Validation of a new prognostic body composition parameter in cancer patients

Cereda, Emanuele; Caraccia, Marilisa; Klersy, Catherine; Cappello, Silvia; Turri, Annalisa; Borioli, Valeria; Stobäus, N.; Giannoni, Antonello; Arcaini, Luca; Benazzo, Marco; Palladini, Giovanni; Pedrazzoli, Paolo; Norman, Kristina; Caccialanza, Riccardo

doi:10.1016/j.clnu.2020.06.011

Cited by 14 publications

(24 citation statements)

References 43 publications

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“…From a nutritional perspective, it has been shown that reaching both protein and energy targets in critically ill patients had a positive impact on survival [11] . The early caloric deficit has already been showed as an independent predictor of ICU mortality together with SOFA score, male sex, obesity and diabetes, suggesting that any effort should be made to implement timely and adequate nutritional support during the ICU stay [12] .…”

Section: Introductionmentioning

confidence: 99%

Qualitative and quantitative muscle ultrasound changes in patients with COVID-19–related ARDS

et al. 2021

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Background & Aims Severe forms of COVID-19 are associated with systemic inflammation and hypercatabolism. We compared the time course of the size and quality of both rectus femoris and diaphragm muscles between critically-ill, COVID-19 survivors and non-survivors, and explored the correlation between the change in muscles size and quality with the amount of nutritional support delivered and the cumulative fluid balance. Methods Prospective observational study in the general ICU of a tertiary care hospital for COVID-19. The right rectus femoris cross-sectional area and the right diaphragm thickness, as well as their echodensities were assessed within 24 hours from ICU admission and on day 7. Anthropometric and biochemical data, respiratory mechanics and gas exchange, daily fluid balance and the amount of calories and proteins administered were recorded. Results 28 patients were analysed (age 65±10 years, 80% males, BMI 30.0±7.8). Rectus femoris and diaphragm sizes were significantly reduced at day 7 (-26.1 [-37.8;-15.2] and -29.2 [-37.8;-19.6]%, respectively) and this reduction was significantly higher in non-survivors. Both rectus femoris and diaphragm echodensity were significantly increased at day 7, with a significantly higher increase in non-survivors. The change in both rectus femoris and diaphragm size at day 7 was related to the cumulative protein deficit (R=0.664, p<0.001 and R=0.640, p<0.001, respectively), while the change in rectus femoris and diaphragm echodensity was related to the cumulative fluid balance (R=0.734, p<0.001 and R=0.646, p<0.001, respectively) Conclusions Early changes in muscle size and quality seem related to the outcome of critically-ill, COVID-19 patients, and be influenced by nutritional and fluid management strategies.

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Section: Introductionmentioning

confidence: 99%

Qualitative and quantitative muscle ultrasound changes in patients with COVID-19–related ARDS

et al. 2021

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“…Italians were characterised by better performance status, although they presented lower muscle strength reasonably due to higher age, lower BMI and more frequent unintentional WL. 37,38 Reduced SMMI was found in 708 patients and 524 showed muscle weakness. The characteristics (clinical…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Muscle weakness as an additional criterion for grading sarcopenia‐related prognosis in patients with cancer

et al. 2021

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“…Muscle strength: Muscle strength [handgrip (HG)] will be measured using a digital hand dynamometer (DynEx, Akern/MD Systems). 13,26–28…”

Section: Methodsmentioning

confidence: 99%

“…31 Muscle strength: Muscle strength [handgrip (HG)] will be measured using a digital hand dynamometer (DynEx, Akern/MD Systems). 13,[26][27][28] Quality of life: It will be evaluated at baseline and at the end of treatment using the European Organization for Research and Treatment of Cancer (EORTC) core QoL questionnaire (QLQ-C30) and the EORTC head and neck cancer QoL questionnaire (QLQ-H&N35). 13,32,33 Fatigue: Self-reported fatigue and its impact on daily activities and function will be assessed at baseline and at the end of treatment using the 40-item functional assessment of chronic illness therapy -fatigue (FACIT-F) scale.…”

Section: End Of Nutriɵonal Intervenɵonmentioning

confidence: 99%

The efficacy of immunonutrition in improving tolerance to chemoradiotherapy in patients with head and neck cancer, receiving nutritional counseling: study protocol of a randomized, open-label, parallel group, bicentric pilot study

et al. 2021

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Background: Nutritional support, including nutritional counseling and oral nutritional supplements (ONSs), has been recommended at the earliest opportunity in head and neck (H&N) cancer patients. The limited available evidence on the efficacy of immunonutrition during chemoradiotherapy (CT-RT) in H&N cancer patients is positive with regard to some secondary endpoints, but is still scanty, particularly with regard to toxicity and treatment tolerance. We hypothesize that early systematic provision of ONSs with a high-protein–high-calorie mixture containing immunonutrients (Impact) compared to standard high-calorie–high-protein nutritional blends, in addition to nutritional counseling, may be beneficial to patients with H&N cancer during CT-RT. Hence, we designed the present study to evaluate the efficacy, in terms of treatment tolerance, toxicity and response, body weight, body composition, protein-calorie intake, quality of life (QoL), fatigue, muscle strength and immunological profile of the early systematic provision of ONSs enriched in immunonutrients compared to isonitrogenous standard blends, in H&N cancer patients undergoing CT-RT. Methods: This is a pragmatic, bicentric, randomized (1:1), parallel-group, open label, controlled, pilot clinical trial. Discussion: Many efforts are still to be taken to improve the efficacy of nutritional support in oncology. Immunonutrition represents a promising approach also in H&N cancer patients, but the evidence on its efficacy in improving clinical outcomes during CT-RT is still inconclusive. The present pilot study, which guarantees the early provision of nutritional assessment and support to all the enrolled patients in accordance with the recent guidelines and recommendations, could represent one of the first proofs of the clinical effectiveness of early oral immunonutrition in cancer patients undergoing CT-RT and could stimulate further large randomized trials, potentially resulting in the improvement of supportive care quality. Trial registration: This study is registered on ClinicalTrials.gov Identifier: NCT04611113.

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Validation of a new prognostic body composition parameter in cancer patients

Cited by 14 publications

References 43 publications

Qualitative and quantitative muscle ultrasound changes in patients with COVID-19–related ARDS

Qualitative and quantitative muscle ultrasound changes in patients with COVID-19–related ARDS

Muscle weakness as an additional criterion for grading sarcopenia‐related prognosis in patients with cancer

The efficacy of immunonutrition in improving tolerance to chemoradiotherapy in patients with head and neck cancer, receiving nutritional counseling: study protocol of a randomized, open-label, parallel group, bicentric pilot study

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