1
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de Medeiros GOC, da Rocha IMG, Marcadenti A, Bezerra RA, Barbalho ER, de Sousa Júnior CA, Fayh APT. The additional benefit of computed tomography in cancer patients: impacts of sarcopenia and cachexia on quality of life during chemotherapy. Radiol Bras 2024; 57:e20240012. [PMID: 39268045 PMCID: PMC11392432 DOI: 10.1590/0100-3984.2024.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 06/14/2024] [Accepted: 06/30/2024] [Indexed: 09/15/2024] Open
Abstract
Objective This study evaluates the effects of sarcopenia and cachexia on the quality of life (QoL) of patients with gastrointestinal cancer during their initial cycle of chemotherapy, emphasizing the significance of computed tomography (CT) in assessing muscle mass. Materials and Methods In this prospective study, we evaluated 60 adult patients with gastrointestinal cancer who started chemotherapy between January and December of 2017. Sarcopenia was diagnosed on the basis of CT findings, and QoL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. Results The mean age was 60.9 years, and 33 (55.0%) of the patients were men. Of the 60 patients, 33 (55.0%) had cachexia and 14 (23.3%) had sarcopenia. Chemotherapy significantly reduced QoL, particularly in the physical, role functioning, and social domains, with no differences between the cachexia and sarcopenia groups. Conclusion Among patients with gastrointestinal cancer submitted to chemotherapy, the chemotherapy-induced decline in QoL does not seem to differ significantly between those with cachexia or sarcopenia, as classified by CT-measured muscle mass, and those without. However, CT-based muscle mass evaluation remains crucial for guiding customized intervention strategies. Integrating this evaluation in radiological reports can provide valuable insights for planning specific care, thus improving patient QoL during treatment.
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Affiliation(s)
| | | | - Aline Marcadenti
- Instituto de Pesquisa do Hospital do Coração (IP-HCor), São Paulo, SP, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
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2
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Huang Y, Chen Y, Wei L, Hu Y, Huang L. Comparison of three malnutrition risk screening tools in identifying malnutrition according to Global Leadership Initiative on Malnutrition criteria in gastrointestinal cancer. Front Nutr 2022; 9:959038. [PMID: 35990353 PMCID: PMC9386177 DOI: 10.3389/fnut.2022.959038] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Malnutrition is common in patients with gastrointestinal cancer. The first step in the diagnosis of malnutrition is to evaluate the malnutrition risk by validated screening tools according to the Global Leadership Initiative on Malnutrition (GLIM). This study aimed to determine the best nutritional screening tool for identifying GLIM malnutrition and validate the performance of these tools in different age subgroups. Materials and methods We did a prospective cohort study of patients who were diagnosed with gastrointestinal cancer from February 2016 to November 2019. The sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and area under the receiver operating characteristic (ROC) curve (AUC) of three screening tools (Nutritional risk screening 2002 (NRS 2002), Geriatric Nutritional Risk Index (GNRI), MNA-SF) were calculated. Results A total of 488 patients were enrolled, and 138 patients (28.27%) were malnutrition according to the GLIM criteria. The consistency of NRS 2002, GNRI, and MNA-SF with GLIM-defined malnutrition was 74.8, 72.1, and 71.1%, respectively. In the subgroup analysis of young patients (<65 years), NRS 2002 exhibited the best discrimination with the AUC of 0.724 (95% CI, 0.567–0.882), the sensitivity of 64.3% (95% CI, 35.6–86.0), and the specificity of 80.6% (95% CI, 69.2–88.6). In patients older than 65 years, MNA-SF exhibited the best discrimination with the AUC of 0.764 (95% CI, 0.714–0.814), the sensitivity of 82.3% (95% CI, 74.1–88.3), and the specificity of 70.5% (95% CI, 64.7–75.7). Conclusions Nutritional risk screening 2002 (NRS 2002) is the best malnutrition screening tool in gastrointestinal cancer patients younger than 65 years, and MNA-SF is the best malnutrition screening tool in patients older than 65 years. It is necessary to select targeted nutritional screening tools according to the difference in age.
