Clinical malnutrition predictive model among gynecologic cancer patients prior to elective operation: A cross-sectional study

Ho, Chiou Yi; Ibrahim, Zuriati; Zaid, Zalina Abu; Daud, Zulfitri Azuan Mat; Yusop, Nor Baizura Md

doi:10.1016/j.clnu.2021.01.008

Cited by 9 publications

(4 citation statements)

References 39 publications

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“…BMI and weight were unable to detect malnutrition among GC patients when used as the sole nutritional variable. This finding was consistent with previous studies in which BMI alone was limited in reflecting nutritional status and thus not accurate in indicating malnutrition in GC patients [ 15 , 16 , 17 , 18 ]. Underestimation of BMI in detecting malnutrition might be caused by body fluid imbalance, which includes the presence of ascites or oedema caused by a decrease in albumin [ 15 , 19 ].…”

Section: Discussionsupporting

confidence: 93%

Postoperative Dietary Intake Achievement: A Secondary Analysis of a Randomized Controlled Trial

Ibrahim

Zaid

et al. 2022

Nutrients

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Sufficient postoperative dietary intake is crucial for ensuring a better surgical outcome. This study aimed to investigate the postoperative dietary intake achievement and predictors of postoperative dietary intake among gynecologic cancer patients. A total of 118 participants were included in this secondary analysis. Postoperative dietary data was pooled and re-classified into early postoperative dietary intake achievement (EDIA) (daily energy intake (DEI) ≥ 75% from the estimated energy requirement (EER)) and delay dietary intake achievement (DDIA) (DEI < 75% EER) There was a significant difference in postoperative changes in weight (p = 0.002), muscle mass (p = 0.018), and handgrip strength (p = 0.010) between the groups. Postoperative daily energy and protein intake in the EDIA was significantly greater than DDIA from operation day to discharged (p = 0.000 and p = 0.036). Four significant independent postoperative dietary intake predictors were found: preoperative whey protein-infused carbohydrate loading (p = 0.000), postoperative nausea vomiting (p = 0.001), age (p = 0.010), and time to tolerate clear fluid (p = 0.016). The multilinear regression model significantly predicted postoperative dietary intake, F (4, 116) = 68.013, p = 0.000, adj. R2 = 0.698. With the four predictors’ recognition, the integration of a more specific and comprehensive dietitian-led supportive care with individualized nutrition intervention ought to be considered to promote functional recovery.

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Section: Discussionsupporting

confidence: 93%

Postoperative Dietary Intake Achievement: A Secondary Analysis of a Randomized Controlled Trial

Ibrahim

Zaid

et al. 2022

Nutrients

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“…The PG-SGA provides a score (higher score indicates a higher risk of malnutrition) and categorizes patients into three distinct classes of nutritional status: A, well-nourished; B, suspected malnutrition or moderately malnourished; and C, severely malnourished. In this analysis, patients were categorized into two groups: wellnourished (PG-SGA score 0-3) and malnourished (PG-SGA score ≥4) (15,(26)(27)(28).…”

Section: Nutritional Assessmentmentioning

confidence: 99%

Progressive Skeletal Muscle Loss After Surgery and Adjuvant Radiotherapy Impact Survival Outcomes in Patients With Early Stage Cervical Cancer

et al. 2022

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The effect of skeletal muscle loss associated with surgery and adjuvant radiotherapy on survival outcomes in patients with early-stage cervical cancer remains unclear. We analyzed the data of 133 patients with early-stage cervical cancer who underwent surgery and adjuvant radiotherapy between 2013 and 2018 at two tertiary centers. Skeletal muscle changes were measured using computed tomography scans at baseline, at simulation for radiotherapy, and at 3 months post-treatment. A decrease of ≥5% in the skeletal muscle was defined as “muscle loss.” The Patient-Reported Outcome version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) was used to assess gastrointestinal toxicity. The Patient-Generated Subjective Global Assessment (PG-SGA) was used for nutritional assessment. Predictors of overall survival were identified using the Cox regression models. The median follow-up period was 3.7 years. After treatment, 32 patients (24.1%) experienced muscle loss. The rate of muscle loss was higher in patients with PRO-CTCAE score ≥3 or PG-SGA score ≥4 at the end of radiotherapy than in patients with PRO-CTCAE score ≤2 or PG-SGA score 0–3 (75.0 vs. 10.5%, p < 0.001; 71.4 vs. 2.2%, p < 0.001). The 3-year overall survival was significantly lower in patients with muscle loss than in those with muscle preserved (65.6 vs. 93.9%, p < 0.001). Multivariate analysis showed that muscle loss was independently associated with poor overall survival (hazard ratio, 4.55; 95% confidence interval: 1.63–12.72; p < 0.001). Muscle loss after surgery and adjuvant radiotherapy was associated with poor overall survival in patients with early-stage cervical cancer. Muscle loss is associated with patient-reported gastrointestinal toxicity and deterioration in nutritional status.

