Assessment of nutritional status of gynecological cancer cases in India and comparison of subjective and objective nutrition assessment parameters

Abstract

Aim:To assess the nutritional status of gynecological cancer patients using scored Patient Generated Subjective Global Assessment (PG-SGA) then compare it with the body mass index (BMI), hemoglobin, serum albumin, and approximate percentage weight lost in last 1 month so as to find any one parameter that can be used in place of the comprehensive assessment tool.Materials and Methods:Sixty gynecological cancer patients were assessed for their nutritional status using BMI, serum albumin, hemoglobin, percentage weight lost in last 1 month, and scored PG-SGA. Correlation, sensitivity, specificity, and predictive values of the former four parameters compared to scored PG-SGA were calculated.Results:88.33% of cases were at risk of or had some degree of malnutrition according to scored PG-SGA. Serum albumin level ≤ 2 g/dl had highest specificity and positive predictive value at 1, whereas percentage weight lost in last month had better overall sensitivity, specificity, and positive and negative predictive values of 0.5833, 0.9444, 0.875, and 0.7727, respectively. The Pearson's correlation coefficient between scored PG-SGA and percentage weight lost in last 1 month was 0.784, highest among all the parameters.Conclusion:88.33% of gynecologic cancer cases had some degree of malnutrition or were at risk of malnutrition. Approximate percentage weight lost in last 1 month, that is, ≥ 5% may be used in place of the comprehensive scored PG-SGA to triage the patients in case the latter is not used for some reason. Severe hypoalbuminemia ≤ 2 g/dl is an indicator of severe malnutrition in gynecologic cancer cases.

Patient Generated Subjective Global Assessment as a prognosis tool in women with gynecologic cancer

“…However, Laky et al 13 found that women with ovarian cancer were more susceptible to NS alterations, while patients with endometrial and uterine cancer comprise a group that is less predisposed to such alterations, which parallels our findings. More recently, Das et al 14 Indeed, the rate of malnutrition in cancer patients seems to depend not only on tumor location, but on histological type, staging and cancer treatment. [15][16][17][18] By analyzing the effect cancer site and stage has on NS, we found no significant difference, that is, NS shared the same distribution pattern across different sites and stages of cancer.…”

Influence of chemoradiotherapy on nutritional status, functional capacity, quality of life and toxicity of treatment for patients with cervical cancer

“…In the present study, despite of the low frequency of underweight individuals diagnosed by the BMI, roughly 33% of the patients had cachexia and/or weight loss greater than 5% before chemoradiotherapy. Other authors also reported a pre‐treatment weight loss ranging from 26% to 40% among patients with gynaecological cancer . Weight loss and anorexia, present in cancer cachexia, can provoke a limitation in the doses of chemoradiotherapy, in addition to higher chances of treatment toxicity .…”

“…Other authors also reported a pre-treatment weight loss ranging from 26% to 40% among patients with gynaecological cancer. 34,35 Weight loss and anorexia, present in cancer cachexia, can provoke a limitation in the doses of chemoradiotherapy, in addition to higher chances of treatment toxicity. 15 It has been suggested that the %WL seems to be a better parameter than BMI in cancer patients undergoing chemotherapy 36 and a good prognostic factor of QoL irrespective of the type of cancer.…”

Severe weight loss during preoperative chemoradiotherapy compromises survival outcome for patients with locally advanced rectal cancer

“…First of all, weight loss does not totally represent malnutrition status. Other reported methods for the evaluation include descending change in serum albumin and hemoglobin level during treatment, as well as the scored Patient Generated Subjective Global Assessment (PG-SGA) (Das et al 2014). Nevertheless, weight loss is closely related to those parameters, and our data provided an essential clue for further research.…”