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Affiliation(s)
- Yangyang Huang
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Chen
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lu Wei
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Hu
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liya Huang
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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3
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Croisier E, Morrissy A, Brown T, Grigg A, Chan P, Goh J, Bauer J. Nutrition risk screening and implications for patients with gynaecological cancers undergoing pelvic radiotherapy and/or other treatment modalities: A retrospective observational study. Nutr Diet 2021; 79:217-228. [PMID: 34854202 DOI: 10.1111/1747-0080.12712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/31/2021] [Accepted: 09/21/2021] [Indexed: 12/26/2022]
Abstract
AIM There is scarcity of research for the nutritional management of pelvic radiotherapy in gynaecological malignancies and delivery of specialised nutrition care is limited due to the current knowledge gap in guidelines. This study aimed to better understand the nutritional risk, weight changes and pattern of nutrition impact symptoms occurring at various treatment timepoints in this population, to inform an effective model of care. METHODS This retrospective, observational study included women with gynaecological cancers receiving pelvic radiotherapy at a tertiary hospital from January 2017 to December 2018 (n = 104). Information was collected on: first day of radiotherapy; weekly during treatment; acute-phase post-treatment (0-6 weeks); and intermediate-phase post-treatment (6 weeks to 6 months). This study reported on incidence of clinically significant weight change (±5%), documented nutrition impact symptoms and the current nutrition care model (nutrition screening, referral, assessment and interventions). RESULTS Clinically significant weight loss was experienced by 38% (n = 40/104) of patients prior to commencing treatment and 19% (n = 14/73) during treatment. Diarrhoea (n = 40/79), fatigue (n = 54/79), nausea (n = 38/79) and pain (n = 31/79) were frequently reported during treatment, and fatigue (n = 33/92) and pain (n = 25/92) continued acutely post-treatment. Despite high rates of weight loss and prevalence of nutrition impact symptoms, only 38% (n = 40/104) of patients were referred to a dietitian. CONCLUSIONS A considerable proportion of patients with gynaecological cancers are at nutrition risk before and during treatment due to clinically significant weight loss and prevalence of nutrition impact symptoms experienced. This highlights the importance of nutrition-risk screening and access to specialised dietetic care as part of their model of care.
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Affiliation(s)
- Emilie Croisier
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia.,Department of Nutrition and Dietetics, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Alana Morrissy
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - Teresa Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia.,Department of Nutrition and Dietetics, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Alice Grigg
- Department of Cancer Care Services, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Philip Chan
- Department of Cancer Care Services, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,School of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Jeffrey Goh
- Department of Cancer Care Services, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,School of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Judy Bauer
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
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4
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Botero L, Agarwal E, Berry R, Gillespie K, Isenring E, McCarthy AL. Nutrition risk and mortality in older oncology patients: An exploratory study. Nutr Diet 2019; 77:449-455. [PMID: 31066198 DOI: 10.1111/1747-0080.12547] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 03/12/2019] [Accepted: 04/07/2019] [Indexed: 11/26/2022]
Abstract
AIM The primary aim of this analysis was to identify if two standard measures incorporated into the comprehensive geriatric assessment; specifically, malnutrition risk and body mass index (BMI), could predict 12-month mortality in older patients with solid tumours. The secondary aim was to evaluate if malnutrition risk and BMI were associated with chemotherapy outcomes (discontinuation/modification of treatment) in older patients with solid tumours. METHODS Older patients (aged ≥70 years) with solid cancers were recruited from the outpatient oncology clinic of a tertiary hospital in Brisbane, Australia. Participants' nutritional parameters, BMI, and malnutrition risk (determined using the Malnutrition Screening Tool (MST)) were recorded at baseline. Mortality data and chemotherapy outcomes were recorded for 12 months. RESULTS Seventy-four participants (67% males, median age 77 (±4.4) years) were recruited. Nearly half the cohort was at-risk of malnutrition at baseline (n = 39, 46%). Chemotherapy was prescribed to 39% (n = 29) of the cohort. For patients receiving chemotherapy neither being underweight nor having a low or medium risk of malnutrition was associated with adverse chemotherapy outcomes or 12-month mortality. At a bivariate level, malnutrition risk was significantly associated with 12-month mortality in patients who did not receive chemotherapy (P = 0.018), but not BMI. CONCLUSIONS This analysis indicates that malnutrition risk was a potential indicator of 12-month mortality in cases where chemotherapy was considered unfeasible. However, this was not an independent risk factor. Further investigation using a larger sample is required to determine the association between malnutrition risk, quality of life and mortality in patients who are not considered to be fit for chemotherapy.
