The preoperative nutrition assessment of colorectal cancer

doi:10.3877/cma.j.issn.2095-3224.2017.02.012

Abstract

Abstract:

The rate of malnutrition in colorectal cancer is higher than non-gastrointestinal tumor, and perioperative nutrition support can improve preoperative nutritional status of patients effectively.However, the preoperative nutrition assessment is the foundation of reasonable perioperative nutrition intervention, the author systemically reviewed the methods of nutrition assessment.

Key words: Colorectal neoplasms, Assessment, Malnutrition

Zhao Lu, Zhaoxu Zheng. The preoperative nutrition assessment of colorectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2017, 06(02): 139-143.

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References 41

[1]	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015 [J]. CA: A Cancer Journal for Clinicians, 2016, 66(2):115-132.
[2]	Hebuterne X, Lemarie E, Michallet M, et al. Prevalence of Malnutrition and Current Use of Nutrition Support in Patients With Cancer [J]. Journal of Parenteral and Enteral Nutrition, 2014, 38(2):196-204.
[3]	Hu WH, Cajas-Monson LC, Eisenstein S, et al. Preoperative malnutrition assessments as predictors of postoperative mortality and morbidity in colorectal cancer: an analysis of ACS-NSQIP [J]. Nutr J, 2015, 14(1):91.
[4]	Huhmann MB, Cunningham RS. Importance of nutritional screening in treatment of cancer-related weight loss [J]. Lancet Oncol, 2005, 6(5):334-343.
[5]	Bozzetti F, Gianotti L, Braga M, et al. Postoperative complications in gastrointestinal cancer patients: The joint role of the nutritional status and the nutritional support [J]. Clinical Nutrition, 2007, 26(6):698-709.
[6]	Smith RK, Broach RB, Hedrick TL, et al. Impact of BMI on Postoperative Outcomes in Patients Undergoing Proctectomy for Rectal Cancer [J]. Diseases of the Colon & Rectum, 2014, 57(6):687-693.
[7]	Gianotti L, Braga M, Nespoli L, et al. A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer [J]. Gastroenterology, 2002, 122(7):1763-1770.
[8]	Wu GH, Liu ZH, Wu ZH, et al. Perioperative artificial nutrition in malnourished gastrointestinal cancer patients [J]. World J Gastroenterol, 2006, 12(15):2441-2444.
[9]	Chen Y. Nutrition support in surgical patients with colorectal cancer [J]. World Journal of Gastroenterology, 2011, 17(13):1779.
[10]	Kondrup J. ESPEN Guidelines for Nutrition Screening 2002 [J]. Clinical Nutrition, 2003, 22(4):415-421.
[11]	梁晓坤，揭彬，蒋朱明. 营养风险理念解读 [J]. 中国临床营养杂志, 2007, 15(03):167-170.
[12]	Sun Z, Kong X, Jing X, et al. Nutritional Risk Screening 2002 as a Predictor of Postoperative Outcomes in Patients Undergoing Abdominal Surgery: A Systematic Review and Meta-Analysis of Prospective Cohort Studies [J]. PLOS ONE, 2015, 10(7):e132857.
[13]	Grass F, Hubner M, Schafer M, et al. Preoperative nutritional screening by the specialist instead of the nutritional risk score might prevent excess nutrition: a multivariate analysis of nutritional risk factors [J]. Nutr J, 2015, 14(1):37.
[14]	Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation [J]. Nutr Rev, 1996, 54(1 Pt 2):S59-S65.
[15]	Ugolini G. Personalized surgical management of colorectal cancer in elderly population [J]. World Journal of Gastroenterology, 2014, 20(14):3762.
[16]	陈春明.国际生命科学学会中国办事处中国肥胖问题工作组联合数据汇总分析协作组.中国成人体质指数分类的推荐意见简介 [J]. 中华预防医学杂志, 2001, 35(5):349-350.
[17]	Lei Z, Qingyi D, Feng G, et al. Clinical study of mini-nutritional assessment for older Chinese inpatients [J]. J Nutr Health Aging, 2009, 13(10):871-875.
[18]	Detsky AS, Mclaughlin JR, Baker JP, et al. What is subjective global assessment of nutritional status? [J]. JPEN J Parenter Enteral Nutr, 1987, 11(1):8-13.
[19]	Stratton RJ, Hackston A, Longmore D, et al. Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the ′malnutrition universal screening tool′ (′MUST′) for adults [J]. British Journal of Nutrition, 2004, 92(05):799.
