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营养状况与老年结直肠癌患者生存的关系。

Association Between Nutrition Status and Survival in Elderly Patients With Colorectal Cancer.

机构信息

1 Department of Gastrointestinal Oncology, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.

2 Faculdade Ceres, SJRPreto/SP, Brazil.

出版信息

Nutr Clin Pract. 2017 Oct;32(5):658-663. doi: 10.1177/0884533617706894. Epub 2017 May 23.

Abstract

BACKGROUND

Aging patients with cancer have a higher risk of mortality and treatment-associated morbidity than younger patients. Nutrition status may play an important role in cancer mortality. We aimed to evaluate the survival time of elderly patients with colorectal cancer and its association with body mass index (BMI), the patient-generated subjective global assessment (PG-SGA), and phase angle (PA).

MATERIALS AND METHODS

BMI, PG-SGA, and PA were determined for all patients (n = 250) at first assessment.

RESULTS

Seventy-one (28.4%) patients were in active oncologic treatment (group 1) and 179 (71.6%) were in remission (group 2). At the time of the analysis, 73 (29.2%) patients had died and 177 (70.8%) were censored. The mean (standard deviation) age was 70.9 (7.49) years; 17.2% were undernourished, 56% normal weight, and 26.8% were overweight. According to the PG-SGA, 35.2% of patients needed some nutrition intervention and 4.4% needed it urgently. The mean PA was 4.94 ± 1°. PG-SGA, tumor stage, and PA differed significantly ( P < .001) between the groups; BMI did not ( P = .459). Severe malnutrition (PG-SGA C), compared with PG-SGA A, was associated with a relative hazard of death of 12.04 (95% confidence interval [CI], 3.43-42.19, P < .001). PA >5° was associated with better prognosis: a relative hazard of 0.456 (95% CI, 0.263-0.792; P < .005).

CONCLUSION

Among elderly patients with colorectal cancer, PA and PG-SGA were prognosis factors. PA >5° was associated with best survival and PG-SGA C with worst survival.

摘要

背景

与年轻患者相比,患有癌症的老年患者的死亡率和与治疗相关的发病率更高。营养状况可能在癌症死亡率中发挥重要作用。我们旨在评估老年结直肠癌患者的生存时间及其与体重指数(BMI)、患者生成的主观整体评估(PG-SGA)和相位角(PA)的关系。

材料和方法

在首次评估时确定所有患者(n=250)的 BMI、PG-SGA 和 PA。

结果

71 例(28.4%)患者正在接受积极的肿瘤治疗(组 1),179 例(71.6%)患者处于缓解期(组 2)。在分析时,73 例(29.2%)患者死亡,177 例(70.8%)被删失。平均(标准差)年龄为 70.9(7.49)岁;17.2%存在营养不良,56%体重正常,26.8%超重。根据 PG-SGA,35.2%的患者需要进行一些营养干预,4.4%需要紧急干预。平均 PA 为 4.94±1°。PG-SGA、肿瘤分期和 PA 在两组之间差异有统计学意义(P<0.001);BMI 则无差异(P=0.459)。与 PG-SGA A 相比,严重营养不良(PG-SGA C)与死亡的相对危险度为 12.04(95%可信区间[CI],3.43-42.19,P<0.001)。PA>5°与更好的预后相关:相对危险度为 0.456(95%CI,0.263-0.792;P<0.005)。

结论

在老年结直肠癌患者中,PA 和 PG-SGA 是预后因素。PA>5°与最佳生存相关,PG-SGA C 与最差生存相关。

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