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Affiliation(s)
- Liliana Botero
- Nutrition and Dietetics, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ekta Agarwal
- Nutrition and Dietetics, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Queensland, Australia.,Master of Nutrition and Dietetic Practice Program, Bond University, Robina, Queensland, Australia.,Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Robyn Berry
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Kerri Gillespie
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Elisabeth Isenring
- Master of Nutrition and Dietetic Practice Program, Bond University, Robina, Queensland, Australia.,Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Alexandra L McCarthy
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Nursing, University of Auckland, Auckland, New Zealand
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Gomes MMA, Silva JM, Silva Ferreira ÁR, Vasconcelos Generoso S, Correia MITD. Implementing Quality Assessment Is Fundamental to Guarantee Optimal Nutrition Therapy. JPEN J Parenter Enteral Nutr 2019; 44:274-281. [DOI: 10.1002/jpen.1600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/22/2019] [Indexed: 11/08/2022]
Affiliation(s)
| | - Jessica Moreira Silva
- Nutrition Post Graduation Program Nursing School Universidade Federal de Minas Gerais
| | | | | | - Maria Isabel Toulson Davisson Correia
- Surgical Department, and Applied Sciences in Surgery and Ophtalmology Post Graduation Program Medical School, and Nutrition Post Graduation Program Nursing School Universidade Federal de Minas Gerais Belo Horizonte Minas Gerais Brazil
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6
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Won HS, Sun DS, Choi JY, An HJ, Ko YH. Factors associated with treatment interruption in elderly patients with cancer. Korean J Intern Med 2019; 34:156-164. [PMID: 29466848 PMCID: PMC6325427 DOI: 10.3904/kjim.2016.318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 05/14/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/AIMS This study was conducted to identify risk factors that predict vulnerability to cancer therapy on the basis of the clinical, geriatric, and quality of life assessment before starting treatment in elderly patients. METHODS Seventy-five patients aged 65 years and over with newly diagnosed stage IV solid cancer receiving chemotherapy were analyzed. Clinical and laboratory data were collected. The geriatric assessment was performed using the Korean versions of the Modified Barthel Index, Instrumental Activities of Daily Living, Mini-Mental State Examination, and Geriatric Depression Scale. The European Organisation for Research and Treatment of Cancer Quality-of-Life Core Questionnaire (EORTC-QLQ-C30) was also performed. RESULTS Forty-one patients stopped cancer treatment during or after the end of first-line therapy and were classified as the treatment interruption group. By univariate analysis, treatment interruption was associated with metastases to ≥ 2 distant sites, lower albumin level, lower EORTC-QLQ-C30 physical and role functioning scores, and higher EORTC-QLQ-C30 fatigue and appetite loss symptom scores. By multivariate analysis, treatment interruption was significantly associated with low score for the EORTC-QLQ-C30 physical functioning scale (odds ratio [OR], 1.020; 95% confidence interval [CI], 1.002 to 1.039; p = 0.030), and ≥ 2 sites of distant metastases (OR, 2.965; 95% CI, 1.012 to 8.681; p = 0.047). CONCLUSION The EORTC-QLQ-C30 physical functioning score and metastases to ≥ 2 organs, which indicate a poor physical functional status and metastatic high tumor burden, were significantly associated with interruption of first-line treatment in elderly patients with cancer.
