The prognostic significance of basic anthropometric data in children with advanced solid tumors

Abstract

In pediatric cancer patients, malnutrition is commonly observed. This may represent the metabolic effect of the primary disease or it may be a consequence of multimodal therapy. This report evaluates the efficacy of using basic anthropometric measurements to predict morbidity during therapy. Twenty children with Wilms' tumor (Stage III, IV, and V) or neuroblastoma (Stage IV) diagnosed at Children's Hospital (Columbus, OH) between January 1983 and December 1985 were evaluated. When compared with the Wilms' tumor patients, the children with neuroblastoma had a significantly lower weight for age at diagnosis. At the completion of therapy, both weight-for-height and weight-for-age measurements were statistically lower in the neuroblastoma group (p less than 0.05). Significant differences were observed between the neuroblastoma and Wilms' tumor patients in the morbidity reported during therapy. Children with neuroblastoma had more frequent hospital admissions, spent a much greater proportion of their treatment time as hospital inpatients, experienced longer delays in therapy, and sustained many more complications. Each of the anthropometric indices was evaluated as a predictor of the complications observed during treatment. In the Wilms' tumor group, the patients with lower weight-for-height percentiles had an increased incidence of incomplete drug infusions, many more complications, more frequent hospital admissions, and an increase in the percentage of time spent as hospital inpatients. In the neuroblastoma group, the anthropometric measurements had no correlation with the subsequent development of complications. Nutritional staging based on anthropometric measurements recorded at diagnosis may be useful in predicting an increased risk of morbidity during therapy in children with Wilms' tumor.

Pediatric neuroblastoma - Impact of nutritional status on complications and outcomes

“…reported that children with neuroblastoma had a significantly lower weight for age at diagnosis when compared with those of Wilms’ tumor. [ 22 ] Their weight for height and weight for age at completion were statistically lower ( P < 0.05). They spent a greater proportion of their treatment time as hospital-admitted patients and had more frequent hospital admissions, longer delays in therapy, and more complications.…”

“…[ 17 18 19 ] Most of them have studied the role of nutrition in neuroblastoma along with other cancers and have included few patients of neuroblastoma. [ 20 21 22 23 24 ] Thus, the impact of nutritional status on neuroblastoma was not very clear.…”

Anthropomorphic measurements and event‐free survival in patients with favorable histology Wilms tumor: A report from the Children's Oncology Group

“…A study of 20 children with advanced stage WT suggested an increase in drug toxicity for those who were lower weight-for-height [7]. Another study, conducted in South Africa, demonstrated no effect of low weight (< 3%) or low weight-for-height on the morbidity of treatment or survival in 59 children with a mixture of stages of FH WT [8].…”

Anorexia/cachexia‐related quality of life for children with cancer

“…Among patients with Wilms tumor, however, those with greater weight-loss-for-height percentiles had poor tolerance to treatment and an increased frequency of hospital admissions. 8 Objective measures of nutritional status such as albumin levels and weight loss are important clinical indicators. They provide objective evidence of anorexia/cachexia and are useful in monitoring response to treatment and prognosis.…”