wuhan and the Surveillance, Epidemiology, and End Results (SEER) program. Joinpoint regression analyses were used to examine trends in the incidence and mortality of GI cancers in Wuhan. Furthermore, we estimated age-specific rates of incidence and mortality and survival rates of GI cancers in both populations. RESULTS Among male GI cancer patients, mortality rates exhibited a significant increasing trend during 2006-2016 in Wuhan, with an annual percentage change (APC) of 7.4% (95% CI 1.7%-13.3%). Among female patients, the incidence of GI cancers showed a declining trend (APC -2.3%, 95% CI -3.4% to -1.3%) during 2006-2013, then escalated with an APC of 6.2% (95% CI 2.3%-10.2%) during 2013-2016. Both male and female patients with esophageal cancer in Wuhan experienced better survival than Chinese Americans. However, survival rates for the other three GI cancers in Wuhan were relatively lower than Chinese Americans. CONCLUSION Escalating trends were observed in incidence among women and mortality among men with GI cancers. In addition, the survival rates of GI cancer patients in Wuhan were lower than Chinese Americans. As such, additional efforts are needed to control GI cancers in Wuhan, central China.
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Affiliation(s)
- Yao Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Jianhua Liu
- Department of Infectious Diseases Prevention and Control, Yichang Centers for Diseases Prevention and Control, Yichang, People’s Republic of China
| | - Qing Liao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Xuejiao Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Hongyan Lv
- Department of Chronic Disease Prevention and Control, Jiang’an District Centers for Disease Preventive and Control, Wuhan, People’s Republic of China
| | - Peiyan Ding
- Department of Chronic Disease Prevention and Control, Jiang’an District Centers for Disease Preventive and Control, Wuhan, People’s Republic of China
| | - Shaofa Nie
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Li Tan
- Department of Hospital Infection Management, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
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Papaconstantinou D, Tsilimigras DI, Moris D, Michalinos A, Mastoraki A, Mpaili E, Hasemaki N, Bakopoulos A, Filippou D, Schizas D. Synchronous resection of esophageal cancer and other organ malignancies: A systematic review. World J Gastroenterol 2019; 25:3438-3449. [PMID: 31341367 PMCID: PMC6639548 DOI: 10.3748/wjg.v25.i26.3438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/01/2019] [Accepted: 06/01/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neoplasms arising in the esophagus may coexist with other solid organ or gastrointestinal tract neoplasms in 6% to 15% of patients. Resection of both tumors synchronously or in a staged procedure provides the best chances for long-term survival. Synchronous resection of both esophageal and second primary malignancy may be feasible in a subset of patients; however, literature on this topic remains rather scarce.
AIM To analyze the operative techniques employed in esophageal resections combined with gastric, pancreatic, lung, colorectal, kidney and liver resections and define postoperative outcomes in each case.
METHODS We conducted a systematic review according to PRISMA guidelines. We searched the Medline database for cases of patients with esophageal tumors coexisting with a second primary tumor located in another organ that underwent synchronous resection of both neoplasms. All English language articles deemed eligible for inclusion were accessed in full text. Exclusion criteria included: (1) Hematological malignancies; (2) Head/neck/pharyngeal neoplasms; (3) Second primary neoplasms in the esophagus or the gastroesophageal junction; (4) Second primary neoplasms not surgically excised; and (5) Preclinical studies. Data regarding the operative strategy employed, perioperative outcomes and long-term outcomes were extracted and analyzed using descriptive statistics.
RESULTS The systematic literature search yielded 23 eligible studies incorporating a total of 117 patients. Of these patients, 71% had a second primary neoplasm in the stomach. Those who underwent total gastrectomy had a reconstruction using either a colonic (n = 23) or a jejunal (n = 3) conduit while for those who underwent gastric preserving resections (i.e., non-anatomic/wedge/distal gastrectomies) a conventional gastric pull-up was employed. Likewise, in cases of patients who underwent esophagectomy combined with pancreaticoduodenectomy (15% of the cohort), the decision to preserve part of the stomach or not dictated the reconstruction method (whether by a gastric pull-up or a colonic/jejunal limb). For the remaining patients with coexisting lung/colorectal/kidney/liver neoplasms (14% of the entire patient population) the types of resections and operative techniques employed were identical to those used when treating each malignancy separately.