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Affiliation(s)
- Hye Sung Won
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Korea
| | - Der Sheng Sun
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Korea
| | - Ji Young Choi
- Department of Nursing, College of Medicine, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Korea
| | - Ho Jung An
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea
| | - Yoon Ho Ko
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Korea
- Correspondence to Yoon Ho Ko, M.D. Division of Medical Oncology, Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, 271 Cheonbo-ro, Uijeongbu 11765, Korea Tel: +82-31-820-3985 Fax: +82-31-847-2719 E-mail:
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7
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Boulahssass R, Gonfrier S, Ferrero JM, Sanchez M, Mari V, Moranne O, Rambaud C, Auben F, Hannoun Levi JM, Bereder JM, Bereder I, Baque P, Turpin JM, Frin AC, Ouvrier D, Borchiellini D, Largillier R, Sacco G, Delotte J, Arlaud C, Benchimol D, Durand M, Evesque L, Mahamat A, Poissonnet G, Mouroux J, Barriere J, Benizri E, Piche T, Guigay J, Francois E, Guerin O. Predicting early death in older adults with cancer. Eur J Cancer 2018; 100:65-74. [PMID: 30014882 DOI: 10.1016/j.ejca.2018.04.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/12/2018] [Accepted: 04/16/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Predicting early death after a comprehensive geriatric assessment (CGA) is very difficult in clinical practice. The aim of this study was to develop a scoring system to estimate risk of death at 100 days in elderly cancer patients to assist the therapeutic decision. METHODS This was a multicentric, prospective cohort study approved by an ethics committee. Elderly cancer patients aged older than 70 years were enrolled before the final therapeutic decision. A standardised CGA was made before the treatment decision at baseline. Within 100 days, event (death), oncologic and geriatric data were collected. Multivariate logistic regression was used to select the risk factors for the overall population. Score points were assigned to each risk factor using the β coefficient. Internal validation was performed by a bootstrap method. Calibration was assessed with the Hosmer-Lemeshow goodness of fit test and accuracy with the mean c-statistic. FINDINGS One thousand fifty patients (mean age: 82 years) joined the study from April 2012 to December 2014. The independent predictors were metastatic cancers (odds ratio [OR] 2.5; 95% confidence interval [CI], [1.7-3.5] p<0 .001); gait speed<0.8 m/s (OR 2.1; 95% CI [1.3-3.3] p=0.001); Mini Nutritional Assessment (MNA) < 17 (OR 8; 95% CI; [3.7-17.3] p<0.001), MNA ≤23.5 and ≥ 17 (OR 4.4; 95% CI, [2.1-9.1) p<0.001); performance status (PS) > 2 (OR 1.7; 95% CI, [1.1-2.6)] p=0.015) and cancers other than breast cancer (OR 4; 95% CI, [2.1-7.9] p<0.001). We attributed 4 points for MNA<17, 3 points for MNA between ≤23.5 and ≥ 17, 2 points for metastatic cancers, 1 point for gait speed <0.8 m/s, 1 point for PS > 2 and 3 points for cancers other than breast cancer. The risk of death at 100 days was 4% for 0 to 6 points, 24% for 7 to 8 points, 39% for 9 to 10 points and 67% for 11 points. INTERPRETATION To our knowledge, this is the first score which estimates early death in elderly cancer patients. The system could assist in the treatment decision for elderly cancer patients.
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Affiliation(s)
- Rabia Boulahssass
- Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France; FHU ONCOAGE; Nice, France.
| | - Sebastien Gonfrier
- Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France.
| | - Jean-Marc Ferrero
- University of Nice Sophia Antipolis, France; Department of Medical Oncology, Lacassagne Center; Nice, France.
| | - Marine Sanchez
- Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France.
| | - Véronique Mari
- Department of Medical Oncology, Lacassagne Center; Nice, France.
| | - Olivier Moranne
- Department of Nephrology, Hopital Caremeau Nimes, France; Institut Universitaire de Recherche Clinique - EA2415 - Epidémiologie, Biostatistiques et Santé Publique/University of Montpellier; Nice, France.
| | - Cyrielle Rambaud
- Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France.
| | - Francine Auben
- Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France.
| | - Jean-Michel Hannoun Levi
- University of Nice Sophia Antipolis, France; Department of Medical Oncology, Lacassagne Center; Nice, France.