[20]	Vugt J LV. Improving the outcomes in oncological colorectal surgery [J]. World Journal of Gastroenterology, 2014, 20(35):12445.
[21]	Liumbruno GM, Bennardello F, Lattanzio A, et al. Recommendations for the use of albumin and immunoglobulins [J]. Blood Transfus, 2009, 7(3):216-234.
[22]	Fulcher DA, Basten A. B cell life span: a review [J]. Immunol Cell Biol, 1997, 75(5):446-455.
[23]	Jamieson AM, Isnard P, Dorfman JR, et al. Turnover and Proliferation of NK Cells in Steady State and Lymphopenic Conditions [J]. The Journal of Immunology, 2004, 172(2):864-870.
[24]	Vrisekoop N, den Braber I, de Boer AB, et al. Sparse production but preferential incorporation of recently produced naive T cells in the human peripheral pool [J]. Proc Natl Acad Sci USA, 2008, 105(16):6115-6120.
[25]	Tokunaga R, Sakamoto Y, Nakagawa S, et al. Prognostic Nutritional Index Predicts Severe Complications, Recurrence, and Poor Prognosis in Patients With Colorectal Cancer Undergoing Primary Tumor Resection [J]. Diseases of the Colon & Rectum, 2015, 58(11):1048-1057.
[26]	Jiang N. Prognostic nutritional index predicts postoperative complications and long-term outcomes of gastric cancer [J]. World Journal of Gastroenterology, 2014, 20(30):10537.
[27]	Feng JF, Chen QX. Significance of the prognostic nutritional index in patients with esophageal squamous cell carcinoma [J]. Ther Clin Risk Manag, 2014, 10:1-7.
[28]	Mohri Y, Inoue Y, Tanaka K, et al. Prognostic Nutritional Index Predicts Postoperative Outcome in Colorectal Cancer [J]. World Journal of Surgery, 2013, 37(11):2688-2692.
[29]	Malietzis G, Aziz O, Bagnall NM, et al. The role of body composition evaluation by computerized tomography in determining colorectal cancer treatment outcomes: A systematic review [J]. European Journal of Surgical Oncology (EJSO), 2015, 41(2):186-196.
[30]	Hunter GR, Snyder SW, Kekes-Szabo T, et al. Intra-abdominal adipose tissue values associated with risk of possessing elevated blood lipids and blood pressure [J]. Obes Res, 1994, 2(6):563-568.
[31]	Oda E. New criteria for ′obesity disease′ in Japan [J]. Circ J, 2006, 70(1):150.
[32]	Prado CM, Lieffers JR, Mccargar LJ, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study [J]. Lancet Oncol, 2008, 9(7):629-635.
[33]	Tsujinaka S, Konishi F, Kawamura YJ, et al. Visceral Obesity Predicts Surgical Outcomes after Laparoscopic Colectomy for Sigmoid Colon Cancer [J]. Diseases of the Colon & Rectum, 2008, 51(12):1757-1767.
[34]	Ballian N, Lubner MG, Munoz A, et al. Visceral obesity is associated with outcomes of total mesorectal excision for rectal adenocarcinoma [J]. Journal of Surgical Oncology, 2012, 105(4):365-370.
[35]	Watanabe J, Tatsumi K, Ota M, et al. The impact of visceral obesity on surgical outcomes of laparoscopic surgery for colon cancer [J]. International Journal of Colorectal Disease, 2014, 29(3):343-351.
[36]	Peng PD, van Vledder MG, Tsai S, et al. Sarcopenia negatively impacts short-term outcomes in patients undergoing hepatic resection for colorectal liver metastasis [J]. HPB, 2011, 13(7):439-446.
[37]	Lieffers JR, Bathe OF, Fassbender K, et al. Sarcopenia is associated with postoperative infection and delayed recovery from colorectal cancer resection surgery [J]. Br J Cancer, 2012, 107(6):931-936.
[38]	Reisinger KW, van Vugt J LA, Tegels JJ W, et al. Functional Compromise Reflected by Sarcopenia, Frailty, and Nutritional Depletion Predicts Adverse Postoperative Outcome After Colorectal Cancer Surgery [J]. Annals of Surgery, 2015, 261(2):345-352.
[39]	Mourtzakis M, Prado C MM, Lieffers JR, et al. A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care [J]. Applied Physiology, Nutrition, and Metabolism, 2008, 33(5):997-1006.
[40]	Kuipers EJ, Grady WM, Lieberman D, et al. Colorectal cancer [J]. Nature Reviews Disease Primers, 2015, 1:15065.
[41]	顾晋，杜长征. 结肠癌术后复发的研究进展 [J]. 中华消化外科杂志, 2008, 7(3):167-169.

