The predictive value of preoperative NRS2002 score for survival in patients with colorectal cancer: an analysis based on the DACCA database_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XU Qinchen ¹ , YANG Hongzhao ^2,3 , SHI Lei ⁴ , LI Zhigui ⁵ ,  WANG Xiaodong ² , LI Li ⁵

1. Gastric Cancer Center, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;
2. Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;
3. West China Medical School of Sichuan University, Chengdu 610041, P. R. China;
4. Division of Clinical Nutrition, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;
5. Colorectal Cancer Center, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WANG Xiaodong, Email: wangxiaodong@wchscu.cn

Keywords：

colorectal cancer; nutritional risk screening 2002; survival; Database of Colorectal Cancer

DOI：

10.7507/1007-9424.202402062

Video：

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Objective By mining data from the Database of Colorectal Cancer (DACCA) at West China Hospital of Sichuan University, this study aims to evaluate the relationship between nutritional risk screening (NRS) 2002 scores at initial diagnosis and long-term survival in patients. Methods The DACCA database version from November 24, 2023, was selected to compare the clinicopathological data of patients with NRS2002 scores <3 and ≥3, and to explore the impact of NRS2002 scores on survival. Results A total of 723 patients were screened, with 585 (80.9%) had NRS2002 scores <3 and 138 (19.1%) had NRS2002 scores ≥3. All 723 patients were followed up, with a follow-up period ranging from 1 to 78 months and a median follow-up time of 34 months. The median survival time for patients with NRS2002 scores <3 was 35 months, while it was 31 months for those with NRS scores ≥3. During the follow-up period, 589 patients (81.5%) survived, including 515 (71.2%) tumor-free survivors and 74 (10.2%) survivors with tumors. There were 134 deaths (18.5%), including 126 cancer-related deaths (17.4%) and 8 non-cancer-related deaths (1.1%). Multivariate logistic regression results showed that after controlling for 6 factors including age, radical surgery, adjuvant therapy, hypertension, differentation, and TNM staging, NRS2002 score was not a factor affecting the survival of colorectal cancer patients (RR=0.98, P=0.875). Conclusion NRS2002 score is not a predictive factor for the survival of colorectal cancer patients, possibly because although patients may have nutritional risks preoperatively, the long-term impact on survival is minimal following surgery and postoperative recovery.

Citation： XU Qinchen, YANG Hongzhao, SHI Lei, LI Zhigui, WANG Xiaodong, LI Li. The predictive value of preoperative NRS2002 score for survival in patients with colorectal cancer: an analysis based on the DACCA database. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(6): 676-681. doi: 10.7507/1007-9424.202402062 Copy

1.	Bracale U, Iacone B, Tedesco A, et al. The use of mixed reality in the preoperative planning of colorectal surgery: preliminary experience with a narrative review. Cir Esp (Engl Ed), 2024: S2173-5077(24)00037-1. doi: 10.1016/j.cireng.2024.01.006.
2.	Zang Y, Xu W, Qiu Y, et al. Association between risk of malnutrition defined by the Nutritional Risk Screening 2002 and postoperative complications and overall survival in patients with cancer: a meta-analysis. Nutr Cancer, 2023, 75(8): 1600-1609.
3.	Xu H, Kong F. Malnutrition-related factors increased the risk of anastomotic leak for rectal cancer patients undergoing surgery. Biomed Res Int, 2020, 2020: 5059670.
4.	汪晓东, 刘健博, 张诗, 等. 数据库研究第三部分: 结直肠癌的内外科合并症及术前体质状态. 中国普外基础与临床杂志, 2019, 26(8): 985-991.
5.	汪晓东, 朱佳怡, 李立. 数据库建设第十一部分: 结直肠癌随访的标签与结构化. 中国普外基础与临床杂志, 2021, 28(10): 1353-1359.
6.	Chen P, Yang L, Xiu M, et al. Effect of individualized nutritional intervention on head and neck cancer patients receiving radiotherapy. Support Care Cancer, 2024, 32(2): 94. doi: 10.1007/s00520-023-08290-5.
7.	Yu M, Li X, Chen M, et al. Prognostic potential of nutritional risk screening and assessment tools in predicting survival of patients with pancreatic neoplasms: a systematic review. Nutr J, 2024, 23(1): 17. doi: 10.1186/s12937-024-00920-w.
8.	Nasser S, Bilir E, Derin X, et al. Pre-operative malnutrition in patients with ovarian cancer: what are the clinical implications? Results of a prospective study. Cancers (Basel), 2024, 16(3): 622. doi: 10.3390/cancers16030622.
9.	Reischl S, Wilhelm DF, Neumann PA, et al. Peri- and postoperative nutrition in colorectal cancer patients. Ther Umsch, 2018, 75(10): 642-648.
10.	Ziętarska M, Krawczyk-Lipiec J, Kraj L, et al. Nutritional status assessment in colorectal cancer patients qualified to systemic treatment. Contemp Oncol (Pozn), 2017, 21(2): 157-161.
11.	Lin JX, Chen XW, Chen ZH, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: a clinical trial. Medicine (Baltimore), 2017, 96(26): e7373. doi: 10.1097/MD.0000000000007373.
12.	Yu J, Li D, Jia Y, et al. Nutritional Risk Screening 2002 was associated with acute kidney injury and mortality in patients with acute coronary syndrome: insight from the REACP study. Nutr Metab Cardiovasc Dis, 2021, 31(4): 1121-1128.
13.	Ingadottir AR, Beck AM, Baldwin C, et al. Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD). Clin Nutr, 2018, 37(4): 1323-1331.
14.	Meyer M, Leiss F, Greimel F, et al. Impact of malnutrition and vitamin deficiency in geriatric patients undergoing orthopedic surgery. Acta Orthop, 2021, 92(3): 358-363.
15.	Mitrache C, Passweg JR, Libura J, et al. Anemia: an indicator for malnutrition in the elderly. Ann Hematol, 2001, 80(5): 295-298.
16.	Berg EP, Mohammed A, Shipp ZJ, et al. Colorectal cancer screening and iron deficiency anemia. Prim Care, 2023, 50(3): 481-491.
17.	Schwegler I, von Holzen A, Gutzwiller JP, et al. Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer. Br J Surg, 2010, 97(1): 92-97.
18.	郭飞, 薛军, 韩磊, 等. Galon免疫评分联合围手术期NRS对结直肠癌患者术后预后的预测价值研究. 中华普外科手术学杂志(电子版), 2020, 14(4): 361-365.

