Nutritional Risk Assessment by Scored Patient-Generated Subjective Global Assessment Associated with Demographic Characteristics in 23,904 Common Malignant Tumors Patients

Song, Chunhua; Cao, Jingjing; Feng, Zhang; Wang, Chang; Guo, Zengqing; Lin, Yuan; Shi, Yingying; Wen, Hairuo; Ba, Yi; Xu, Hongxia; Li, Wei; Shi, Hanping

doi:10.1080/01635581.2019.1566478

Cited by 50 publications

(36 citation statements)

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“…Our study demonstrates an increased risk of grade 3+ chemotherapy toxicity in the setting of a low BMI and low albumin levels among patients 65 years old or older who are treated with chemotherapy. Undernutrition is highly prevalent among older adults with cancer and is associated with morbidity, hospitalization, decreased quality of life, functional decline, and mortality . In addition, oncology studies have demonstrated an increase in the risk of treatment‐related toxicity in the setting of poor nutritional status …”

Section: Discussionmentioning

confidence: 99%

“…Undernutrition is highly prevalent among older adults with cancer and is associated with morbidity, hospitalization, decreased quality of life, functional decline, and mortality. 18,[35][36][37][38] In addition, oncology studies have demonstrated an increase in the risk of treatment-related toxicity in the setting of poor nutritional status. [39][40][41][42][43] UWL is a clinical factor that has been shown to predict poor outcomes and has been suggested as a nutritional status assessment tool for patients with cancer in the clinical setting.…”

Section: Discussionmentioning

confidence: 99%

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Associations between nutritional factors and chemotherapy toxicity in older adults with solid tumors

Dotan

Tew

Mohile

et al. 2020

Cancer

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Background Nutritional status can directly affect morbidity and mortality in older adults with cancer. This study evaluated the association between pretreatment body mass index (BMI), albumin level, and unintentional weight loss (UWL) in the prior 6 months and chemotherapy toxicity among older adults with solid tumors. Methods This was a secondary analysis of a prospective, multicenter study involving chemotherapy‐treated patients 65 years old or older. Geriatric assessment, BMI, albumin level, and UWL data were collected before treatment. Multivariable logistic regression models evaluated the associations between nutritional factors and the risk of grade 3 or higher (grade 3+) chemotherapy toxicity. Results Seven hundred fifty patients with a median age of 72 years (range, 65‐94 years) and mostly stage IV disease were enrolled. The median pretreatment BMI and albumin values were 26 kg/m2 (range, 15.1‐52.1 kg/m2) and 3.9 mg/dL (range, 1.0‐5.0 mg/dL), respectively. Nearly 50% of the patients reported UWL, with 17.6% reporting >10% UWL. Multivariable analysis revealed no association between >10% UWL and a risk for grade 3+ chemotherapy toxicity (adjusted odds ratio [AOR], 0.87; P = .58). Multivariable analysis showed a trend toward an association between a BMI ≥ 30 kg/m2 and a decreased risk of grade 3+ chemotherapy toxicity (AOR, 0.65; P = .06), whereas a low albumin level (≤3.6 mg/dL) was associated with a higher risk of grade 3+ chemotherapy toxicity (AOR, 1.50; P = .03). An analysis of the joint effect of BMI and albumin demonstrated the lowest risk of grade 3+ chemotherapy toxicity among patients with high BMIs (≥30 kg/m2) and normal albumin levels (AOR, 0.41; P = .008). Conclusions Among older adults with solid tumors, higher BMIs and normal albumin levels are associated with a lower risk of grade 3+ chemotherapy toxicity. Additional research is warranted to define the clinical significance of nutritional markers and to inform future interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Associations between nutritional factors and chemotherapy toxicity in older adults with solid tumors

Dotan

Tew

Mohile

et al. 2020

Cancer

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“…Em razão do envelhecimento da população e do aumento da expectativa de vida dos idosos, o número de pacientes idosos com leucemia crônica aumenta em paralelo. Estudos evidenciam que idosos com tumores malignos são mais propensos à desnutrição, à redução da funcionalidade, à diminuição das capacidades cognitivas e ao aumento da inflamação, acarretando perda de massa corporal magra, maior gasto energético e aumento da termogênese [22][23][24][25] .…”

Section: Discussionunclassified

Prevalência de Desnutrição em Pacientes Adultos e Idosos em Fase de Pré-Tratamento de Leucemia

