Prognostic value of preoperative malnutrition, based on albumin level and body mass index, on operative outcomes in noncirrhosis patients with liver metastases of colorectal cancer Impact of preoperative malnutrition, based on albumin level and body mass index, on operative outcomes in non-cirrhosis patients with liver metastases of colorectal cancer

Yixian Guo Runkun Liu Yufeng Wang Hanqi Li Guozhi Yin Hang Tuo Yifeng Zhu Yiheng Wang Wei Yang Zhikui Liu ^*

• Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China

Background: Serum albumin level and body mass index (BMI), acting as indicators of nutritional status, are frequently applied to predict the surgical outcome of a cancer patient. The aim of our study was to evaluate the impact of preoperative serum albumin level and BMI on operative outcomes of non-cirrhotic patients with colorectal cancer liver metastasis, who underwent hepatectomy.Methods: This research was a retrospective study of medical records from January 2013 to December 2022. Preoperative malnutrition was defined as hypoalbuminemia with serum albumin level < 35g/L before surgery or BMI < 18.5 kg/m 2 within 30 days before surgery. Multiple statistical methods were applied to analyze the data, mainly including two independent samples t-test, analysis of variance, Chi-square, multivariate analysis and so on.Results: In the 159 eligible patients, 42 patients (26.4%) were classified as the preoperative malnutrition group. The blood transfusion (45.24% vs. 18.80%, P=0.040) was significantly higher in malnutrition group. The drainage volume of the malnutrition group was significantly higher on the first day (65 (115) vs. 60 (80), P < 0.05) and the second day (50 (95) vs. 40 (79), P < 0.05) than that of the non-malnutrition group. The postoperative hemoglobin of malnutrition group was significantly lower (101.20±2.43 vs. 108.76±1.61, P=0.015)). In short, the incidence of grade Ⅱ or Ⅲ/Ⅳ complications was significantly higher in the malnutrition group (16.67% vs. 5.31% or 11.9% vs.3.42%, P=0.001), while the length of hospital stays (18(12) vs. 15(8), P=0.002) was significantly extended. In multivariate analysis, preoperative malnutrition (Odds Ratio, p=0.010) and operation time (OR=1.009, 95%CI 1.002-1.016, P=0.0011) were independent predictors of postoperative complication.Preoperative malnutrition in patients who underwent hepatectomy for colorectal cancer liver metastasis was associated with worse surgical outcomes, especially aggrandizing the emergence of postoperative complications.