Association of dental occlusal support with the Prognostic Nutritional Index in patients with esophageal cancer who underwent esophagectomy

Abstract

Background

The Prognostic Nutritional Index is useful for predicting surgical risk and overall survival based on preoperative immunological and nutritional status in patients undergoing digestive organ cancer surgery. The purpose of this study was to examine the association between the Prognostic Nutritional Index and dental status in patients with esophageal cancer who underwent esophagectomy.

Methods

This retrospective case–control study included 73 patients who underwent resection of esophageal cancer (69 males, 4 females; age 36–83). General and dental status were evaluated. The Prognostic Nutritional Index was calculated based on the serum albumin concentration and the total lymphocyte count, and subjects were divided into two groups based on index scores: a higher group, characterized by scores ≥ 45 (n = 54); and a lower group, characterized by scores < 45 (n = 19). Univariate analysis and multiple logistic regression analyses were used to compare between groups.

Results

Total protein, C-reactive protein, the number of sound and total decayed, missing and filled teeth, and the rate of patients with poor dental occlusal support showed significant differences between the lower and higher Prognostic Nutritional Index groups (p < 0.05). Stepwise logistic regression analysis by backward selection approach showed that low total protein, few sound teeth, and poor status of dental occlusal support were significantly associated with the lower Prognostic Nutritional Index (p = 0.007, 0.042, and 0.009, respectively).

Conclusion

Dental status, especially dental occlusal support and the number of sound teeth, showed a positive relationship with the Prognostic Nutritional Index in esophageal cancer patients who underwent esophagectomy.

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Acknowledgements

The authors are deeply grateful to the team members in Okayama University Hospital. The authors give a special thanks to Daisuke Ekuni DDS, Ph.D. (Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences) for his advice about statistical analysis. This work was supported in part by the Japan Society for the Promotion of Science (JSPS) through KAKENHI Grant-in-Aid for Scientific Research (C) (Nos. 16K11858 and 19K10444) from JSPS.

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Contributions

RY-K designed the study, obtained research funds, performed data collection, analysis and interpretation of data, and wrote the initial draft of the manuscript. YS, ST, and TF contributed to the analysis and interpretation of data from the perspective of esophageal surgeons and assisted in the preparation of the manuscript. MI-M and AY contributed to data collection, analysis and interpretation of data, and assisted in the preparation of the manuscript. MM and HK contributed to data collection. MM contributed to analysis and interpretation of the data from the perspective of a dentist, epidemiologist, and statistician, and assisted in the preparation of the manuscript. All authors contributed to interpretation and critically reviewed the manuscript. All authors approved the final version of the manuscript, and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Yasuhiro Shirakawa.

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Ethical Statement

All procedures were in accordance with the ethical standards of the responsible committees on human experimentation and with the Helsinki Declaration of 1964 and later versions.

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The authors declare that they have no conflict of interest to report.

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Yamanaka-Kohno, R., Shirakawa, Y., Inoue-Minakuchi, M. et al. Association of dental occlusal support with the Prognostic Nutritional Index in patients with esophageal cancer who underwent esophagectomy. Esophagus (2020). https://doi.org/10.1007/s10388-020-00751-8

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Keywords

  • Esophageal cancer surgery
  • Prognostic factor
  • Nutrition