Mauricio Sílvia Fernandes, Ribeiro Helem Sena, Correia Maria Isabel Toulson Davisson
a Department of Surgery , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.
b Alfa Institute of Gastroenterology, Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.
Nutr Cancer. 2016 Aug-Sep;68(6):949-57. doi: 10.1080/01635581.2016.1188971. Epub 2016 Jun 27.
The aim of this study was to verify the relationship between weight loss, handgrip strength (HGS) and phase angle (PA) before the beginning of chemotherapy with overall survival in cancer patients. Patients diagnosed with gastrointestinal and breast cancer who were over 18 years old and were scheduled to undergo adjuvant treatment at Hospital Borges da Costa/Brazil were evaluated. The exclusion criteria were neoadjuvant treatment, patients with kidney and liver disease and using diuretics. Weight, HGS and PA tests were performed by trained dietitians. The Kaplan-Meier survival method and the log-rank test, cox regression and ROC curve were used and p < 0.05 was considered significant. Two-hundred and twenty-eight patients were evaluated.The median survival time was higher among the patients who showed weight loss of less than 10% of usual body weight (p < 0.05). Regarding HGS, patients with decreased HGS had a 22.0 month survival versus 34.2 months for those with normal values (p < 0.05). 146 patients had normal PA values, and these patients had increased survival time compared to those with inappropriate values (p < 0.05). In the Cox regression, weight loss and PA were predictors of mortality, HGS wasn't significantly associated with mortality. ROC analysis revealed that weight loss was the nutritional status parameter with the most predictive power.
本研究的目的是验证癌症患者化疗开始前体重减轻、握力（HGS）和相位角（PA）与总生存期之间的关系。对巴西博尔热斯·达科斯塔医院诊断为胃肠道和乳腺癌、年龄超过18岁且计划接受辅助治疗的患者进行了评估。排除标准为新辅助治疗、患有肾脏和肝脏疾病以及使用利尿剂的患者。体重、HGS和PA测试由训练有素的营养师进行。采用Kaplan-Meier生存法、对数秩检验、Cox回归和ROC曲线，p<0.05被认为具有统计学意义。共评估了228例患者。体重减轻少于正常体重10%的患者中位生存时间更长（p<0.05）。关于HGS，HGS降低的患者生存期为22.0个月，而正常值患者为34.2个月（p<0.05）。146例患者PA值正常，与PA值异常的患者相比，这些患者生存时间延长（p<0.05）。在Cox回归中，体重减轻和PA是死亡率的预测因素，HGS与死亡率无显著相关性。ROC分析显示，体重减轻是预测能力最强的营养状况参数。
