465. relationship between the perioperative nutrition, inflammation and prognosis in resectable esophageal cancer patients, possible significance of nutritional intervention

Abstract Inversed relationship between inflammatory response and nutrition were reported, and preoperative mGPS score has been proposed as a useful prognostic biomarkers in several malignancies. It has been reported that the postoperative inflammatory responses may cause cancer recurrence and metastasis. In the present study, we investigated the treatment strategy from perioperative inflammatory reaction and nutritional status in patients with resectable esophageal cancer. 110 esophageal cancer patients (Squamous cell carcinoma, Stage I / II / III / IV: 44/17/39/20) were evaluated. The preoperative mGPS score was evaluated on a scale of 0 to 2. The cut-off value of albumin, CRP were 3.5g/dl, 0.14mg/dl, respectively. As the postoperative CRP, CRPmax and the area under the CRP curve (CRP (7), CRP (14)) for 7 days and 14 days after the operation, and ROC curve was used to set at optimal cut-off value of these parameters. Outcome was RFS (Recurrence Free Survival) and identified prognostic factors were determined by Cox multivariate analysis. 1, Preoperative albumin value was significantly lower in high CRP (> 0.14mg / dl) (p <0.05)). 2, Preoperative mGPS score 0 was better RFS than in the other groups(p<0.05).3, Univariate analysis showed that mGPS, albumin, and CRP were prognostic factors for RFS, but Cox analysis showed mGPS was not prognostic factor. 4, The cut-off value of CRP (7) and CRP (14) were 59.9, 115.3, respectively. CRP (7) was prognostic factor for RFS in univariate analysis, but Cox analysis showed that only pStage and tumor locations were significant prognostic factors, high CRP (7) was tended to be poor prognostic (p = 0.089). Clinical Stages, tumor locations were most important prognostic factors in resectable esophageal cancer patients. However, preoperative nutritional intervention may improve the prognosis of patients with esophageal cancer if preoperative CRP values can be suppressed. Suppressing the inflammatory reaction one week after surgery may improve the prognosis of patients with esophageal cancer.