Malnutrition Is High and Underestimated During Chemotherapy in Gastrointestinal Cancer: An AGEO Prospective Cross-Sectional Multicenter Study
Malnutrition Is High and Underestimated During Chemotherapy in Gastrointestinal Cancer: An AGEO Prospective Cross-Sectional Multicenter Study
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DOI：
10.1080/01635581.2012.670743
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发表时间：
2012-01-01
影响因子：
2.9
通讯作者：
Taieb, J.
中科院分区：
文献类型：
--
作者：
Attar, A.;Malka, D.;Taieb, J.
虽然已知营养不良在癌症患者中很常见，但尚未在仅接受化疗的胃肠道恶性肿瘤患者中进行描述。医生对营养不良的判断和营养不良的危险因素也进行了评估。11个中心的所有连续住院和门诊患者前瞻性地纳入了一项为期14天的横断面研究，并根据法国健康建议[Haute Autorite de Sante (HAS)]进行分类。在11个研究中心的313例患者中（平均年龄63岁，范围21-93岁，男性67%），主要为结直肠（58%）、胰腺（15%）、胃（11%）和肝胆（10%）原发肿瘤，营养不良发生率为52%。中度和重度营养不良分别出现在27%和25%的病例中。医生分别在36%和6%的病例中考虑到这一点，其中有134名患者（43%）被错误分类。HAS定义与医师判断的一致性很低（kappa = 0.30）。大多数被确定为严重营养不良的患者没有得到营养支持。工作状态、胰腺癌和胃癌与营养不良独立相关。营养不良水平高，约50%，根据原发肿瘤分布不均。它仍然被医生们低估了。体重减轻仍然是临床相关的、简单的、可靠的营养不良标志。
Although malnutrition is known to be frequent in cancer patients, it has not been described in a selected population of patients with gastrointestinal malignancies under chemotherapy only. Physician judgment about malnutrition and risk factors for malnutrition were also evaluated. All consecutive in-and outpatients of 11 centers were prospectively enrolled in a cross-sectional 14-day period study and classified according to the French health recommendations [Haute Autorite de Sante (HAS)]. Among 313 patients enrolled in 11 centers (mean age = 63 yr; range = 21-93; 67% male) mainly with colorectal (58%), pancreatic (15%), gastric (11%), and hepatobiliary (10%) primary tumors, the prevalence of malnutrition was 52%. Moderate and severe malnutrition was present in 27% and 25% of cases, respectively. Physicians considered it in 36% and 6% of cases, respectively, there by misclassifying 134 patients (43%). The agreement between the HAS definition and the physicians' judgment was very low (kappa = 0.30). Most of the patients who were identified as severely malnourished received no nutritional support. Performance status and pancreatic and gastric cancers were independently associated with malnutrition. Malnutrition levels are high, around 50%, unequally distributed according to the primitive tumor. It is still underestimated by physicians. Weight loss remains a clinically relevant, simple, and reliable marker of malnutrition.