<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>In patients with gastrointestinal cancer with planned elective surgery, malnutrition increases the risk of adverse outcomes in the postoperative period. The phase angle, measured by the bioelectrical impedance analysis is an indicator of the metabolic and functional status of the patient. It may be an important prognostic indicator for the clinical outcome of post-surgical treatment in patients with gastrointestinal cancer.</p>
</sec>
<sec><h3>Patients and methods</h3>
<p>In this prospective study, 70 patients with gastrointestinal cancer had their phase angles measured by the bioelectrical impedance analysis before the surgery. During the first month after the surgery, we documented the postoperative complications from the patient's records and classified them according to the Clavien Dindo classification of surgical complications. The time of hospitalization was also recorded. The data was statistically analysed in SPSS.</p>
</sec>
<sec><h3>Results</h3>
<p>We found a statistically significant difference (p = 0.036) in the average value of phase angles between the group of patients who had postoperative complications (phase angle 5.09°) and the group without postoperative complications (5.64°). We noted a correlating trend of decreasing phase angle values and increasing hospitalization time (Pe R = −0,40, p = 0,001). The phase angle cut-off value (5.5°) was calculated using the ROC curve method, predicting a higher risk of the postoperative complications (p = 0,037) in patients with lower phase angle.</p>
</sec>
<sec><h3>Conclusions</h3>
<p>Lower phase angle values before surgery were associated with more complications during the first month after surgery and longer hospitalization time. We found that a phase angle below than 5.5° could serve as a marker that predicts a greater risk of postoperative complications.</p>
</sec>
</abstract>

Background
In patients with gastrointestinal cancer with planned elective surgery, malnutrition increases the risk of adverse outcomes in the postoperative period. The phase angle, measured by the bioelectrical impedance analysis is an indicator of the metabolic and functional status of the patient. It may be an important prognostic indicator for the clinical outcome of post-surgical treatment in patients with gastrointestinal cancer.

Patients and methods
In this prospective study, 70 patients with gastrointestinal cancer had their phase angles measured by the bioelectrical impedance analysis before the surgery. During the first month after the surgery, we documented the postoperative complications from the patient's records and classified them according to the Clavien Dindo classification of surgical complications. The time of hospitalization was also recorded. The data was statistically analysed in SPSS.

Results
We found a statistically significant difference (p = 0.036) in the average value of phase angles between the group of patients who had postoperative complications (phase angle 5.09°) and the group without postoperative complications (5.64°). We noted a correlating trend of decreasing phase angle values and increasing hospitalization time (Pe R = −0,40, p = 0,001). The phase angle cut-off value (5.5°) was calculated using the ROC curve method, predicting a higher risk of the postoperative complications (p = 0,037) in patients with lower phase angle.

Conclusions
Lower phase angle values before surgery were associated with more complications during the first month after surgery and longer hospitalization time. We found that a phase angle below than 5.5° could serve as a marker that predicts a greater risk of postoperative complications.

Phase angle as a prognostic indicator of surgical outcomes in patients with gastrointestinal cancer

Radiology and Oncology

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
In patients with gastrointestinal cancer with planned elective surgery, malnutrition increases the risk of adverse outcomes in the postoperative...

Characteristics	All patients	Patients with no complications (G0)	Patients with complications (G1–G5)	p-value
Gender
Male	50 (71 %)
Female	20 (29 %)
Age (years)^a	65.0 (10.7) [62.4–67.6]	61.7 (9.8) [56.9–66.6]	66.1 (10.9) [63.1–69.2]	0.137
Phase Angle (°)^a	5.23 (2.77) [5.0–5.5]	5.64 (0.72) [5.3–6.0]	5.09 (0.98) [4.8–5.4]	0.036*
Location of the primary tumor (%)
Colon	17 (24,3)	4 (22.2)	13 (25.0)
Rectosigmoid	2 (2,9)	1 (5.5)	1 (1.9)
Rectum	45 (64,3)	11 (61.1)	34 (65.4)
Anus	1 (1,4)	1 (5.5)	0 (0)
Breast	1 (1,4)	0 (0)	1 (1.9)
Ovary	4 (5,7)	1 (5.5)	3 (5.8)

Phase Angle (°)	Odds of a complication	Probability of a complication (%)
4.5	5.532	84.7
5.0	3.831	79.3
5.5	2.651	72.6
6.0	1.837	64.8

	Number of patients (%)	Age (years) ^a	Phase angle (°)^a
Grade 0	18 (26)	61.7 [56.9–66.6]	5.64 [5.28–6.00]
Grade I	5 (7)	56.0 [50.2–61.8]	6.22 [5.64–6.80]
Grade II	38 (54)	67.1 [63.4–70.7]	4.99 [4.67–5.31]
Grade III	4 (6)	62.2 [45.0–79.5]	5.15 [3.41–6.88]
Grade IV	5 (7)	72.2 [60.5–83.9]	4.64 [3.77–5.51]
Grade V	0 (0)

	Phase angle < 5,5	Phase angle ≥ 5,5
Complication	33 (true positive)	19 (false negative)	52
No complication	7 (false positive)	11 (true negative)	18
	40	30

Phase angle as a prognostic indicator of surgical outcomes in patients with gastrointestinal cancer

Article Category: Research Article

Data publikacji: 30 lis 2023

Zakres stron: 524 - 529

Otrzymano: 03 sie 2023

Przyjęty: 30 wrz 2023

DOI: https://doi.org/10.2478/raon-2023-0060

Słowa kluczowe
phase angle, colorectal cancer, postoperative complications, malnutrition

© 2023 Jana Gulin et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

FIGURE 1.

Characteristics of patients

Odds for developing a complication and probabilities of developing a complication at different values of phase angle

Mean age and mean phase angle in each Clavien Dindo grade

Contingency Table with the sensitivity and a specificity of the phase angle

Phase angle as a prognostic indicator of surgical outcomes in patients with gastrointestinal cancer

Article Category: Research Article

Data publikacji: 30 lis 2023

Zakres stron: 524 - 529

Otrzymano: 03 sie 2023

Przyjęty: 30 wrz 2023

DOI: https://doi.org/10.2478/raon-2023-0060

Słowa kluczowephase angle, colorectal cancer, postoperative complications, malnutrition

© 2023 Jana Gulin et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

FIGURE 1.

Characteristics of patients

Odds for developing a complication and probabilities of developing a complication at different values of phase angle

Mean age and mean phase angle in each Clavien Dindo grade

Contingency Table with the sensitivity and a specificity of the phase angle

Słowa kluczowe
phase angle, colorectal cancer, postoperative complications, malnutrition