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Iván Macía



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    P2.17 - Treatment of Early Stage/Localized Disease (ID 189)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Treatment of Early Stage/Localized Disease
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.17-10 - Effects of the Omega-6/Omega-3 Ratio on Postoperative Complications After Lung Resection: Preliminary Results (ID 1862)

      10:15 - 18:15  |  Author(s): Iván Macía

      • Abstract
      • Slides

      Background

      In the last 3 decades, the intake of omega-6 (n-6) fatty acids has increased while the intake of omega-3 (n-3) has decreased, leading to an increase in the n-6/n-3 ratio, which is now 20:1. This ratio has been postulated as an inflammatory marker of carcinogenesis, implicated in the development of multiple chronic diseases, and associated with postoperative complications due to the proinflammatory effects of omega 6. Consequently, the preoperative assessment of nutritional markers, together with immunonutrition, represent a promising target to improve outcomes in patients with lung cancer who are candidates for surgical resection. The aim of this study was to assess the effect of the n-6/n-3 ratio on postoperative complications in patients undergoing radical-intent surgery for lung cancer.

      Method

      Prospective cohort study of 38 patients diagnosed with lung cancer treated with radical surgery between October 2017 and May 2018. The n-6/n-3 ratio was determined immediately prior to surgery with the patient under anesthesia.

      Result

      Of the 38 surgically-treated patients, 29 were men (76%) and 9 women (24%). Mean patient age was 62 ±10 years. Twelve (32%) patients were active smokers at the time of surgery. The most common histological subtype was adenocarcinoma (60%) and most patients underwent lobectomy (68%). The mean body mass index (BMI) was 27 ±5 and the mean preoperative prognostic nutritional index (PNI) score was 48±7. The mean n-6/n-3 ratio was 20 ±6. The most common complications were prolonged air leak (> 5 days) in 11 patients (29%) and respiratory failure in 6 patients (16%). Patients with prolonged air leak had a significantly higher n-6/n-3 ratio than patients without prolonged air leak (25 ±3 vs. 18 ±6, respectively; p=0.02). Patients with an n-6/n-3 ratio > 20 were significantly more likely (p=0.002) to present prolonged air leak. Neither BMI nor PNI were significant predictors of air leak duration.

      Conclusion

      These preliminary findings indicate that patients with a higher n-6/n-3 ratio—that is, those with a greater proinflammatory status—were more likely to present prolonged air leak than those with a lower inflammatory status. Based on these encouraging results, we propose to continue with this line of research to better understand the effects and prognostic value of immunonutritional status on the clinical course of patients after lung cancer surgery.

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