CONCLUSION Despite the poor quality of available evidence and the great interstudy heterogeneity, combined procedures may be feasible with acceptable safety and satisfactory oncologic outcomes on individual basis.
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Affiliation(s)
- Dimitrios Papaconstantinou
- Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens 12462, Greece
| | - Diamantis I Tsilimigras
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH 43210, United States
| | - Dimitrios Moris
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, United States
| | | | - Aikaterini Mastoraki
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens 11527, Greece
| | - Efstratia Mpaili
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens 11527, Greece
| | - Natasha Hasemaki
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens 11527, Greece
| | - Anargyros Bakopoulos
- Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens 12462, Greece
| | - Dimitrios Filippou
- Department of Anatomy and Surgical Anatomy, National and Kapodistrian University of Athens, Medical School, Athens 11527, Greece
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens 11527, Greece
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Paudel N, Helenowski I, Kane L, Sachdev S, Bloch O, Tate M, Chandler JP, Kruser TJ. Stereotactic radiosurgery for the treatment of brain metastasis from gastrointestinal primary cancers. JOURNAL OF RADIOSURGERY AND SBRT 2019; 6:27-34. [PMID: 30775072 PMCID: PMC6355451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/04/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE We aimed to determine the efficacy of gamma knife stereotactic radiosurgery (SRS) to control brain metastases (BM) from GI primaries and report on the patient outcomes. MATERIALS/METHODS We retrospectively evaluated patients who had undergone SRS at our institution for the treatment BM from GI primaries from 2000 to 2016. Actuarial rates for overall survival (OS) and local control (LC) were calculated. Survival rates were computed via the Kaplan-Meier method from the day of SRS. Multivariate analysis (MVA) using proportional hazards regression was done to determine prognostic factors for OS and LC. RESULTS 53 patients with a total of 148 BM were treated with SRS. The median age at SRS was 60 years and the median treatment dose was 18 Gy. SRS was given as an adjuvant treatment to 30.4% of lesions. Twelve patients underwent second course of SRS for new/recurrent lesions at a median of 8 months from the first SRS (range 2-25.5). Twelve patients (22.6%) received salvage whole brain radiation. The median follow up time from the diagnosis of BM was 6 months. Local control rate at 6 months was 74.33% and 57.21% at 12 months. The OS at 1 year was 34% and 8% at 3 years. On MVA, higher GK dose was associated with better LC, and and >10 BM trended towards higher risk of local recurrence (LR). None of the tested factors proved to be significant for OS on MVA. No radiographic radionecrosis was observed on follow up MRI. CONCLUSIONS SRS is a safe treatment modality for the management of CNS metastases from GI primary. Consideration for dose-escalated approaches may improve LC rates.
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Affiliation(s)
- Nitika Paudel
- Department of Radiation Oncology, 251 E. Huron St. Galter Pavilion, Chicago, IL 60611, USA
| | - Irene Helenowski
- Department of Biostatistics, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA
| | - Liam Kane
- Northwestern University Feinberg School of Medicine, 420 East Superior Street, Chicago, IL 60611, USA
| | - Sean Sachdev
- Department of Radiation Oncology, 251 E. Huron St. Galter Pavilion, Chicago, IL 60611, USA
| | - Orin Bloch
- Department of Neurosurgery, 676 N. St. Clair Street Suite 2210, Chicago, IL 60611, USA
| | - Matthew Tate
- Department of Neurosurgery, 676 N. St. Clair Street Suite 2210, Chicago, IL 60611, USA
| | - James P. Chandler
- Department of Neurosurgery, 676 N. St. Clair Street Suite 2210, Chicago, IL 60611, USA
| | - Tim J Kruser
- Department of Radiation Oncology, 251 E. Huron St. Galter Pavilion, Chicago, IL 60611, USA
