Intensified outpatient nutrition counselling improves body weight and skeletal muscle loss after esophageal cancer surgery

Background : The progression of malnutrition and sarcopenia after esophagectomy for esophageal cancer negatively influences long-term prognosis. To improve nutritional status after esophagectomy, we introduced an intensified nutrition counselling (iNC) protocol. The aim of this study was to evaluate the efficacy of iNC compared with the conventional NC (cNC). Methods : We included 126 patients who underwent esophagectomy before and after NC revision, and compared nutritional status and changes in body composition after esophagectomy between the cNC and iNC groups. Nutritional parameters, including body weight, serum albumin level, and prealbumin level, were assessed. We also calculated skeletal muscle index (SMI) and visceral fat area (VFA) using computed tomography volumetry. Results : There were no significant differences in baseline characteristics or surgical outcomes between the groups. Compared with the cNC group, NC was provided more frequently (P < 0.001) in the iNC group, and compliance rate increased from 56.3% to 91.9% (P < 0.001). Body weight loss at 4 and 6 months and SMI reduction at 6 months were significantly improved in the iNC group compared with the cNC group (P < 0.001, P = 0.032, and P = 0.006, respectively). There were no significant differences in the changes in VFA, serum albumin level, and prealbumin level between the two groups. Conclusions : Outpatient iNC significantly improved body weight and SMI loss 3–6 months after esophagectomy. Therefore, iNC may improve patient quality of life and outcomes by maintaining patient nutritional status.