初步筛查	是	否
BMI<20.5 kg/m²（国内<18.5 kg/m²）	?	?
最近3个月内有无体重减轻	?	?
最近1周内有无膳食摄入量减少	?	?
病人病情是否严重（如ICU，大手术后等）	?	?

初步筛查	是	否
BMI<20.5 kg/m²（国内<18.5 kg/m²）	?	?
最近3个月内有无体重减轻	?	?
最近1周内有无膳食摄入量减少	?	?
病人病情是否严重（如ICU，大手术后等）	?	?

?	营养状况	疾病严重程度
0分	营养状况正常	正常营养需求
1分	3个月内体重丢失>5% 或近一周摄食量比正常需要量减少25~50%	慢性疾病急性加重、慢性疾病发生骨折、肿瘤、糖尿病、肝硬化、血液透析者、COPD
2分	2个月内体重丢失>5% 或BMI 18.5~20.5 kg/m²，加上受损的基本营养状况或近一周摄食量比正常需要量减少50~75%	比较大的腹部手术、中风、严重肺炎、恶性血液肿瘤
3分	1个月内体重丢失>5%（或3个月内体重下降15%）或BMI<18.5 kg/m²，加上受损的基本营养状况或近一周摄食量比正常需要量减少75~100%	脑损伤、骨髓移植、ICU病人（APACHE>10）
总分=营养状况评分＋疾病严重程度评分＋年龄评分（年龄等于或大于70岁加1分）

?	营养状况	疾病严重程度
0分	营养状况正常	正常营养需求
1分	3个月内体重丢失>5% 或近一周摄食量比正常需要量减少25~50%	慢性疾病急性加重、慢性疾病发生骨折、肿瘤、糖尿病、肝硬化、血液透析者、COPD
2分	2个月内体重丢失>5% 或BMI 18.5~20.5 kg/m²，加上受损的基本营养状况或近一周摄食量比正常需要量减少50~75%	比较大的腹部手术、中风、严重肺炎、恶性血液肿瘤
3分	1个月内体重丢失>5%（或3个月内体重下降15%）或BMI<18.5 kg/m²，加上受损的基本营养状况或近一周摄食量比正常需要量减少75~100%	脑损伤、骨髓移植、ICU病人（APACHE>10）
总分=营养状况评分＋疾病严重程度评分＋年龄评分（年龄等于或大于70岁加1分）

指标	A级	B级	C级
近期体重变化（2周）	无/升高	减少<5%	减少>5%
饮食改变	无	减少	不进食/低热量流食
胃肠道症状（持续2周）	无/食欲不减	轻微恶心、呕吐	严重恶心、呕吐
活动能力改变	无/减退	能下床走动	卧床
应激反应	无/低度	中度	高度
肌肉消耗	无	轻度	重度
三头肌皮褶厚度	正常	轻度减少	重度减少
踝部水肿	无	轻度	重度

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