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Shao Y, Hua Z, Zhao L, Shen Y, Guo X, Niu C, Wei W, Liu F. Time Trends of Gastrointestinal Cancers Incidence and Mortality in Yangzhong From 1991 to 2015: An Updated Age-Period-Cohort Analysis. Front Oncol 2018; 8:638. [PMID: 30619771 PMCID: PMC6306425 DOI: 10.3389/fonc.2018.00638] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 12/06/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Gastrointestinal (GI) cancers are the common cause of morbidity and mortality in China which seriously threaten people's health and lives. The aim of this study was to describe the temporal trend in the epidemiology of GI cancers from 1991 to 2015, with an emphasis on the effects of age, period and cohort in Yangzhong City, Jiangsu province, a high-risk area of GI cancers in China. Methods: Our study extracted cases of gastric cancer, esophageal cancer and colorectal cancer diagnosed from 1991 to 2015 from Yangzhong Cancer Registry. Age-standardized rates (ASRs) were calculated and joinpoint regression was used to compute the estimated annual percent changes. Age-period-cohort (APC) model was performed to investigate the independent effects of age, calendar period, and birth cohort. Results: Between 1991 and 2015, 18,006 new cases and 10,262 deaths were registered with GI cancers in Yangzhong. The age-standardized incidence rates (ASIRs) of gastric cancer decreased in both sexes during the study period. And the incidence rates of esophageal cancer stabilized at first then continued to decline, the turning point was in 2005 for men and 2001 for women. Changes in the mortality rates of gastric cancer and esophageal cancer showed significant declined trends around 2000-2010 in both genders. The incidence rates of colorectal cancer increased steadily during the entire study period, and the increase was more pronounced in the mortality rates of men. The results of APC analysis suggest that general decreases in incidence and mortality of esophageal cancer and gastric cancer might be caused by the downward trend of the period and cohort effects, while the increases in colorectal cancer might be caused by the uptrend of the period effects. Conclusions: The incidence and mortality rates of esophageal and gastric cancers showed a downward trend and colorectal cancer was on the rise as a whole in Yangzhong City. The different burden of gastrointestinal cancer indicating heterogeneous risk factors exist and may have contributed to these temporal variations.
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Affiliation(s)
- Yi Shao
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Zhaolai Hua
- Department of Epidemiology, Yangzhong Cancer Research Institute, Yangzhong, China
| | - Lei Zhao
- Department of Molecular Physiology and Biophysics, Holden Comprehensive Cancer Center, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Yi Shen
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xudong Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Chen Niu
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Wenqiang Wei
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Fen Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
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Casamayor M, Morlock R, Maeda H, Ajani J. Targeted literature review of the global burden of gastric cancer. Ecancermedicalscience 2018; 12:883. [PMID: 30679950 PMCID: PMC6345079 DOI: 10.3332/ecancer.2018.883] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Indexed: 12/12/2022] Open
Abstract
Gastric cancer (GC) and gastroesophageal junction cancers (GEJCs) are the third leading cause of cancer-related death worldwide. Although several studies have evaluated the epidemiology and management of GC and GEJC, to our knowledge, no global estimates of the economic burden of GC and GEJC have yet been reported. This targeted literature review was conducted to summarise the epidemiology and management of GC and GEJC and to estimate its global economic and humanistic burden. The incidence of GC and GEJC is highest in Eastern Asia, several South and Central American countries and Central and Eastern Europe and lowest in North America and Africa. Prognosis is generally poor; the global 5-year survival rate is 5%-10% in advanced stages. Patients with GC and GEJC have more severe symptoms compared with patients with other cancers, and health-related quality of life (HRQoL) worsens as the disease progresses. Given the rapid progression of GC and GEJC at advanced stages, chemotherapy, despite its toxicity, improves HRQoL compared with best supportive care. The costs of GC/GEJC are generally higher than for other cancers; in the US, the average annual cost per patient between 1998 and 2003 was 46,501 USD, compared with 29,609 USD and 35,672 USD for colorectal and lung cancer, respectively. Based on the 2012 incidence data and average costs per patient, estimates of the annual financial burden of GC and GEJC revealed great regional differences. Japan and Iran had the highest (8,492 million USD) and lowest (27 million USD) costs for 2017, respectively, while the estimate for the US was 3,171 million USD. The overall annual cost of GC and GEJC estimated for 2017 in a geographic area including Europe (France, Germany, Italy, Spain and the UK), Asia (Iran, Japan and China), North America (Canada and the US) and Australia was 20.6 billion USD.
