Malnutrition and Quality of Life in Chinese Cancer Patients:a Clinical Study of 23,994 Subjects

• 作者: Hong Xia Xu Chun Hua Song Zhen Ming Fu Chang Wang Zeng Qing Guo Yuan Lin Ying Ying Shi Wen Hu Yi Ba Su Yi Li Zeng Ning Li Kun Hua Wang Jing Wu Ying He Jia Jun Yang Cong Hua Xie Fu Xiang Zhou Xin Xia Song Gong Yan Chen Wen Jun Ma Su Xia Luo Zi Hua Chen Ming Hua Cong Hu Ma Chun Ling Zhou Wei Wang Qi Luo Yong Mei Shi Yu Mei Qi Hai Ping Jiang Wen Xian Guan Jun Qiang Chen Jia Xin Chen Yu Fang Lan Zhou Yong Dong Feng Rong Shao Tan Tao Li Jun Wen Ou Qing Chuan Zhao Jian Xiong Wu Min Weng Qing Hua Yao Jiu Wei Cui Wei Li Han Ping Shi the Investigation on Nutrition Status and Clinical Outcome of Common Cancers(INSCOC)Group
• 来源期刊: 肿瘤营养学杂志（英文）
• 年，卷（期）: 2021,（1）
• 所属期刊栏目: Research
• 页码范围: 16-32
• 页数: 17页
• 语种: 中文
• DOI: 10.34175/jno202101002

摘要

Background Malnutrition is common in patients with cancer,and can negatively impact their quality of life(QoL)and even survival.However,there is currently no large data available on the prevalence of malnutrition in Chinese cancer patients.This study evaluated the prevalence of malnutrition and the QoL of Chinese patients with locoregional,recurrent or metastatic cancer.Methods We conducted a nationwide observational,multi-center,hospital-based cross-sectional study within the Chinese Society of Nutritional Oncology(CSNO)Network.All of the patients were diagnosed with one of the following 18 different types of malignant tumors:lung cancer,gastric cancer,liver cancer,colorectal cancer,breast cancer,esophageal cancer,cervical cancer,endometrial cancer,nasopharyngeal carcinoma,malignant lymphoma,leukemia,pancreatic cancer,ovarian cancer,prostate cancer,bladder cancer,brain cancer,biliary tract malignant tumors or gastrointestinal stromal tumors.These patients were enrolled from 72 hospitals located in different regions of China.The patients'nutritional status was evaluated based on the body mass index(BMI),loss of bodyweight,laboratory measurements and patient generated-subjective global assessment(PG-SGA)scores.The cancer patients'physical status and QoL were assessed by the Karnofsky Performance Status(KPS)questionnaire and the European Organization for Research and Treatment of Cancer(EORTC)QLQ-C30 questionnaire,respectively.Results From December 2013 to April 2016,23,994 patients hospitalized for cancer treatment(such as surgery,chemotherapy or radiotherapy)were enrolled in the study.The patients included 12,494(52.9％)males and 11,124(47.1％)females.The mean age was 55.8±13.7 years.The proportions of patients in cancer stages Ⅰ,Ⅱ,Ⅲ,Ⅳand uncertain were 11.5％,20.3％,27.5％,30.2％and 10.5％,respectively.Among the 23,994 inpatients,the proportions of patients who were underweight(BMI＜18.5 kg/m2),normal(18.5 kg/rr2＜BMI＜24 kg/m2),overweight(24 kg/m2≤BMI＜28 kg/m2)and obese(BMI≥28 kg/m2)were 9.3％,59.9％,26.1％and 4.7％,respectively.A total of 18.3％(4,101/22,424)of patients had lost 5％or more of their bodyweight within the past month and 19.6％(2,463/12,538)of patients had lost 10％or more of their bodyweight within the past 6 months.According to the PG-SGA scores,26.6％of the patients were severely malnourished(score≥9),31.3％were moderately malnourished(scores 4～8).A total of 22.2％of patients had a serum albumin level lower than 35g/L.Only 8.6％(2056/23,991)of the patients had severe KPS scores(≤60).The patients with these severe KPS scores were most frequently among those with cancers of the brain(19.7％),prostate(18.0％),pancreas(15.5％)and bladder(15.0％).Based on the QLQ-C30 score,11.6％of patients had a poor QoL.The PG-SGA score and global QoL were correlated(r =-0.593,P＜0.001).Conclusion The prevalence of malnutrition in patients with cancer is relatively high,and is related to a poorer QoL.The present findings should be kept in mind when assessing cancer patients,because addressing the patient's problems in nutritional status would be expected to improve both the clinical outcomes and QoL in cancer patients with malnutrition.