Nutritional Status of Patients with Cancer: A Prospective Cohort Study of 1,588 Hospitalized Patients

Na, Byung-Gon; Han, Sung‐Sik; Cho, Yeong-Ah; Wie, Gyung-Ah; Kim, Jiyeon; Lee, Jongmog; Lee, Seung Duk; Kim, Seong Hoon; Park, Sang-Jae

doi:10.1080/01635581.2019.1578392

Cited by 32 publications

(27 citation statements)

References 23 publications

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“…Patients with EC often suffer from relevant disease due to impaired oral food uptake by tumor-associated dysphagia [37]. Besides the impact on quality of life, this accelerates tumor cachexia and further reduces the condition of patients [38]. In the course of RT, dysphagia may be aggravated by therapy-associated side effects.…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant and Definitive Radiochemotherapeutic Approaches in Esophageal Cancer: A Retrospective Evaluation of 122 Cases in Daily Clinical Routine

et al. 2020

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Introduction: Esophageal cancer (EC) is a common malignant tumor entity with increasing occurrence. The incidence of esophageal adenocarcinoma (AC), particularly, is constantly rising in the Western world. The mainstays of therapy with curative intent for EC in advanced stages are neoadjuvant radiochemotherapy (neoRCT) with surgery and definitive radiochemotherapy (defRCT). Methods: We examined our internal files to identify patients suffering from EC. Palliative cases were excluded. Statistical testing was performed by χ 2 test, Student's t test, Kaplan-Meier analyses, and the Mann-Whitney U test. Results: One hundred and twentytwo cases were included. Histology revealed squamous cell carcinoma in 92 cases and AC in 23 cases. Ninety-five patients underwent defRCT, 27 underwent neoRCT, and 114 (in both therapy regimes) received simultaneous chemotherapy. There was no difference in the overall survival (OS) (p = 0.654; HR 1.145; 95% CI 0.629-2.086) or and progression-free survival (PFS) (p = 0.912) of patients who underwent neoRCT or defRCT. Median OS was 13.5 (2-197) months for defRCT patients and 19.5 (2-134) months for neoRCT patients (p = 0.751). Karnofsky index (KI) with a cutoff of 70% was strongest, but not a significant parameter for OS (p = 0.608) or PFS (p = 0.137). Conclusion: defRCT is a valid and an equal alternative to neoRCT for patients suffering from EC. Selection of patients for therapy is of crucial relevance. Further studies and improvements in follow-up are needed when neoRCT has been completed before surgery, in order to spare the patient undergoing operative treatment if there is complete remission. The identification of valid markers urgently needed to limit treatment side effects.

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Section: Discussionmentioning

confidence: 99%

Neoadjuvant and Definitive Radiochemotherapeutic Approaches in Esophageal Cancer: A Retrospective Evaluation of 122 Cases in Daily Clinical Routine

et al. 2020

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“…Moreover, PG-SGA is a reliable tool as evidenced by several findings that have indicated acceptable internal consistency (Cronbach’s alpha = 0.72 to 0.73) in a variety of patient populations and acceptabletest-retest reliability ( r = 0.87) witha 14-day-period reassessment [ 40 , 41 ]. PG-SGA correlates with various nutritional parameters and nutritionally associated outcomes, such as global quality of life, to mostly assess patients with cancer in Australian and Asian populations [ 35 , 41 , 46 , 70 ]. Furthermore, a higher PG-SGA score can predict longer hospital stays for patients with stroke [ 71 ], cancer [ 35 ], and undergoing gastrointestinal surgery [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical measurement properties of malnutrition assessment tools for use with patients in hospitals: a systematic review