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“…The trained nutrition support team used the Chinese version of PG-SGA in the ward to investigate the nutritional status of the patients included in this study prior to PORT/CRT. During this research, the study subjects were classified into two groups based on previous studies (20,21): the well-nourished group containing individuals with a PG-SGA score between 1 and 3 and the malnourished group containing individuals with a PG-SGA score ≥ 4.…”

Section: Treatment Work-up and Nutritional Assessmentmentioning

confidence: 99%

Development and validation of a radiomics-based nomogram for the prediction of postoperative malnutrition in stage IB1-IIA2 cervical carcinoma

Yu¹,

Chen

et al. 2023

Front. Nutr.

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ObjectiveIn individuals with stage IB1-IIA2 cervical cancer (CC) who received postoperative radiotherapy ± chemotherapy (PORT/CRT), the interaction between sarcopenia and malnutrition remains elusive, let alone employing a nomogram model based on radiomic features of psoas extracted at the level of the third lumbar vertebra (L3). This study was set to develop a radiomics-based nomogram model to predict malnutrition as per the Patient-Generated Subjective Global Assessment (PG-SGA) for individuals with CC.MethodsIn total, 120 individuals with CC underwent computed tomography (CT) scans before PORT/CRT. The radiomic features of psoas at L3 were obtained from non-enhanced CT images. Identification of the optimal features and construction of the rad-score formula were conducted utilizing the least absolute shrinkage and selection operator (LASSO) logistic regression to predict malnutrition in the training dataset (radiomic model). Identification of the major clinical factors in the clinical model was performed by means of binary logistic regression analysis. The radiomics-based nomogram was further developed by integrating radiomic signatures and clinical risk factors (combined model). The receiver operating characteristic (ROC) curves and decision curves analysis (DCA) were employed for the evaluation and comparison of the three models in terms of their predictive performance.ResultsTwelve radiomic features in total were chosen, and the rad-score was determined with the help of the non-zero coefficient from LASSO regression. Multivariate analysis revealed that besides rad-score, age and Eastern Cooperative Oncology Group performance status could independently predict malnutrition. As per the data of this analysis, a nomogram prediction model was constructed. The area under the ROC curves (AUC) values of the radiomic and clinical models were 0.778 and 0.847 for the training and 0.776 and 0.776 for the validation sets, respectively. An increase in the AUC was observed up to 0.972 and 0.805 in the training and validation sets, respectively, in the combined model. DCA also confirmed the clinical benefit of the combined model.ConclusionThis radiomics-based nomogram model depicted potential for use as a marker for predicting malnutrition in stage IB1-IIA2 CC patients who underwent PORT/CRT and required further investigation with a large sample size.

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Clinical malnutrition predictive model among gynecologic cancer patients prior to elective operation: A cross-sectional study

Cited by 9 publications

References 39 publications

Postoperative Dietary Intake Achievement: A Secondary Analysis of a Randomized Controlled Trial

Postoperative Dietary Intake Achievement: A Secondary Analysis of a Randomized Controlled Trial

Progressive Skeletal Muscle Loss After Surgery and Adjuvant Radiotherapy Impact Survival Outcomes in Patients With Early Stage Cervical Cancer

Development and validation of a radiomics-based nomogram for the prediction of postoperative malnutrition in stage IB1-IIA2 cervical carcinoma

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