Nutritional deterioration in cancer: the role of disease and diet

Details

Serval ID
serval:BIB_47A0961AABC9
Type
Article: article from journal or magazin.
Collection
Publications
Title
Nutritional deterioration in cancer: the role of disease and diet
Journal
Clinical Oncology (royal College of Radiologists (great Britain))
Author(s)
Ravasco P., Monteiro-Grillo I., Vidal P.M., Camilo M.E.
ISSN
0936-6555 (Print)
ISSN-L
0936-6555
Publication state
Published
Issued date
2003
Volume
15
Number
8
Pages
443-450
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
AIMS: Under-nutrition is a major source of morbidity and mortality in cancer patients. This prospective, cross-sectional study aimed to evaluate the relative contributions of cancer staging, duration and diet on patients' nutritional deterioration.
MATERIALS AND METHODS: We included 205 consecutive patients (133 men and 72 women) with head and neck, gastro-oesophageal, colon and rectum cancer, age 53 +/- 12 (33-86) years, referred for radiotherapy (primary, adjunctive to surgery, combined with chemotherapy or with palliative intent). We registered clinical variables, nutritional status (percentage of weight loss, Patient-Generated Subjective Global Assessment and body mass index), nutritional requirements, usual diet intake (diet history) and current intake (24-h recall).
RESULTS: In stage III and IV, we observed a significant decrease of usual and current energy and protein intake (P=0.002), which were not observed in stage I and II. Reduction in nutritional intake was influenced by disease duration (P=0.04), but when the latter was evaluated in a multivariate analysis, current dietary intake was associated only with staging (P=0.004), thus disclosing a distinct pattern of nutritional intake between stages and diagnosis. Using a general linear model, advanced staging showed the most significant association with nutritional depletion (P=0.0001). We also found significant associations for tumour location (P=0.001), disease duration (P=0.002), nutritional intake (P=0.003) and previous surgery or chemotherapy (P=0.02). Percentage weight loss showed a consistently superior performance with regard to clinical variables and ability to detect mild to extreme nutritional changes. Patient-Generated Subjective Global Assessment had a very high sensitivity and specificity, and a strong capacity for detecting patients at nutritional risk compared with body mass index.
CONCLUSIONS: Nutritional depletion is multifactorial, dependent mainly on the tumour burden of the host. Percentage weight loss is a sensitive and specific tool that can screen and identify malnutrition effectively. Its joint use with Patient-Generated Subjective Global Assessment, which establishes boundaries for nutritional therapy, will optimise the efficacy of nutritional assessment and support in cancer patients.
Keywords
Gastrointestinal Neoplasms/radiotherapy, Head and Neck Neoplasms/radiotherapy, Nutritional Status/radiation effects, Weight Loss/radiation effects
Pubmed
Web of science
Create date
01/12/2016 15:01
Last modification date
22/07/2020 5:26
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