Risk factors for malnutrition after oesophageal and cardia cancer surgery.

BACKGROUND: Oesophageal cancer surgery is often followed by malnutrition, but the factors causing weight loss are unknown. The aim of this population-based study was to identify such risk factors. METHODS: Data were collected from a nationwide Swedish organization for research on surgery for oesophageal cancer. A total of 340 patients (75.9 per cent of those eligible) responded to a study-specific questionnaire concerning height and weight, just before and 6 months after surgery. Factors influencing malnutrition, defined as loss of body mass index of at least 15 per cent 6 months after operation, were identified by logistic regression. RESULTS: Neoadjuvant therapy (received by 10.6 per cent of all patients) and female sex were associated with at least a twofold increased risk of weight loss (odds ratio (OR) 2.41 (95 per cent confidence interval 1.01 to 5.77) and 2.14 (1.07 to 4.28) respectively), whereas preoperative weight loss was associated with a decreased risk (OR 0.13 (0.03 to 0.65)). Age, tumour stage and location, type of oesophageal substitute, suture technique and postoperative complications did not influence the risk. CONCLUSION: Neoadjuvant therapy and female sex appear to be associated with an increased risk of malnutrition after oesophageal cancer surgery.