| | - Jean-Marc Bereder
- Department of Surgical Digestive Oncology, CHU de Nice; Nice, France.
| | | | - Patrick Baque
- University of Nice Sophia Antipolis, France; University of Nice Sophia Antipolis, Emergency Surgery Unit, CHU de Nice; Nice, France.
| | - Jean Michel Turpin
- Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France.
| | - Anne-Claire Frin
- Unit of Medical Oncology, Department of Gastroenterology, CHU Nice, Nice, France.
| | - Delphine Ouvrier
- Unit of Medical Oncology, Department of Gastroenterology, CHU Nice, Nice, France.
| | | | - Remy Largillier
- Cancer Center: Centre Azuréen de Cancérologie; Mougins, France.
| | - Guillaume Sacco
- University of Nice Sophia Antipolis, France; Geriatric Department CHU de NICE, France; CoBtek, France.
| | - Jerome Delotte
- University of Nice Sophia Antipolis, France; Department of Obstetrics and Gynecology, Reproduction and Fetal Medicine, CHU de Nice; Nice, France.
| | | | - Daniel Benchimol
- University of Nice Sophia Antipolis, France; Department of Surgical Digestive Oncology, CHU de Nice; Nice, France.
| | - Matthieu Durand
- University of Nice Sophia Antipolis, France; Department of Urology, CHU de Nice, University of Nice Sophia-Antipolis; Nice, France.
| | - Ludovic Evesque
- Department of Medical Oncology, Lacassagne Center; Nice, France.
| | | | | | - Jérôme Mouroux
- University of Nice Sophia Antipolis, France; Department of Thoracic and Cardiovascular Surgery, Hopital Pasteur, CHU Nice, Nice, France.
| | - Jérôme Barriere
- Department of Medical Oncology: Clinic Saint Jean; Cagnes sur Mer France.
| | - Emmanuel Benizri
- University of Nice Sophia Antipolis, France; Geriatric Department CHU de NICE, France.
| | - Thierry Piche
- University of Nice Sophia Antipolis, France; Unit of Medical Oncology, Department of Gastroenterology, CHU Nice, Nice, France.
| | - Joel Guigay
- FHU ONCOAGE; Nice, France; University of Nice Sophia Antipolis, France; Department of Medical Oncology, Lacassagne Center; Nice, France.
| | - Eric Francois
- Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France; Department of Medical Oncology, Lacassagne Center; Nice, France.
| | - Olivier Guerin
- Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France; FHU ONCOAGE; Nice, France; University of Nice Sophia Antipolis, France.
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Ye XJ, Ji YB, Ma BW, Huang DD, Chen WZ, Pan ZY, Shen X, Zhuang CL, Yu Z. Comparison of three common nutritional screening tools with the new European Society for Clinical Nutrition and Metabolism (ESPEN) criteria for malnutrition among patients with geriatric gastrointestinal cancer: a prospective study in China. BMJ Open 2018; 8:e019750. [PMID: 29654013 PMCID: PMC5898289 DOI: 10.1136/bmjopen-2017-019750] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate and compare three common nutritional screening tools with the new European Society for Clinical Nutrition and Metabolism (ESPEN) diagnostic criteria for malnutrition among elderly patients with gastrointestinal cancer. RESEARCH METHODSANDPROCEDURES Nutritional screening tools, including the Nutritional Risk Screening 2002 (NRS 2002), the Malnutrition Universal Screening Tool (MUST) and the Short Form of Mini Nutritional Assessment (MNA-SF), were applied to 255 patients with gastrointestinal cancer. We compared the diagnostic values of these tools for malnutrition, using the new ESPEN diagnostic criteria for malnutrition as the 'gold standards'. RESULTS According to the new ESPEN diagnostic criteria for malnutrition, 20% of the patients were diagnosed as malnourished. With the use of NRS 2002, 52.2% of the patients were found to be at high risk of malnutrition; with the use of MUST, 37.6% of the patients were found to be at moderate/high risk of malnutrition; and according to MNA-SF, 47.8% of the patients were found to be at nutritional risk. MUST was best correlated with the ESPEN diagnostic criteria (К=0.530, p<0.001) compared with NRS 2002 (К=0.312, p<0.001) and MNA-SF (К=0.380, p<0.001). The receiver operating characteristic curve of MUST had the highest area under the curve (AUC) compared with NRS 2002 and MNA-SF. CONCLUSIONS Among the tools, MUST was found to perform the best in identifyingmalnourished elderly patients with gastrointestinal cancer distinguished by the new ESPEN diagnostic criteria for malnutrition. Nevertheless, further studies are needed to verify our findings. TRIAL REGISTRATION NUMBER ChiCTR-RRC-16009831; Pre-results.
