食管癌新辅助放化疗后标准和延长手术时间的营养结局和营养不良的影响的随机比较

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2025-06-11 DOI:10.1016/j.ejso.2025.110228

Jessica Ericson , Fredrik Klevebro , Berit Sunde , Eva Szabo , Ingvar Halldestam , Ulrika Smedh , Bengt Wallner , Jan Johansson , Gjermund Johnsen , Eirik Kjus Aahlin , Hans-Olaf Johannessen , Geir-Olav Hjortland , Sissi Stove Lorentzen , Malene Slott , Wolfgang Schröder , Ioannis Rouvelas , Magnus Nilsson

{"title":"食管癌新辅助放化疗后标准和延长手术时间的营养结局和营养不良的影响的随机比较","authors":"Jessica Ericson , Fredrik Klevebro , Berit Sunde , Eva Szabo , Ingvar Halldestam , Ulrika Smedh , Bengt Wallner , Jan Johansson , Gjermund Johnsen , Eirik Kjus Aahlin , Hans-Olaf Johannessen , Geir-Olav Hjortland , Sissi Stove Lorentzen , Malene Slott , Wolfgang Schröder , Ioannis Rouvelas , Magnus Nilsson","doi":"10.1016/j.ejso.2025.110228","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Prolonged time to surgery (TTS) after neoadjuvant chemoradiotherapy (nCRT) may enable malnourished oesophageal cancer patients' nutritional status to recover better, possibly improving outcomes with fewer complications and better overall survival (OS) after oesophagectomy.</div></div><div><h3>Methods</h3><div>This is a substudy within a multicentre randomised controlled trial comparing outcomes in patients with oesophageal cancer after standard TTS of 4–6 weeks to prolonged TTS of 10–12 weeks after nCRT. Patients were categorised as malnourished or non-malnourished at baseline and compared regarding weight, dysphagia, postoperative complications, and OS.</div></div><div><h3>Results</h3><div>The mean weight from baseline to time of surgery decreased significantly in patients allocated to standard TTS (p < 0.001) while patients with prolonged TTS recovered during the extended time to similar weight as at baseline (p = 0.131). The mean dysphagia score at the time of surgery improved significantly in both groups (p < 0.001). There were no significant differences between patients allocated to standard versus prolonged TTS regarding postoperative complications, regardless of malnourishment status at baseline. No significant differences in OS after prolonged TTS compared to standard TTS, was observed in neither malnourished patients (hazard ratio, HR 1.72 (95 %, CI: 0.82–3.59, p = 0.147) nor non-malnourished patients (HR 1.26 (95 % CI:0.82–1.94, p = 0.291).</div></div><div><h3>Conclusions</h3><div>Prolonged TTS was associated with better weight recovery at the time of surgery compared to standard TTS. Patients malnourished at baseline did not benefit in terms of less postoperative complications after prolonged TTS.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110228"},"PeriodicalIF":3.5000,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Nutritional outcomes and impact of malnutrition in a randomised comparison between standard and prolonged time to surgery after neoadjuvant chemoradiotherapy for oesophageal cancer\",\"authors\":\"Jessica Ericson , Fredrik Klevebro , Berit Sunde , Eva Szabo , Ingvar Halldestam , Ulrika Smedh , Bengt Wallner , Jan Johansson , Gjermund Johnsen , Eirik Kjus Aahlin , Hans-Olaf Johannessen , Geir-Olav Hjortland , Sissi Stove Lorentzen , Malene Slott , Wolfgang Schröder , Ioannis Rouvelas , Magnus Nilsson\",\"doi\":\"10.1016/j.ejso.2025.110228\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Prolonged time to surgery (TTS) after neoadjuvant chemoradiotherapy (nCRT) may enable malnourished oesophageal cancer patients' nutritional status to recover better, possibly improving outcomes with fewer complications and better overall survival (OS) after oesophagectomy.</div></div><div><h3>Methods</h3><div>This is a substudy within a multicentre randomised controlled trial comparing outcomes in patients with oesophageal cancer after standard TTS of 4–6 weeks to prolonged TTS of 10–12 weeks after nCRT. Patients were categorised as malnourished or non-malnourished at baseline and compared regarding weight, dysphagia, postoperative complications, and OS.</div></div><div><h3>Results</h3><div>The mean weight from baseline to time of surgery decreased significantly in patients allocated to standard TTS (p < 0.001) while patients with prolonged TTS recovered during the extended time to similar weight as at baseline (p = 0.131). The mean dysphagia score at the time of surgery improved significantly in both groups (p < 0.001). There were no significant differences between patients allocated to standard versus prolonged TTS regarding postoperative complications, regardless of malnourishment status at baseline. No significant differences in OS after prolonged TTS compared to standard TTS, was observed in neither malnourished patients (hazard ratio, HR 1.72 (95 %, CI: 0.82–3.59, p = 0.147) nor non-malnourished patients (HR 1.26 (95 % CI:0.82–1.94, p = 0.291).</div></div><div><h3>Conclusions</h3><div>Prolonged TTS was associated with better weight recovery at the time of surgery compared to standard TTS. Patients malnourished at baseline did not benefit in terms of less postoperative complications after prolonged TTS.</div></div>\",\"PeriodicalId\":11522,\"journal\":{\"name\":\"Ejso\",\"volume\":\"51 9\",\"pages\":\"Article 110228\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-06-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ejso\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0748798325006560\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ejso","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0748798325006560","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