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Affiliation(s)
| | - Robert Morlock
- Astellas Pharma Global Development, Inc., 1 Astellas Way, Northbrook, IL 60062 USA
| | - Hiroshi Maeda
- Astellas Pharma Global Development, Inc., 1 Astellas Way, Northbrook, IL 60062 USA
| | - Jaffer Ajani
- University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 USA
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Yang G, Du W, Zhang X, Huang T, Zhang J, Liu J, Ling Y. The white substance may be a potential endoscopic marker for flat esophageal mucosal neoplastic lesions: A new endoscopic observation. Medicine (Baltimore) 2018; 97:e11885. [PMID: 30170379 PMCID: PMC6392511 DOI: 10.1097/md.0000000000011885] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To determine whether the white substance can act as an endoscopic marker for flat esophageal mucosal neoplastic lesions.Esophageal mucosal neoplastic lesions are mainly identified using white light endoscopy, because it is cost-effective; however, this method is limited for detecting early esophageal cancer and precancerous lesions, because these are typically flat mucosal neoplastic lesions. In our experience, a white substance surrounds or covers some flat esophageal mucosal lesions that are eventually diagnosed as neoplastic lesions by biopsy pathology.After retrospective analysis of pathological and clinical data of 20,390 patients, we identified 352 patients with flat esophageal mucosal lesions on endoscopic images. Images were re-evaluated by 2 experienced endoscopists and the prevalence of the white substance recorded. Patients were divided into non-neoplastic and neoplastic groups, based on pathology.The white substance was present in 3.5% (5/144) of non-neoplastic and 14.9% (31/208) of neoplastic cases (P < .05). The diagnostic sensitivity and specificity of the white substance for neoplastic lesions diagnosis were 14.9% and 96.5%, respectively. The presence of white substance was more common in males and in those aged 50 to 79 years. It was more commonly observed in the middle third of the esophagus, and its presence did not correlate with sex, age, or lesion location (P > .05).The white substance, which is easily detected by white light endoscopy, may be an endoscopic marker facilitating detection of flat esophageal mucosal neoplastic lesions, irrespective of sex, age, and lesion location.
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Impact Exerted by Nutritional Risk Screening on Clinical Outcome of Patients with Esophageal Cancer. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7894084. [PMID: 29780831 PMCID: PMC5892299 DOI: 10.1155/2018/7894084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/21/2018] [Indexed: 01/26/2023]
Abstract
Objective Preoperative nutritional status of patients is closely associated with their recovery after the surgery. This study aims to ascertain the impact exerted by the nutritional risk screening on clinical outcome of patients with esophageal cancer. Methods 160 patients with esophageal cancer aged over 60, having got therapy at the First Hospital of Jilin University from Jun 2016 to Feb 2017 were evaluated by adopting the NRS2002. 80 cases of patients got active therapy of nutritional support, and the other patients not supported nutritionally were selected as the control group. The comparison was drawn between two groups in serum albumin, serum immunoglobulin, postoperative complications, hospitalization, and hospitalization expenses. Results For all the patients, in 3 and 7 days after the surgery, the serum albumin in the nutritionally supported group outstripped that in group without nutritional support (P < 0.05) regardless of the nutritional risk. For the patients in the risk of nutrition, the IgA in the nutritionally supported group outstripped that of group without nutritional support (P < 0.05) in 3 and 7 days before the surgery, and the serum IgG outstripped that of the group without nutritional support in 1 and 3 days before the surgery (P < 0.05). In terms of the patients in the risk of nutrition, the average hospitalization of nutritionally supported group was shorter (P < 0.05), and the average hospitalization expenses were lower compared with those of the group without nutritional support. And for the patients in no risk, the hospitalization expenses of supported group surmounted those of group without nutritional support (P < 0.05), whereas the average hospitalization took on no statistic difference (P > 0.05). Conclusion For the patients in the risk of nutrition, preoperative nutritional support can facilitate the nutritional status and immunization-relative result after surgery, which shall also decrease the average hospitalization and hospitalization cost.
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