Among elderly patients with colorectal cancer, PA and PG-SGA were prognosis factors. PA >5° was associated with best survival and PG-SGA C with worst survival.
Background The prognosis of colorectal cancer (CRC) patients can be influenced by genetic mutations and nutritional status. The relationship between these variables is unclear. The objective of the study was to verify the variables involved in the nutritional status and genetic mutations, which correlate with survival of CRC patients. Methods Patients with surgical intervention for tumor resection were evaluated using body mass index, nutritional screening, patient self-produced global subjective assessment, phase angle, and computed tomography to calculate the areas of visceral adipose tissue (VAT) and subcutaneous adipose tissue, and muscle mass for the determination of sarcopenia. Ten gene mutations involved in CRC carcinogenesis were studied ( PIK3CA, KRAS, BRAF, EGFR, NRAS, TP53, APC, PTEN, SMAD4 , and FBXW7 ). DNA was extracted from fresh tumor or paraffin tissues. Results Of the 46 patients, 29 (64.4%) were at nutritional risk and 21 (45.7%) were moderately malnourished. However, there was a high percentage of VAT in 24 (61.5%) and sarcopenia in 19 (48.7%) patients. These variables were associated with a higher risk of mortality. Nutritional risk, moderate or severe malnutrition, phase angle < 5°, VAT < 163.8 cm 2 in men and < 80.1 cm 2 in women, and sarcopenia were associated with the relative risk of death, with respective hazard ratios/odds ratios and 95% confidence intervals of 8.77 (1.14–67.1), 3.95 (1.11–14.0), 3.79 (1.10–13.1), 3.43 (1.03–11.4), and 3.95 (1.06–14.6). Increased VAT was associated with a lower risk of death, even in patients older than 60 years or those harboring mutated KRAS . Conclusions Patients with positive indicators for malnutrition or risk of malnutrition had an increased risk of death. No relationship was identified between the presence of mutations and survival.
BACKGROUND: Considering the high incidence of colorectal cancer (CRC) related deaths, many studies have investigated variables that can affect survival, with the aim of prolonging survival. The nutritional status can also be predict survival in patients with CRC. OBJECTIVE: The aim of the present study was to evaluate if BMI, %FAT, PhA, PG-SGA, adiponectin levels, and vitamin D levels are relevant to the characterization and differentiation of patients with advanced CRC and patients with a history of CRC. METHODS: The study was carried out by patients with advanced colorectal cancer (Group 1) and patients in follow-up after colorectal cancer treatment (Group 2). Nutritional status was assessed using the body mass index, body fat percentage, phase angle from bioelectrical impedance, Patient-Generated Subjective Global Assessment score. Adiponectin concentrations were determined using an enzyme-linked immunosorbent assay, and vitamin D levels were measured using high performance liquid chromatography. RESULTS: Groups 1 and 2 consisted of 23 and 27 patients, respectively. The body mass index, body fat percentage, phase angle, vitamin D and adiponectin levels were not significantly different between the groups. The mean Patient-Generated Subjective Global Assessment score was significantly higher in group 1 compared with group 2, and was significantly correlated with the long-term mortality risk. CONCLUSION: Among the nutritional status parameters, only the Patient-Generated Subjective Global Assessment score was significantly different between the groups and was an important predictor of survival in patients with advanced colorectal cancer.
Introduction: Cancer causes an increase in nutritional demands and the presence of of nutritional impact symptoms (NIS) contributes to reduction of nutrient intake and absorption, leading to weight loss, malnutrition and predicting overall survival. Assess the prevalence and predict the weight loss related to cancer, the Grade Scheme and the NIS. Methods: Data were collected from 2012 to 2018 from the first nutritional consultation of cancer patients in a clinic linked to SUS in the city of Guarapuava-PR. The primary outcome was to determine the % of weight loss (% WL), NIS and by the Grade Scheme proposed by Martin et. al (2015) the prognosis was determined by univariate and multivariate Multinomial Logistic Regression (MLR) analysis (adjusted for age, sex and tumor location). Results: 1164 patients aged 56.9 years. In the first consultation, a 6.7 %WL was observed, and it was observed that 21.6% of the patients were underweight. The main sites and %WL were, respectively: Lung 140 (12.0%) and 9.4 %WL, Head and Neck 113 (9.7%) and 10.5 %WL, Colorectal 84 (7.2%) and 10.3 %WL, Stomach 90 (7.7%) and 13.7 %WL, Esophagus 85 (7.3%) and 14.0 %WL, Pancreas 24 (2.1%) and 16.1 %WL. The main NIS were: dry mouth (51.0%), abdominal pain (23.0%), constipation (21.7%), nausea (15.3%) and altered taste (10.5%). In the RML for univariate analysis, age, sex, cancer site and SIN and for multivariate analysis, all cancer locations showed significant OR to be classified in grades 3 and 4. Conclusion: Before chemotherapy, weight loss and malnutrition are present. The cancer site and SIN increase the chance of the patient being classified in grades 3 and 4, leading these patients to a worse nutritional status and contributing to adverse results.
The objective of the papper was to verify the relationship between dietary intake and interdialytic weight gain in patients with chronic kidney disease. Cross-sectional study, in a renal clinic in Irati, Paraná, Brazil. Prehemodialysis weight and weight after hemodialysis were evaluated. Food intake was analyzed according to food frequency and usual food day (DAH). The data were evaluated descriptively and also through the chi-square test, Student's t-test and Mann-Whitney test. Sixty-one patients (54.1%) participated in the study, with a mean age of 57.78±14.58 years, 62.3% of males. The mean pre-hemodialysis weight was 68.28±15.14 kg, while hemodialysis was 65.63±15.01 kg (p<0.05), with a variation of 4.04%. The mean interdialytic weight gain was 2.63±1.26 kg, basically composed of liquids. The majority (60.7%) reached an adequate percentage of carbohydrates and proteins; While 89.3% presented an ideal percentage of lipids. Among vitamins and minerals, all were below the recommended value. Calcium and phosphorus had 98.2% of inadequacy. Those who consumed fruits and vegetables had lower weight (p>0.05). The other food groups (meat, cereals, fats and sweets) also had no association with weight gain (p> 0.05). When the nutrients were compared, according to the DAH, there was no relation with the interdialytic weight gain (p>0.05). Thus, it was observed that there was a relationship between interdialytic weight gain and macronutrient consumption; The same was not observed for micronutrients.
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