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Isamu Watanabe



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    P3.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 981)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.15-28 - Prognostic Nutritional Index for Predicting Postoperative Complications After Surgery Thoracic Tumor Involving the Neighboring Structures (ID 13845)

      12:00 - 13:30  |  Presenting Author(s): Isamu Watanabe

      • Abstract
      • Slides

      Background

      The prognostic nutritional index (PNI), which is scored based on laboratory data of albumin and lymphocyte count, predicts postoperative complications in various types of malignancies. This study aimed to assess the risk factors of postoperative complications, especially the preoperative immune nutritional condition as estimated with the PNI, after surgical treatment of patients for thoracic tumor involving the neighboring structures.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      From July 2008 to December 2015, 159 patients with resected thoracic tumor involving the neighboring structures were retrospectively analyzed and the relationship between the preoperative PNI and postoperative complications was evaluated. There were 119 men and 40 women with a median age of 61 years (range 21–88 years). Invading neighboring structures, including chest wall, superior sulcus, diaphragm, tracheal carina, left atrium, superior vena cava, aorta, and vertebrae were performed when possible in patients with locally advanced disease.

      4c3880bb027f159e801041b1021e88e8 Result

      Multivariate logistic regression analysis revealed that a preoperative PNI was a significant independent predictor of postoperative complications of Clavien-Dindo Grade ≥Ⅱ (odds ratio:3.87, p=0.0489). Using receiver-operating characteristics curve analysis predicting postoperative complications, we established cutoff values 46 (Area Under the Curve; 0.61) for the PNI. Patients were divided into two groups according to the preoperative PNI: high (≥46; n=95 (59.7%)), low (<46, n=64 (40.3%)). The incidence of postoperative complications of Grade ≥ Ⅱ and Grade ≥Ⅲ was higher in the low PNI groups than in the high PNI groups (p=0.019 and p=0.009, respectively). The incidence of pneumonia and the length of postoperative hospital stay were significantly higher in the low PNI groups than in the high PNI groups. However, the 30 day mortality (1.88%) and 90 day mortality (4.40%) were not correlation with PNI.

      8eea62084ca7e541d918e823422bd82e Conclusion

      The preoperative PNI might be a useful marker to predict the risk of postoperative complications after surgery for thoracic tumor involving the neighboring structures. We have to intensive attention to the low PNI patients in the perioperative management.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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