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Published in: Supportive Care in Cancer 7/2015

01-07-2015 | Original Article

Nutrition support can bring survival benefit to high nutrition risk gastric cancer patients who received chemotherapy

Authors: Miaozhen Qiu, Yi-xin Zhou, Yin Jin, Zi-xian Wang, Xiao-li Wei, Hong-yu Han, Wen-feng Ye, Zhi-wei Zhou, Dong-sheng Zhang, Feng-hua Wang, Yu-hong Li, Da-jun Yang, Rui-hua Xu

Published in: Supportive Care in Cancer | Issue 7/2015

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Abstract

Purpose

The aim of our study is firstly to evaluate the prevalence and prognostic value of nutrition risk in gastric cancer patients and secondly to explore whether the nutrition support can prolong the survival of advanced gastric cancer patients.

Methods

It contained two study periods. In the first period, we prospectively evaluated the nutritional risk of gastric adenocarcinoma patients from 2009 to 2011 using the method of European Nutritional Risk Screening (NRS) 2002. The Kaplan-Meier method and log-rank test were used to evaluate the prognostic value of high nutrition risk. The second period was between 2012 and 2013. We prospectively gave the nutrition support to stage IV gastric cancer patients whose NRS is ≥3.

Results

There were 830 patients in the first period, 50.7 % patients with a NRS ≥ 3. Patients with NRS ≥ 3 presented a significantly higher percentage of stage IV diseases, elevated values of C-reactive protein, and hypoproteinemia. The median survival was significantly higher in NRS < 3 patients (31.9 vs. 25.7 months, P < 0.001). Multivariate analysis confirmed that NRS status was an independent prognostic factor. There were 347 patients in the second period. Young, male, and good response to chemotherapy were more likely to have the NRS shift to <3 after nutrition support. The median survival was 14.3 and 9.6 months for patients with and without NRS shift, respectively, P = 0.001.

