AIM:To assess the effects of poor nutritional and psychological status on tolerance of cancer treatment and the recovery of physical performance status in patients with gastrointestinal cancer. METHODS:An epidemiological survey with respect to nutritional and psychological status in patients with gastrointestinal cancer was conducted among 182 operated patients in four provincial-level hospitals from December 2005 to June 2006. The food frequency survey method, state-trait anxiety inventory (STAI) and depression status inventory (DSI) were used to obtain information about the diet and psychological status in the patients. Nutritional status in the participants was reflected by serum albumin (Alb), hemoglobin (HB) and body mass index (BMI). RESULTS:Alb, protein intake and anxiety were associated with the severity of side effects of treatment. The adjusted relative risk (RR ) for Alb, protein intake and anxiety was 3.30 (95% CI: 1.08, 10.10, P = 0.03), 3.25 (95% CI: 1.06, 9.90, P = 0.04) and 1.48 (95% CI: 1.29, 1.70, P < 0.0001), respectively. Moreover, calorie intake, HB and depression were associated with the recovery of physical performance status in the patients. Adjusted relative risk was 2.12 (95% CI: 1.09, 4.03, P = 0.028), 2.05 (95% CI: 1.08, 3.88, P =0.026) and 1.07 (95% CI: 1.02, 1.12, P = 0.007), respectively. CONCLUSION:B o t h p o o r n u t r i t i o n s t a t u s a n d psychological status are independent risk factors for severe side effects of cancer treatment, and have impact on the recovery of physical performance status in patients after treatment.

Depression, low score of "Confrontation", low levels of HB, and low level of daily calorie intake may be the risk factors of poor performance status of the patients with advanced stomach cancer.

To assess the association between nutrition status and prognosis of patients with digestive system cancer, epidemiological investigations were conducted in 2 periods to obtain information about the patients' nutrition status, survival time, and quality of life. Relative risks and 95% confidence intervals were estimated by logistic regression. Among the patients with esophagus, stomach, and colorectal cancers, nutritional indicators at time 1 did not affect relative risk for survival at time 2. At time 2, relations between quality of life and albumin, daily intake of calories, and daily intake of protein were statistically significant (P < .05). This study offers evidence that nutrition status shortly after operation does not affect 1-year survival rate and that nutritional status at 1 year is associated with quality of life.

To assess the association between psychological status and prognosis of patients with digestive system cancer, epidemiological investigations were conducted in 2 periods to obtain information about the patients' psychological status, survival time, and quality of life. Adjusted relative risks (95% confidence interval) of 1-year survival rate for anxiety and depression were 8.43 (1.18-60.20) and 9.62 (1.76-52.63), respectively. Relations between quality of life and depression and social support were statistically significant (P <.05). This study offers evidences that psychological status in a short-term postoperative period may affect 1-year survival rate, and poor psychological status and social support after being discharged from hospitals are associated with poor quality of life.