新辅助放化疗（nCRT）后延长手术时间（TTS）可能使营养不良食管癌患者的营养状况恢复得更好，可能改善预后，减少并发症，提高食管癌切除术后的总生存期（OS）。方法：这是一项多中心随机对照试验的亚研究，比较食管癌患者接受4-6周标准TTS和接受nCRT后延长TTS 10-12周的结果。在基线时将患者分为营养不良或非营养不良，并比较体重、吞咽困难、术后并发症和生存期。结果标准TTS组患者从基线到手术时间的平均体重显著下降(p <；0.001)，而延长TTS患者在延长的时间内恢复到与基线相似的体重（p = 0.131）。两组患者手术时的平均吞咽困难评分均显著改善(p <；0.001)。无论基线时营养不良状况如何，标准TTS组与延长TTS组在术后并发症方面无显著差异。与标准TTS相比，营养不良患者(风险比，HR 1.72 （95%, CI: 0.82-3.59, p = 0.147）和非营养不良患者(风险比，HR 1.26 （95% CI: 0.82-1.94, p = 0.291）延长TTS后的OS均无显著差异。结论与标准TTS相比，延长TTS与手术时更好的体重恢复有关。在延长TTS后，基线营养不良的患者在减少术后并发症方面并没有获益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Nutritional outcomes and impact of malnutrition in a randomised comparison between standard and prolonged time to surgery after neoadjuvant chemoradiotherapy for oesophageal cancer

Background

Prolonged time to surgery (TTS) after neoadjuvant chemoradiotherapy (nCRT) may enable malnourished oesophageal cancer patients' nutritional status to recover better, possibly improving outcomes with fewer complications and better overall survival (OS) after oesophagectomy.

Methods

This is a substudy within a multicentre randomised controlled trial comparing outcomes in patients with oesophageal cancer after standard TTS of 4–6 weeks to prolonged TTS of 10–12 weeks after nCRT. Patients were categorised as malnourished or non-malnourished at baseline and compared regarding weight, dysphagia, postoperative complications, and OS.

Results

The mean weight from baseline to time of surgery decreased significantly in patients allocated to standard TTS (p < 0.001) while patients with prolonged TTS recovered during the extended time to similar weight as at baseline (p = 0.131). The mean dysphagia score at the time of surgery improved significantly in both groups (p < 0.001). There were no significant differences between patients allocated to standard versus prolonged TTS regarding postoperative complications, regardless of malnourishment status at baseline. No significant differences in OS after prolonged TTS compared to standard TTS, was observed in neither malnourished patients (hazard ratio, HR 1.72 (95 %, CI: 0.82–3.59, p = 0.147) nor non-malnourished patients (HR 1.26 (95 % CI:0.82–1.94, p = 0.291).

Conclusions

Prolonged TTS was associated with better weight recovery at the time of surgery compared to standard TTS. Patients malnourished at baseline did not benefit in terms of less postoperative complications after prolonged TTS.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.