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Background The study aims to evaluate the accuracy of isolated nutrition indicators in diagnosing malnutrition in patients with gastric and colorectal cancer and their association with mortality. Methods Prospective cohort study involving patients with cancer (n = 178) attending a reference center of oncology at any point in the disease trajectory or treatment. Nutrition status was evaluated in a unique moment by body mass index (BMI), Patient‐Generated Subjective Global Assessment (PG‐SGA), handgrip strength (HGS), and calf circumference (CC). Kappa coefficient, accuracy, sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC) were calculated for each nutrition indicator (PG‐SGA as the reference method). The Cox proportional hazards model was used to assess hazard ratio (HR) and CI of mortality. Results From the total patients, 11% were underweight, 48% were malnourished (PG‐SGA B or C), 43% had low HGS, and 55% presented low CC. There were 46 deaths (25.8%). BMI, HGS, and CC showed poor and fair agreements (κ < 0.30 for all ) and poor accuracy (AUC < 0.70 for all) in identifying malnutrition by PG‐SGA. After the adjustment for confounders (age, treatment performed, site, and stage of cancer), PG‐SGA (HR, 2.9; 95% CI, 1.5–5.9) and low CC (HR, 2.4; 95% CI, 1.1–5.2) were independent predictors of mortality. Conclusion The nutrition indicators are not accurate in diagnosing malnutrition, whereas PG‐SGA and low CC could predict mortality in gastric and colorectal cancer patients. Thus, CC should be combined with PG‐SGA in nutrition assessments.

The aim of this study was to evaluate whether body composition, muscle function, and their association are predictive factors for short-term postoperative complications in patients with gastric and colorectal cancer. A prospective cohort study was conducted with patients undergoing resection of gastric and colorectal tumors. Nutritional status was assessed using Patient-Generated Subjective Global Assessment (PG-SGA) and anthropometric techniques. Low handgrip strength (HGS) was observed when <16kg for women, and <27kg for men. Computed tomography images were used to measure visceral adipose tissue, skeletal muscle index (SMI), and skeletal muscle radiodensity (SMD). Complications of grade II or above (according to Clavien-Dindo’s classification) were considered in a follow-up period of up to 30 days after surgery. Major complications were defined when they reached grade III or above. A total of 84 patients were analyzed (57.1% female, 59.7 ± 12.6 years) and 19% were diagnosed with low HGS + low SMI or SMD. Postoperative complications occurred in 51.2%, and these patients presented significantly longer duration of surgery and hospital stay. Major complications were observed in 16.7% of the total number of patients. Binary logistic regression adjusted by age, sex, and tumor staging showed that low SMD, low HGS + low SMI or SMD, and obesity were independent risk factors for postoperative complications, but only low SMD was an independent risk factor for major postoperative complications. Low SMD is an independent risk factor for short-term major complications following surgery in patients with gastric and colorectal cancer.

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Introdução: A leucemia linfoblástica aguda (LLA ) constitui a neoplasia mais comum em pediatria e a avaliação nutricional é um instrumento essencial para conhecer as condições de saúde dos pacientes. O presente estudo teve como objetivo avaliar e descrever o estado nutricional de pacientes pediátricos recém-diagnosticados com LLA e verificar a relação do índice de massa corporal para idade (IMC/I) com as demais medidas antropométricas. Método: Estudo observacional, transversal, realizado com pacientes de 1 a 18 anos, recém-diagnosticados com  LLA , no período de janeiro/2004 a dezembro/2009. Os dados coletados foram idade, peso corporal, estatura, prega cutânea tricipital (PCT), circunferência do braço (CB) e circunferência muscular do braço (CMB). O IMC foi calculado e a classificação IMC/I utilizada na análise. O teste Qui-quadrado de Pearson e Exato de Fisher foram utilizados para analisar a associação entre os parâmetros antropométricos. Resultados: Foram incluídos no estudo 54 pacientes. A classificação do “estado nutricional adequado” foi a mais frequente em todos os parâmetros antropométricos. Em adição, observou-se que a associação do estado nutricional pela CMB com o IMC/I (p=0,001) demonstra que este último pode ser adequado para classificação dos pacientes pediátricos com LLA ao diagnóstico. E a concordância da CB com a CMB (p=0,01) de 43% (p=0,001) também ratifica a utilização da CB frente à CMB, por ser uma medida mais simples. Conclusão: Na população estudada, o estado nutricional encontrava-se preservado. Assim como a associação da CMB com o IMC/I, a CB demonstrou ser um parâmetro sensível para classificar eutrofia.

BACKGROUND: During a surgical procedure, patients are often subjected to fasting for times that are more prolonged than the ideal, which may lead to complications. OBJECTIVE: To evaluate the duration of perioperative fasting and its association with postoperative complications, length of hospital stay (LOS) and mortality among gastric and colorectal cancer patients. DESIGN AND SETTING: Cohort study developed in a surgical oncology hospital in the city of Natal (Rio Grande do Norte, Brazil). METHODS: Patients aged over 18 years were included. The Clavien-Dindo surgical complication scale was used to evaluate occurrences of postoperative complications. LOS was defined as the number of days for which patients stayed in the hospital after surgery, or until the day of death. RESULTS: Seventy-seven patients participated (59.8 ± 11.8 years; 54.5% females; 70.1% with bowel tumor). The incidences of postoperative complications and death were 59.7% and 3.9%, respectively. The duration of perioperative fasting was 59.0 ± 21.4 hours, and it was higher among non-survivors and among patients with prolonged hospital stay (≥ 6 days). For each one-hour increase in the durations of perioperative and postoperative fasting, the odds of prolonged hospitalization increased by 12% (odds ratio, OR = 1.12; 95% confidence interval, CI 1.04-1.20) and 5% (OR = 1.05; 95% CI 1.02-1.08), respectively. CONCLUSION: Prolonged perioperative fasting, especially in the postoperative period, was observed in a sample of patients with gastric and colorectal cancer, and this was an independent predictor of LOS.

Introdução: A leucemia linfoblástica aguda é a neoplasia mais comum na população pediátrica, e estudos apontam o estado nutricional como um fator prognóstico importante. Objetivo: Avaliar o estado nutricional de uma coorte de crianças e adolescentes durante o tratamento para leucemia linfoblástica aguda, determinar a sua associação com o risco de recaída e com a sobrevida em cinco anos de seguimento. Método: Estudo observacional, retrospectivo, com 54 pacientes de 1 a 18 anos com leucemia linfoblástica aguda, tratados em um hospital de referência em oncologia, entre janeiro de 2004 e dezembro de 2009. Os dados antropométricos foram coletados pela equipe de pesquisadores, nos prontuários, no período de junho a outubro de 2015. Verificaram-se a incidência de recaída e o óbito nos pacientes estudados em cinco anos de seguimento. Resultados: Houve predomínio do sexo masculino (55,6%) e a mediana de idade foi de 7,0 anos no início do seguimento. Observou-se um aumento significativo no escore-z médio do índice de massa corporal para idade durante o tratamento de 0,13±1,19 ao diagnóstico para 0,72±1,07 no início da fase de manutenção (p=0,000). No presente estudo, o estado nutricional ao diagnóstico não foi determinante para o risco de recaída. As curvas de sobrevida não foram diferentes entre os pacientes com ou sem excesso de peso ao diagnóstico. Conclusão: Na população estudada, observou-se um ganho ponderal significativo durante o tratamento, porém não foi encontrada associação entre estado nutricional ao diagnóstico e risco de recaída, e não se verificou influência do excesso de peso na sobrevida.