Conclusions

NRS ≥ 3 was an independent adverse prognostic factor in gastric cancer patients. For stage IV patients whose NRS ≥ 3, the nutrition support might be helpful to improve the prognosis.
Literature
1.
go back to reference Kamangar F, Dores GM, Anderson WF (2006) Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 24:2137–2150CrossRefPubMed Kamangar F, Dores GM, Anderson WF (2006) Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 24:2137–2150CrossRefPubMed
2.
go back to reference Moore MA, Eser S, Igisinov N, Igisinov S, Mohagheghi MA, Mousavi-Jarrahi A, Ozenturk G, Soipova M, Tuncer M, Sobue T (2010) Cancer epidemiology and control in North-Western and Central Asia—past, present and future. Asian Pac J Cancer Prev 11(Suppl 2):17–32PubMed Moore MA, Eser S, Igisinov N, Igisinov S, Mohagheghi MA, Mousavi-Jarrahi A, Ozenturk G, Soipova M, Tuncer M, Sobue T (2010) Cancer epidemiology and control in North-Western and Central Asia—past, present and future. Asian Pac J Cancer Prev 11(Suppl 2):17–32PubMed
3.
go back to reference Drissi M, Cwieluch O, Lechner P, Radziwill R, Vehling-Kaiser U, Hengst K, Masin M (2014) Nutrition care in patients with cancer: a retrospective multicenter analysis of current practice—indications for further studies? Clin Nutr. doi:10.1016/j.clnu.2014.03.002 PubMed Drissi M, Cwieluch O, Lechner P, Radziwill R, Vehling-Kaiser U, Hengst K, Masin M (2014) Nutrition care in patients with cancer: a retrospective multicenter analysis of current practice—indications for further studies? Clin Nutr. doi:10.​1016/​j.​clnu.​2014.​03.​002 PubMed
4.
go back to reference Gavazzi C, Colatruglio S, Sironi A, Mazzaferro V, Miceli R (2011) Importance of early nutritional screening in patients with gastric cancer. Br J Nutr 106:1773–1778CrossRefPubMed Gavazzi C, Colatruglio S, Sironi A, Mazzaferro V, Miceli R (2011) Importance of early nutritional screening in patients with gastric cancer. Br J Nutr 106:1773–1778CrossRefPubMed
5.
go back to reference Huhmann MB, Cunningham RS (2005) Importance of nutritional screening in treatment of cancer-related weight loss. Lancet Oncol 6:334–343CrossRefPubMed Huhmann MB, Cunningham RS (2005) Importance of nutritional screening in treatment of cancer-related weight loss. Lancet Oncol 6:334–343CrossRefPubMed
6.
go back to reference Bedikian AY, Chen TT, Malahy MA, Patt YZ, Bodey GP (1984) Prognostic factors influencing survival of patients with advanced colorectal cancer: hepatic-artery infusion versus systemic intravenous chemotherapy for liver metastases. J Clin Oncol 2:174–180PubMed Bedikian AY, Chen TT, Malahy MA, Patt YZ, Bodey GP (1984) Prognostic factors influencing survival of patients with advanced colorectal cancer: hepatic-artery infusion versus systemic intravenous chemotherapy for liver metastases. J Clin Oncol 2:174–180PubMed
7.
go back to reference Dewys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR, Cohen MH, Douglass HO Jr, Engstrom PF, Ezdinli EZ, Horton J, Johnson GJ et al (1980) Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med 69:491–497CrossRefPubMed Dewys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR, Cohen MH, Douglass HO Jr, Engstrom PF, Ezdinli EZ, Horton J, Johnson GJ et al (1980) Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med 69:491–497CrossRefPubMed
8.
go back to reference Kemeny N, Niedzwiecki D, Shurgot B, Oderman P (1989) Prognostic variables in patients with hepatic metastases from colorectal cancer. Importance of medical assessment of liver involvement. Cancer 63:742–747CrossRefPubMed Kemeny N, Niedzwiecki D, Shurgot B, Oderman P (1989) Prognostic variables in patients with hepatic metastases from colorectal cancer. Importance of medical assessment of liver involvement. Cancer 63:742–747CrossRefPubMed
9.
go back to reference Kondrup J, Rasmussen HH, Hamberg O, Stanga Z (2003) Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 22:321–336CrossRefPubMed Kondrup J, Rasmussen HH, Hamberg O, Stanga Z (2003) Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 22:321–336CrossRefPubMed
10.
go back to reference Bozzetti F (1998) Comments on: Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies, Andreyev et al., Eur J Cancer 1998, 34, pp. 503–509. Eur J Cancer 34:2132–2133CrossRefPubMed Bozzetti F (1998) Comments on: Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies, Andreyev et al., Eur J Cancer 1998, 34, pp. 503–509. Eur J Cancer 34:2132–2133CrossRefPubMed
11.