Silva

Oliveira²

2020

Rev. Brasileira.De.Cancerologia

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Introdução: O estado nutricional em fase pré-tratamento pode estar relacionado a desfechos clínicos desfavoráveis em pacientes com câncer. Objetivo: Avaliar o estado nutricional de pacientes adultos e idosos com leucemia em fase de pré-tratamento oncológico. Método: Trata-se de um estudo transversal, retrospectivo, envolvendo pacientes com leucemia em fase pré-tratamento oncológico. Os critérios de inclusão foram ≥20 anos de idade; ambos os sexos; e matricula no Instituto Nacional de Câncer Jose Alencar Gomes da Silva (INCA). Os critérios de exclusão foram não ter diagnostico confirmado de leucemia; registro de avaliação do estado nutricional por meio da avaliação subjetiva global produzida pelo paciente; e não ter recebido tratamento oncológico prévio. Os testes qui-quadrado e t de Student foram utilizados. Resultados: Foram avaliados 69 pacientes com leucemia em fase pré-tratamento oncológico, sendo em sua maioria homens (52,2%) com menos de 60 anos de idade (52,2%). A prevalência de desnutrição foi de 65,2%, sendo mais expressiva nos idosos (78,8%, p=0,023). A prevalência de risco nutricional apresentou a mesma frequência (65,2%), no entanto, foi maior em pacientes com comorbidades (80,8%, p=0,017) e historia de tabagismo (90,9%, p=0,056). Conclusão: A maior parte dos pacientes com leucemia iniciou seu tratamento oncológico com o estado nutricional debilitado, o que se exacerbou entre aqueles com leucemia crônica, idosos, com comorbidades e historia de tabagismo.

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“…An understanding of cancer patient's nutritional status is essential to therapeutic decisions and their survival [4]. According to nutrition assessments from several countries, 25-85% of cancer patients are estimated to have cancer-related malnutrition [5][6][7]. More than half of all patients with solid tumors, especially gastrointestinal cancer, suffer from malnutrition, which is associated with decreased therapeutic response and increased mortality [8,9].…”

Section: Introductionmentioning

confidence: 99%

A novel model with nutrition-related parameters for predicting overall survival of cancer patients

Zhang

et al. 2021

Support Care Cancer

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BackgroundIncreasing evidence indicates that nutritional status could in uence the survival of cancer patients. This study aims to develop and validate a nomogram with nutrition-related parameters for predicting the overall survival of cancer patients.Patients and Methods 8,749 patients from the multicentre cohort study in China were included as the primary cohort to develop the nomogram, and 696 of these patients were recruited as a validation cohort. Patients nutritional status were assessed using the PG-SGA. LASSO regression models and Cox regression analysis were used for factor selection and nomogram development. The nomogram was then evaluated for its effectiveness in discrimination, calibration, and clinical usefulness by the C-index, calibration curves, and Decision Curve Analysis. Kaplan-Meier survival curves were used to compare the survival rate. ResultsSeven independent prognostic factors were identi ed and integrated into the nomogram. The C-index was 0.73 (95% CI, 0.72 to 0.74) and 0.77 (95% CI, 0.74 to 0.81) for the primary cohort and validation cohort, which were both higher than 0.59 (95% CI, 0.58 to 0.61) of the TNM staging system. DCA demonstrated that the nomogram was higher than the TNM staging system and the TNM staging system combined with PG-SGA. Signi cantly median overall survival differences were found by stratifying patients into different risk groups (score <18.5 and ≥18.5) for each TNM category (all Ps < 0.001). ConclusionOur study screened out seven independent prognostic factors and successfully generated an easy-to-use nomogram, validated and shown a better predictive validity for the overall survival of cancer patients.

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Nutritional Risk Assessment by Scored Patient-Generated Subjective Global Assessment Associated with Demographic Characteristics in 23,904 Common Malignant Tumors Patients

Cited by 50 publications

References 25 publications

Associations between nutritional factors and chemotherapy toxicity in older adults with solid tumors

Associations between nutritional factors and chemotherapy toxicity in older adults with solid tumors

Prevalência de Desnutrição em Pacientes Adultos e Idosos em Fase de Pré-Tratamento de Leucemia

A novel model with nutrition-related parameters for predicting overall survival of cancer patients

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