1. Bracale U, Iacone B, Tedesco A, et al. The use of mixed reality in the preoperative planning of colorectal surgery: preliminary experience with a narrative review. Cir Esp (Engl Ed), 2024: S2173-5077(24)00037-1. doi: 10.1016/j.cireng.2024.01.006.
2. Zang Y, Xu W, Qiu Y, et al. Association between risk of malnutrition defined by the Nutritional Risk Screening 2002 and postoperative complications and overall survival in patients with cancer: a meta-analysis. Nutr Cancer, 2023, 75(8): 1600-1609.
3. Xu H, Kong F. Malnutrition-related factors increased the risk of anastomotic leak for rectal cancer patients undergoing surgery. Biomed Res Int, 2020, 2020: 5059670.
4. 汪晓东, 刘健博, 张诗, 等. 数据库研究第三部分: 结直肠癌的内外科合并症及术前体质状态. 中国普外基础与临床杂志, 2019, 26(8): 985-991.
5. 汪晓东, 朱佳怡, 李立. 数据库建设第十一部分: 结直肠癌随访的标签与结构化. 中国普外基础与临床杂志, 2021, 28(10): 1353-1359.
6. Chen P, Yang L, Xiu M, et al. Effect of individualized nutritional intervention on head and neck cancer patients receiving radiotherapy. Support Care Cancer, 2024, 32(2): 94. doi: 10.1007/s00520-023-08290-5.
7. Yu M, Li X, Chen M, et al. Prognostic potential of nutritional risk screening and assessment tools in predicting survival of patients with pancreatic neoplasms: a systematic review. Nutr J, 2024, 23(1): 17. doi: 10.1186/s12937-024-00920-w.
8. Nasser S, Bilir E, Derin X, et al. Pre-operative malnutrition in patients with ovarian cancer: what are the clinical implications? Results of a prospective study. Cancers (Basel), 2024, 16(3): 622. doi: 10.3390/cancers16030622.
9. Reischl S, Wilhelm DF, Neumann PA, et al. Peri- and postoperative nutrition in colorectal cancer patients. Ther Umsch, 2018, 75(10): 642-648.
10. Ziętarska M, Krawczyk-Lipiec J, Kraj L, et al. Nutritional status assessment in colorectal cancer patients qualified to systemic treatment. Contemp Oncol (Pozn), 2017, 21(2): 157-161.
11. Lin JX, Chen XW, Chen ZH, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: a clinical trial. Medicine (Baltimore), 2017, 96(26): e7373. doi: 10.1097/MD.0000000000007373.
12. Yu J, Li D, Jia Y, et al. Nutritional Risk Screening 2002 was associated with acute kidney injury and mortality in patients with acute coronary syndrome: insight from the REACP study. Nutr Metab Cardiovasc Dis, 2021, 31(4): 1121-1128.
13. Ingadottir AR, Beck AM, Baldwin C, et al. Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD). Clin Nutr, 2018, 37(4): 1323-1331.
14. Meyer M, Leiss F, Greimel F, et al. Impact of malnutrition and vitamin deficiency in geriatric patients undergoing orthopedic surgery. Acta Orthop, 2021, 92(3): 358-363.
15. Mitrache C, Passweg JR, Libura J, et al. Anemia: an indicator for malnutrition in the elderly. Ann Hematol, 2001, 80(5): 295-298.
16. Berg EP, Mohammed A, Shipp ZJ, et al. Colorectal cancer screening and iron deficiency anemia. Prim Care, 2023, 50(3): 481-491.
17. Schwegler I, von Holzen A, Gutzwiller JP, et al. Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer. Br J Surg, 2010, 97(1): 92-97.
18. 郭飞, 薛军, 韩磊, 等. Galon免疫评分联合围手术期NRS对结直肠癌患者术后预后的预测价值研究. 中华普外科手术学杂志(电子版), 2020, 14(4): 361-365.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The predictive value of preoperative NRS2002 score for survival in patients with colorectal cancer: an analysis based on the DACCA database

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