[Postoperative nutritional assessment in gastric and colorectal cancer]

From the 200 malnutritional cancer patients, we had obtained, so called, prognostic nutritional index (PNI): PNI = 10 X Alb. + 0.005 Lymph. C., where Alb. is serum albumin level (g/dl) and Lymph. C. is total lymphocytes count of peripheral blood level. This index, as we had reported, shows linear predictive model correlating the risk of operative complication, mortality or both with nutritional status. In this study, we report on the utility of the PNI as a nutritional index (NI) for postoperative patients. The subjects of this study were 22 gastric cancer patients (G group), performed total gastrectomy or proximal gastrectomy, and 18 colorectal cancer patients (C group), underwent colectomy or rectal resection and anastomosis but amputation. All these cases underwent nutritional support by TPN postoperatively. The values of NI of both groups were the lowest at the first postoperative day, and increased gradually to the seventh postoperative day. And the value of C group was higher than that of G group throughout the TPN period: From the first postoperative day to the 14th day. These results reflected the result obtained from the estimation of nitrogen balance, urinary 3-methylhistidine excretion and serum rapid turnover protein (transferrin, prealbumin and retinol binding protein). These results suggest that the NI is useful to estimate the improvement of the postoperative nutritional status.