Department of Radiology, Suleyman Demirel University Faculty of Medicine, Isparta, 32260, Turkey.
Department of Obstetrics and Gynecology, Suleyman Demirel University Faculty of Medicine, Isparta, 32260, Turkey.
Clin Nutr ESPEN. 2022 Apr;48:253-258. doi: 10.1016/j.clnesp.2022.02.004. Epub 2022 Feb 15.
Screening of the nutrition status is recommended for the early detection and treatment of cancer-associated malnutrition to improve the prognosis. We aimed to compare the prognostic value of Patient Generated-Subjective Global Assessment (PG-SGA) and CT measured sarcopenia in patients with gynecological cancer.
A total of 107 patients of which were 57 endometrial, 37 ovarian, and 13 cervical cancer who underwent surgery and evaluated by PG-SGA were enrolled. Skeletal muscle index (SMI) was calculated by automatic segmentation of the muscle area at the L3 level on abdominal CT scan and defined by the cut-off value of 38.9 cm/m. Karnofsky and Eastern Cooperative Oncology Group (ECOG) Performance Status scorings were performed. Hospitalization length (HL), overall- (OS), and progression-free- survival (PFS) were analyzed. Body muscle index (BMI) (kg/m) was calculated. Serum CA-125 and albumin levels were obtained.
The prevalence of malnutrition and sarcopenia were 67% and 26.2%, respectively. BMI was significantly associated with PG-SGA (p = 0.02) and SMI (p = 0.01). PG-SGA significantly correlated with CA-125 (r = 0.33, p = 0.002), ECOG (r = 0.29, p = 0.002), Karnofsky (r = -0.34, p < 0.001), and HL (r = 0.27, p = 0.004). PG-SGA showed a significant association with PFS (p = 0.007) and OS (p = 0.001). PG-SGA≥9 showed a significant relationship with prolonged HL, mortality, and progression (OR = 1.08; p = 0.03, OR = 23.09; p = 0.003, and OR = 5.39; p = 0.001, respectively).
PG-SGA can identify patients at nutritional risk earlier than SMI. PG-SGA shows a higher correlation with HL and clinical performance scores than SMI. PG-SGA is a better prognostic factor for prolonged HL, OS, and PFS.
建议对癌症相关营养不良进行营养状况筛查，以早期发现和治疗，从而改善预后。我们旨在比较妇科癌症患者中患者自评主观整体评估（PG-SGA）和 CT 测量的肌肉减少症的预后价值。
共纳入 107 例接受手术且接受 PG-SGA 评估的患者，其中子宫内膜癌 57 例、卵巢癌 37 例、宫颈癌 13 例。通过腹部 CT 扫描自动分割 L3 水平的肌肉区域计算骨骼肌指数（SMI），并以 38.9cm/m 的截断值定义。进行卡诺夫斯基和东部合作肿瘤学组（ECOG）表现状态评分。分析住院时间（HL）、总生存期（OS）和无进展生存期（PFS）。计算身体肌肉指数（BMI）（kg/m）。获得血清 CA-125 和白蛋白水平。
营养不良和肌肉减少症的患病率分别为 67%和 26.2%。BMI 与 PG-SGA（p=0.02）和 SMI（p=0.01）显著相关。PG-SGA 与 CA-125（r=0.33，p=0.002）、ECOG（r=0.29，p=0.002）、卡诺夫斯基（r=-0.34，p<0.001）和 HL（r=0.27，p=0.004）显著相关。PG-SGA 与 PFS（p=0.007）和 OS（p=0.001）显著相关。PG-SGA≥9 与 HL 延长、死亡率和进展显著相关（OR=1.08；p=0.03，OR=23.09；p=0.003，OR=5.39；p=0.001）。
PG-SGA 可以比 SMI 更早地识别有营养风险的患者。PG-SGA 与 HL 和临床表现评分的相关性高于 SMI。PG-SGA 是 HL 延长、OS 和 PFS 的更好预后因素。