go back to reference Guo W, Ou G, Li X, Huang J, Liu J, Wei H (2010) Screening of the nutritional risk of patients with gastric carcinoma before operation by NRS 2002 and its relationship with postoperative results. J Gastroenterol Hepatol 25:800–803CrossRefPubMed Guo W, Ou G, Li X, Huang J, Liu J, Wei H (2010) Screening of the nutritional risk of patients with gastric carcinoma before operation by NRS 2002 and its relationship with postoperative results. J Gastroenterol Hepatol 25:800–803CrossRefPubMed
12.
go back to reference Pacelli F, Bossola M, Rosa F, Tortorelli AP, Papa V, Doglietto GB (2008) Is malnutrition still a risk factor of postoperative complications in gastric cancer surgery? Clin Nutr 27:398–407CrossRefPubMed Pacelli F, Bossola M, Rosa F, Tortorelli AP, Papa V, Doglietto GB (2008) Is malnutrition still a risk factor of postoperative complications in gastric cancer surgery? Clin Nutr 27:398–407CrossRefPubMed
13.
go back to reference Ryu SW, Kim IH (2010) Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients. World J Gastroenterol 16:3310–3317CrossRefPubMedCentralPubMed Ryu SW, Kim IH (2010) Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients. World J Gastroenterol 16:3310–3317CrossRefPubMedCentralPubMed
14.
go back to reference Kondrup J, Allison SP, Elia M, Vellas B, Plauth M (2003) ESPEN guidelines for nutrition screening 2002. Clin Nutr 22:415–421CrossRefPubMed Kondrup J, Allison SP, Elia M, Vellas B, Plauth M (2003) ESPEN guidelines for nutrition screening 2002. Clin Nutr 22:415–421CrossRefPubMed
15.
go back to reference Lauren P (1965) The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 64:31–49PubMed Lauren P (1965) The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 64:31–49PubMed
16.
go back to reference Gianni L, Eiermann W, Semiglazov V, Manikhas A, Lluch A, Tjulandin S, Zambetti M, Vazquez F, Byakhow M, Lichinitser M, Climent MA, Ciruelos E et al (2010) Neoadjuvant chemotherapy with trastuzumab followed by adjuvant trastuzumab versus neoadjuvant chemotherapy alone, in patients with HER2-positive locally advanced breast cancer (the NOAH trial): a randomised controlled superiority trial with a parallel HER2-negative cohort. Lancet 375:377–384CrossRefPubMed Gianni L, Eiermann W, Semiglazov V, Manikhas A, Lluch A, Tjulandin S, Zambetti M, Vazquez F, Byakhow M, Lichinitser M, Climent MA, Ciruelos E et al (2010) Neoadjuvant chemotherapy with trastuzumab followed by adjuvant trastuzumab versus neoadjuvant chemotherapy alone, in patients with HER2-positive locally advanced breast cancer (the NOAH trial): a randomised controlled superiority trial with a parallel HER2-negative cohort. Lancet 375:377–384CrossRefPubMed
17.
go back to reference Sorensen J, Kondrup J, Prokopowicz J, Schiesser M, Krahenbuhl L, Meier R, Liberda M (2008) EuroOOPS: an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome. Clin Nutr 27:340–349CrossRefPubMed Sorensen J, Kondrup J, Prokopowicz J, Schiesser M, Krahenbuhl L, Meier R, Liberda M (2008) EuroOOPS: an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome. Clin Nutr 27:340–349CrossRefPubMed
18.
go back to reference Schiesser M, Muller S, Kirchhoff P, Breitenstein S, Schafer M, Clavien PA (2008) Assessment of a novel screening score for nutritional risk in predicting complications in gastro-intestinal surgery. Clin Nutr 27:565–570CrossRefPubMed Schiesser M, Muller S, Kirchhoff P, Breitenstein S, Schafer M, Clavien PA (2008) Assessment of a novel screening score for nutritional risk in predicting complications in gastro-intestinal surgery. Clin Nutr 27:565–570CrossRefPubMed
19.
go back to reference Vanis N, Mesihovic R (2008) Application of nutritional screening tests for determining prevalence of hospital malnutrition. Med Arh 62:211–214PubMed Vanis N, Mesihovic R (2008) Application of nutritional screening tests for determining prevalence of hospital malnutrition. Med Arh 62:211–214PubMed
20.
go back to reference Yu Q, Yu XF, Zhang SD, Wang HH, Wang HY, Teng LS (2013) Prognostic role of C-reactive protein in gastric cancer: a meta-analysis. Asian Pac J Cancer Prev 14:5735–5740CrossRefPubMed Yu Q, Yu XF, Zhang SD, Wang HH, Wang HY, Teng LS (2013) Prognostic role of C-reactive protein in gastric cancer: a meta-analysis. Asian Pac J Cancer Prev 14:5735–5740CrossRefPubMed
Metadata
Title
Nutrition support can bring survival benefit to high nutrition risk gastric cancer patients who received chemotherapy
Authors
Miaozhen Qiu
Yi-xin Zhou
Yin Jin
Zi-xian Wang
Xiao-li Wei
Hong-yu Han
Wen-feng Ye
Zhi-wei Zhou
Dong-sheng Zhang
Feng-hua Wang
Yu-hong Li
Da-jun Yang
Rui-hua Xu
Publication date
01-07-2015
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 7/2015
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-014-2523-6

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