Phase angle and extracellular water/total body water ratio predict postoperative acute nutritional and inflammatory status in cancer patients

Abstract

Abstract Objectives To identify the difference of body composition between cancer patients and those non-malignant tumor patients and analyze changes in body composition after surgical treatment for cancer, as well as estimate the relationship of preoperative body composition on postoperative systemic nutritional status and inflammation.Methods 92 patients diagnosed with different type of cancer and 91 non-malignant tumor patients were assessment body composition by bioelectrical impedance analysis (BIA) and compared the changes between two groups. Spearman correlation and multiple linear regression were used to analyze the correlation and relationship between preoperative body composition and postoperative length of stay, albumin (Alb), prealbumin (PreAlb) and C-reactive protein (CRP) in cancer patients, respectively.Results Compared to the normal group, patients with gastric cancer have lower PA (P < 0.1), fat mass index (FMI) and higher extracellular water/total body water (ECW/TBW) ratio (P < 0.05). Regarding patients with prostatic cancer, findings similar to lower PA (male comparison patients 5.91° vs. prostatic cancer patients 5.51°, P < 0.1) in gastric cancer patients in the test cohort were observed. And body cell mass (BCM) in prostatic cancer patients also decreased (male comparison patients 33.43kg vs. prostatic cancer patients 33.21kg, P < 0.1). No significant differences were found in body composition between lung, breast and colorectal cancers and patients in comparison group (P > 0.1). A negative association between preoperative ECW/TBW level and postoperative Alb were observed (β=-125.05, P = 0.0403) in fully adjusted model. We found positive associations between preoperative PA level and postoperative Alb (β = 1.52, P = 0.0593) and preoperative BMI and postoperative CRP (β = 2.54, P = 0.0690). And the preoperative FFM, FFMI, FMI, BCM, HGS level were not associated with length of hospital stay, postoperative Alb, PreAlb and CRP for cancer patients in maximally adjusted models (P > 0.10).Conclusions In conclusion, the results of this study demonstrated that preoperative body composition, especially PA and ECW/TBW ratio, were significantly associated with the Alb, PreAlb and CRP of early stage after operation for cancer patients.