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

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.

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作者 Hong Xia Xu [1] Chun Hua Song [2] Zhen Ming Fu [3] Chang Wang [4] Zeng Qing Guo [5] Yuan Lin [6] Ying Ying Shi [7] Wen Hu [8] Yi Ba [9] Su Yi Li [10] Zeng Ning Li [11] Kun Hua Wang [12] Jing Wu [13] Ying He [14] Jia Jun Yang [15] Cong Hua Xie [16] Fu Xiang Zhou [16] Xin Xia Song [17] Gong Yan Chen [18] Wen Jun Ma [19] Su Xia Luo [20] Zi Hua Chen [21] Ming Hua Cong [22] Hu Ma [23] Chun Ling Zhou [24] Wei Wang [25] Qi Luo [26] Yong Mei Shi [27] Yu Mei Qi [28] Hai Ping Jiang [29] Wen Xian Guan [30] Jun Qiang Chen [31] Jia Xin Chen [32] Yu Fang [33] Lan Zhou [34] Yong Dong Feng [35] Rong Shao Tan [36] Tao Li [37] Jun Wen Ou [38] Qing Chuan Zhao [39] Jian Xiong Wu [40] Min Weng [41] Qing Hua Yao [42] Jiu Wei Cui [4] Wei Li [4] Han Ping Shi [43] the Investigation on Nutrition Status and Clinical Outcome of Common Cancers(INSCOC)Group 学术成果认领
作者单位 Department of Nutrition,Daping Hospital&Research Institute of Surgery,Third Military Medical University,Chongqing 400042,China [1] Department of Epidemiology,College of Public Health,Zhengzhou University,Zhengzhou 450001,Henan,China [2] Cancer Center Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China [3] Cancer Center of the First Hospital of Jilin University,Changchun 130021,Jilin,China [4] Department of Medical Oncology,Fujian Cancer Hospital,Fujian Medical University Cancer Hospital,Fuzhou 350014,Fujian,China [5] Department of Gastrointestinal Surgery,Cancer Hospital Affiliated to Guangxi Medical University,Nanning 530021,Guangxi,China [6] Department of Surgery,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,Guangdong,China [7] Department of Clinical Nutrition,West China Hospital of Sichuan University,Chengdu 610041,Sichuan,China [8] Department of Gastrointestinal Oncology,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin 300060,China [9] Department of Nutrition and Metabolism of Oncology,Affiliated Provincial Hospital of Anhui Medical University,Hefei 230031,Anhui,China [10] Department of Clinical Nutrition,the First Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China [11] Department of Gastrointestinal Surgery,Institute of Gastroenterology,the First Affiliated Hospital of Kunming Medical University 650032,Kunming,Yunnan,China [12] Department of Clinical Nutrition,the First People's Hospital of Kashi,Kashi 844000,Xinjiang,China [13] Department of Clinical Nutrition,Chongqing General Hospital,Chongqing 400014,China [14] Department of Colorectal and Anal Surgery,Huizhou Municipal Central Hospital,Huizhou 516001,Guangdong,China [15] Department of Radiation and Medical Oncology,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China [16] Department of Oncology,Xingtai People's Hospital,Hebei Medical University,Xingtai 054031,Hebei,China [17] Harbin Medical University Cancer Hospital,Harbin 150085,Heilongjiang,China [18] Department of Nutrition,Guangdong General Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,Guangdong,China [19] Department of Oncology,Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital,Zhengzhou 450008,Henan,China [20] Department of General Surgery,Xiangya Hospital,Central South University,Changsha 410008,Hunan,China [21] Comprehensive Oncology Department,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China [22] Department of Oncology,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou,China [23] The Fourth Affiliated Hospital,Harbin Medical University,Harbin 150001,Heilongjiang,China [24] Cancer center the First People's Hospital of Foshan,Foshan 528000,Guangdong,China [25] Department of Gastrointestinal Tumor Surgery,the First Affiliated Hospital,Xiamen University,Xiamen,Fujian 361003,China [26] Department of Nutrition,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China [27] Department of Nutrition,Tianjin Third Central Hospital,Tianjin 300170,China [28] Department of Surgery,the First Affiliated Hospital of Jinan University,Guangzhou 510632,Guangdong,China [29] Department of General Surgery,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu,China [30] Department of Gastrointestinal Surgery,First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China [31] Department of Radiation and Medical Oncology,People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China [32] Department of Clinical Nutrition,Peking University Cancer Hospital and Institute,Beijing 100142,China [33] Department of Nutrition,Third Affiliated Hospital of Kunming Medical College,Tumor Hospital of Yunnan Province,Kunming 650118,Yunnan,China [34] Department of Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China [35] Department of Nutrition,Guangzhou Red Cross Hospital,Guangzhou 510220,Guangdong,China [36] Department of Radiotherapy,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China [37] Department of Clinical Nutrition,Clifford Hospital,Guangzhou University of Chinese Medicine,Guangzhou 510632,Guangdong,China [38] Department of Digestive Diseases,Xijing Hospital,Fourth Military Medical University,Xi'an 710032,Shaanxi,China [39] Department of Hepatobiliary Surgery,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China [40] Department of Clinical Nutrition,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,Yunnan,China [41] Department of Integrated Traditional Chinese and Western Medicine,Zhejiang Cancer Hospital&Key Laboratory of Traditional Chinese Medicine Oncology,Zhejiang Cancer Hospital,Hangzhou 310022,Zhejiang,China [42] Department of Gastrointestinal Surgery,Department of Clinical Nutrition,Beijing Shijitan Hospital/Department of Oncology,Capital Medical University/Ninth Clinical Medical College,Peking University,Beijing 100038,China [43]
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DOI 10.34175/jno202101002
发布时间 2021-07-20(万方平台首次上网日期,不代表论文的发表时间)
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