Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, USA; Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas, Health Science Center at Houston, USA.
General Internal Medicine, University of Texas, MD Anderson Cancer Center, USA.
Clin Nutr. 2021 Mar;40(3):966-977. doi: 10.1016/j.clnu.2020.06.026. Epub 2020 Jul 1.
BACKGROUND & AIMS: In this study, we assessed the prevalence of malnutrition and its association with overall survival among patients with cancer aged 65 years and older.
In this retrospective cohort study, patients receiving cancer care underwent a comprehensive geriatric assessment (CGA). Malnutrition status was determined through the CGA. We used univariate and multivariable Cox regression survival analyses to assess the association between baseline malnutrition and survival.
A total of 454 patients with cancers were included in the analysis. The median age was 78 years and men and women were equally represented. Forty-two percent (n = 190) were malnourished at baseline, and 33% died during the follow-up (range 0.2-51.1 month). Univariate analysis showed that malnutrition increased the risk of all-cause mortality in older patients with cancer (HR, 1.49; 95% CI, 1.08-2.05; p = 0.01). In the multivariate Cox regression model, malnutrition increased the risk of all-cause mortality (HR, 1.87; 95% CI, 1.10-3.17; p = 0.02) in older patients with solid tumors. However, malnutrition did not increase the risk of all-cause mortality for hematologic malignancies.
In our study, we found that malnutrition was a risk factor for mortality in older cancer patients, especially in older patients with solid tumors. Prospective inter ventional studies are recommended.
本研究评估了 65 岁及以上癌症患者的营养不良患病率及其与总生存率的关系。
在这项回顾性队列研究中,接受癌症治疗的患者接受了全面老年评估(CGA)。通过 CGA 确定营养不良状况。我们使用单变量和多变量 Cox 回归生存分析来评估基线营养不良与生存之间的关系。
共纳入 454 名癌症患者进行分析。中位年龄为 78 岁,男女比例相当。42%(n=190)在基线时存在营养不良,33%的患者在随访期间死亡(范围 0.2-51.1 个月)。单因素分析显示,营养不良增加了老年癌症患者全因死亡的风险(HR,1.49;95%CI,1.08-2.05;p=0.01)。在多变量 Cox 回归模型中,营养不良增加了老年实体瘤患者全因死亡的风险(HR,1.87;95%CI,1.10-3.17;p=0.02)。然而,营养不良不会增加血液恶性肿瘤患者全因死亡的风险。
在本研究中,我们发现营养不良是老年癌症患者死亡的一个危险因素,尤其是老年实体瘤患者。建议进行前瞻性干预研究。