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Affiliation(s)
- Xiao-Jun Ye
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
- Department of Medicine, Medical College of Soochow University, Suzhou, China
| | - Yan-Bin Ji
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
- Department of Gastrointestinal Surgery, Shanghai Clinical Institution, Anhui Medical University, Shanghai, China
| | - Bing-Wei Ma
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Dong-Dong Huang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Wei-Zhe Chen
- The First Affiliated Hospital, Wenzhou Medical University, Department of Gastrointestinal Surgery, Wenzhou, China
| | - Zong-You Pan
- Department of Sports Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xian Shen
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Cheng-Le Zhuang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Zhen Yu
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
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9
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Bicakli DH, Ozveren A, Uslu R, Dalak RM, Cehreli R, Uyar M, Karabulut B, Akcicek F. The effect of chemotherapy on nutritional status and weakness in geriatric gastrointestinal system cancer patients. Nutrition 2018; 47:39-42. [DOI: 10.1016/j.nut.2017.09.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/22/2017] [Accepted: 09/17/2017] [Indexed: 12/18/2022]
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10
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Vega MCMD, Laviano A, Pimentel GD. Sarcopenia and chemotherapy-mediated toxicity. EINSTEIN-SAO PAULO 2017; 14:580-584. [PMID: 28076611 PMCID: PMC5221390 DOI: 10.1590/s1679-45082016md3740] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 08/18/2016] [Indexed: 01/06/2023] Open
Abstract
This narrative review focuses on the role of sarcopenia and chemotherapy-induced toxicity in cancer patients. Consistent evidence shows that sarcopenia in cancer patients leads to decreased overall survival by influencing treatment discontinuation and dose reduction. Therefore, sarcopenia should be considered a robust prognostic factor of negative outcome as well as a determinant of increased healthcare costs.
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Affiliation(s)
| | | | - Gustavo Duarte Pimentel
- Laboratório de Investigação em Nutrição Clínica e Esportiva, Faculdade de Nutrição, Universidade Federal de Goiás, Goiânia, GO, Brazil
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11
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Martucci RB, Barbosa MV, D'Almeida CA, Rodrigues VD, Bergmann A, de Pinho NB, Thuler LCS. Undernutrition as independent predictor of early mortality in elderly cancer patients. Nutrition 2017; 34:65-70. [DOI: 10.1016/j.nut.2016.09.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 09/22/2016] [Accepted: 09/23/2016] [Indexed: 10/20/2022]
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12
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Tomasini P, Mascaux C, Barlesi F. Elderly selection on geriatric index assessment. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:245. [PMID: 27428614 DOI: 10.21037/atm.2016.05.61] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Pascale Tomasini
- Multidisciplinary Oncology & Therapeutic Innovations Department, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, Marseille, France;; Aix Marseille University, Inserm U911 CRO2, Marseille, France
| | - Celine Mascaux
- Multidisciplinary Oncology & Therapeutic Innovations Department, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, Marseille, France;; Aix Marseille University, Inserm U911 CRO2, Marseille, France
| | - Fabrice Barlesi
- Multidisciplinary Oncology & Therapeutic Innovations Department, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, Marseille, France;; Aix Marseille University, Inserm U911 CRO2, Marseille, France
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Bozzetti F. Evidence-based nutritional support of the elderly cancer patient. Nutrition 2015; 31:585-6. [DOI: 10.1016/j.nut.2014.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 11/24/2014] [Indexed: 02/08/2023]
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