Vincent

2020

Nutr J

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Background The use of malnutrition outcome measures (OM) by registered dietitians (RD) with inpatients in hospitals has increased promoting the achievement of nutritional care goals and supporting decision-making for the allocation of nutritional care resources in hospitals. There are 3 commonly used OMs: Subjective Global Assessment (SGA), Patient Generated-Subjective Global Assessment (PG-SGA) and Mini Nutritional Assessment (MNA). The purpose of this current study was to systematically review the evidence of the clinical measurement properties of malnutrition assessment tools for use with patients admitted in hospitals. Methods MEDLINE, Cinahl, EMBASE, and PubMed were searched for articles published between 2000 and 2019. Research articles were selected if they established reliability, validity, and responsiveness to change properties of the SGA, PG-SGA and MNA tools, were written in English, and used any of these OMs as an outcome measure. Abstracts were not considered. The risk of bias within studies was assessed using the Quality Appraisal for Clinical Measurement Study (QA-CMS). Results Five hundred five studies were identified, of which 34 articles were included in the final review: SGA (n = 8), PG-SGA (n = 13), and MNA (n = 13). Of the 34 studies, 8 had a quality score greater than 75%; 23 had a quality score of 40–75% and 3 studies had a quality score of less than 40%. PG-SGA was found to have excellentdiagnostic accuracy (ROC: 0.92–0.975; Sensitivity: 88.6–98%; Specificity: 82–100%), sufficient internal consistency (Cronbach’s alpha: 0.722–0.73), and strong test-retest reliability (r = 0.866). There was insufficient evidence to suggest adequate diagnostic accuracy and good inter-rater reliability for SGA. Only one study examined the minimum detectable change of MNA (MDC = 2.1). Conclusions The evidence of validity for the existing malnutrition assessment tools supports the use of these tools, but more studies with sound methodological quality are needed to assess the responsiveness of these OMs to detect the change in nutritional status.

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“…These results, most likely, are due to the preservation of parietal digestion in the gastrointestinal tract, the preservation of a relatively satisfactory passage of the intestine with the possibility of absorption of nutrients in the intestine while maintaining or activating its functional activity in the early postoperative period [1], [3], [6], [12], [18].…”

Section: Discussionmentioning

confidence: 99%

“…In most cases, patients continue to enter specialized hospitals only with the development of various complications of cancer of the organs of the hepatopancreatoduodenal zone. Violation of nutritional status has a significant impact on the outcome and prognosis of the disease, increases the duration of treatment and the cost of treatment, and also increases mortality and the number of complications [1], [2], [3], [4].…”

Section: Introductionmentioning

confidence: 99%

Nutritional Support for Patients with Diseases of Hepatopancreotoduodenal Zone in the Early After the Operational Period

Kurbanalievich¹,

Vladimirovich²,

Kabildina³

2020

Open Access Maced J Med Sci

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AIM: Analysis of the effectiveness of nutritive nutrition in cancer patients in the early post-operative period. MATERIALS AND METHODS: The examination included 80 patients with an average age of more than 20 years (men – 35, and women – 4 5). All patients for analysis were divided into two groups: The first, the main-receiving strictly enteral and/or probe nutrition (n = 41), the second, control-isolated parenteral nutrition (n = 39). The dynamics of laboratory examination results was assessed – the level of total blood protein, including albumin, the number of lymphocytes, the values of alanine aminotransferase, aspartate aminotransferase, total blood bilirubin, and serum ferritin. In addition, the duration of the use of enteral and parenteral nutrition, the number of patient days in the intensive care unit, the nutritional status of patients on the subjective global assessment (SGA), and nutritional risk index (NRI) scales were evaluated. RESULTS: Most patients in the control group (n = 31) on the 10–12th days of the post-operative period, according to the SGA and NRI estimates, were in a state of normal nutritional status (n = 8) – in a state of moderate malnutrition. Since the introduction of parenteral nutrition with enteral nutrition (13–15 days), patients with signs of malnutrition have not been identified in this group. The assessment of the dynamics of total blood protein values in patients showed a significant difference between the average values of indicators in the clinical groups throughout the study period (p < 0.05). In the main group, the average content of total blood protein was 62.5 ± 10.0 g/l, in the control group – 57.5 ± 10.1 g/l by 8 days of the post-operative period. The dynamics of specific indicators of the biochemical composition of blood is determined by the methods of surgical intervention, the volume, duration, and nature of the operation. CONCLUSIONS: When carrying out nutritional support in cancer patients operated on for tumors, hepatopancreatoduodenal region, in the early post-operative period, the enteral route to the action of nutrient mixtures may be preferable, provided there is a pronounced intestinal paresis and congestive discharge from the stomach.

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Nutritional Status of Patients with Cancer: A Prospective Cohort Study of 1,588 Hospitalized Patients

Cited by 32 publications

References 23 publications

Neoadjuvant and Definitive Radiochemotherapeutic Approaches in Esophageal Cancer: A Retrospective Evaluation of 122 Cases in Daily Clinical Routine

Neoadjuvant and Definitive Radiochemotherapeutic Approaches in Esophageal Cancer: A Retrospective Evaluation of 122 Cases in Daily Clinical Routine

Clinical measurement properties of malnutrition assessment tools for use with patients in hospitals: a systematic review

Nutritional Support for Patients with Diseases of Hepatopancreotoduodenal Zone in the Early After the Operational Period

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