[Nutritional risk screening and related factors of cancer patients in community of Shanghai, 2018-2019]

Assessing the performance of QLQ-C30 in predicting all-cause mortality in community cancer patients

BACKGROUND

To evaluate the ability of QLQ-C30 in predicting mortality in community-based cancer patients in China.

METHODS

A whole-cluster sampling method was adopted to enroll cancer patients in four communities in Shanghai from 2018 to 2019. The patients were surveyed using a questionnaire enquiring demographic information, cancer types, and QLQ-C30 scale. Death information of participants was collected and updated from community health care centers. Cox regression models were used to assess the relationship between various QLQ-C30 scores (i.e., total score, five dimension scores, and utility score) and all-cause mortality.

RESULTS

A total of 3,304 participants were enrolled with a mean age of 63.9 years. Among them, 2,710 patients survived while 594 died by 2023. The mean total QLQ-C30 score in living patients was statistically significantly higher than that in deceased patients ( 92.96 vs. 85.21, p < 0.001); and the mean values of the five dimension scores and utility score were also significantly higher for the living patients. Cox regression models with the adjustment of covariates also confirmed that higher QLQ-C30 scores were associated with lower risk of death, with the hazard ratio value being 0.81 for the total score, 0.83-0.89 for the dimension scores, and 0.83 for the utility score, respectively (p < 0.001 for all).

CONCLUSIONS

QLQ-C30 could accurately predict all-cause mortality in Chinese community cancer patients.

[Nutritional Risk Screening in head-and-neck cancer patients prior to oncological therapy]

OBJECTIVE

Head-and-neck cancer patients run a high risk of peri- or post-treatment malnutrition that can severely affect the therapy outcome. However, little is known about malnutrition under the pre-treatment condition. Therefore, this study aimed to provide a systematic description of the pre-treatment nutritional status and risk of malnutrition in this population.

MATERIAL AND METHODS

Before the onset of the oncological therapy, nutritional status of 102 head-and-neck cancer patients was assessed by body mass index (BMI), their risk of malnutrition by "Nutritional Risk Screening" (NRS). Tumour stage and site, patients' age and sex as well as oropharyngeal dysphagia were analysed as possible influence factors. The latter was quantified by the Flexible Endoscopic Evaluation of Swallowing (FEES).

RESULTS

According to BMI, malnutrition (undernutrition) was found in 6% of patients, a risk of malnutrition (NRS) in 27% of patients, and oropharyngeal dysphagia in 15%. In a linear regression, only oropharyngeal dysphagia was identified as a significant influence factor for the risk of malnutrition (β = 0.380/3.776; p < .001).

CONCLUSIONS

Pre-treatment risk of malnutrition was found in a quarter of head-and-neck cancer patients. For the early identification of this risk and for the introduction of measures that would help to avoid it, a pre-treatment examination of swallowing functions and a systematic malnutrition screening by means of NRS are recommended.