Yan Xin, Zhang Sanyuan, Jia Junmei, Yang Jiaolin, Song Yilai, Duan Haoran
Department of Drug Clinical Trial, First Hospital of Shanxi Medical University, Taiyuan, China.
Department of Gynecology, First Hospital of Shanxi Medical University, Taiyuan, China.
Front Med (Lausanne). 2022 Jan 20;8:759387. doi: 10.3389/fmed.2021.759387. eCollection 2021.
Malnutrition is often observed in gynecological cancer patients, however its prevalence in these patients remains largely unexplored. Total parenteral nutrition (TPN) is a nutritional intervention method that has controversial treatment outcome on gynecological cancer patients. The present retrospective study is designed to evaluate the nutrition status and TPN treatment outcome on patients diagnosed with endometrial, cervical or ovarian malignant tumors.
Medical records of a total of 263 patients treated at the First Hospital of Shanxi Medical University, China were included. Nutrition status was assessed by patient-generated subjective global assessment (PG-SGA). Patients were grouped based on nutrition status, cancer type or treatment strategy for clinical characteristic comparison. Multivariable logistic regression analysis was used to identify predictors for malnutrition status and hospital stay duration.
Presence of endometrial and cervical cancer, body weight before nutritional intervention and serum albumin level ( < 0.001 for all) were found to be significant predictors for malnutrition status in gynecological cancer patients. In the malnourished patients, those who were treated with TPN had significantly lower serum albumin levels before and after treatment ( < 0.001) and PG-SGA scores after treatment. Also, TPN treatment could significantly increase the serum albumin levels in these patients after 1 week. In addition, shorter hospitalization period was needed for TPN-treated endometrial ( = 0.019) and ovarian ( < 0.001) patients. Moreover, serum albumin levels ( < 0.001), use of TPN treatment ( = 0.025) and nutrition status ( = 0.010) were identified to be independent predictors for hospital stay duration.
Our results suggest that malnutrition is a significant clinical manifestation in gynecological cancer patients who may benefit from TPN treatment for reduced hospitalization and improved serum albumin levels.
营养不良在妇科癌症患者中较为常见,但其在这些患者中的患病率仍未得到充分研究。全胃肠外营养(TPN)是一种营养干预方法,对妇科癌症患者的治疗效果存在争议。本回顾性研究旨在评估诊断为子宫内膜癌、宫颈癌或卵巢恶性肿瘤患者的营养状况及TPN治疗效果。
纳入山西医科大学第一医院共263例接受治疗的患者病历。通过患者主观整体评定法(PG-SGA)评估营养状况。根据营养状况、癌症类型或治疗策略对患者进行分组,以比较临床特征。采用多变量逻辑回归分析确定营养不良状态和住院时间的预测因素。
子宫内膜癌和宫颈癌的存在、营养干预前的体重以及血清白蛋白水平(均P<0.001)被发现是妇科癌症患者营养不良状态的显著预测因素。在营养不良患者中,接受TPN治疗的患者治疗前后血清白蛋白水平显著较低(P<0.001),治疗后PG-SGA评分也较低。此外,TPN治疗可在1周后显著提高这些患者的血清白蛋白水平。另外,接受TPN治疗的子宫内膜癌患者(P=0.019)和卵巢癌患者(P<0.001)住院时间较短。此外,血清白蛋白水平(P<0.001)、TPN治疗的使用(P=0.025)和营养状况(P=0.010)被确定为住院时间的独立预测因素。
我们的结果表明,营养不良是妇科癌症患者的一种重要临床表现,这些患者可能从TPN治疗中获益,从而缩短住院时间并提高血清白蛋白水平。