Journal Article

The relationship between nutritional status, inflammatory markers and survival in patients with advanced cancer: a prospective cohort study

Tan, Cindy S. Y., Read, Jane A., Clarke, Stephen J., Beale, Philip J., Phan, Viet H., Peat, Jennifer K.

2015

Overview

s Background Malnutrition and elevated inflammatory markers have a negative impact on clinical outcomes in cancer patients. Few studies have investigated the associations between inflammatory makers, nutritional status and survival. This study investigates the association between nutritional status, inflammatory markers and overall survival (OS) in patients with advanced cancer. Methods This prospective cohort study recruited 114 adult patients from January 2007 to January 2010. It included patients diagnosed with advanced cancer, good Eastern Cooperative Oncology Group (ECOG) performance status 0–2, a prognosis of more than 3 months and had not received chemotherapy for advanced cancer prior to enrolment. Baseline data were collected prior to commencement of chemotherapy. Patients were followed up from the date of baseline nutritional assessment until the date of death or the date that data were last updated, whichever came first. Results Malnourished cancer patients had statistically significant higher concentrations of serum C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) or modified Glasgow Prognostic Score (mGPS) prior to starting chemotherapy. In univariate analyses to predict survival, mGPS 1 or 2 had a hazard ratio (HR) of 1.81 (95 % confidence interval (CI) 1.13–2.89) and NLR ≥ 5 had a HR of 1.13 (95 % CI 1.08–4.60) and malnutrition (HR of 1.66 for Patient-Generated Subjective Global Assessment (PG-SGA) B (95 % CI 1.02–2.71), and HR for severely malnourished patients (PG-SGA C) was 2.73 (95 % CI 1.50–4.96). Conclusions Inflammatory markers were statistically associated with malnutrition. Malnutrition and mGPS were significant independent predictors of overall survival in patients with advanced cancer.

• Publisher: Springer Berlin Heidelberg,Springer,Springer Nature B.V
• Subject: Adult / Aged / Analysis / Australia - epidemiology / Biomarkers / Biomarkers - blood / C-reactive protein / C-Reactive Protein - analysis / Cancer / Cancer patients / Care and treatment / Chemotherapy / Clinical outcomes / Cohort analysis / Cohort Studies / Cooperation / Drug Therapy - methods / Female / Humans / Inflammation - blood / Inflammation - etiology / Inflammatory diseases / Leukocyte Count / Lymphocytes / Male / Malnutrition / Malnutrition - blood / Malnutrition - etiology / Medical prognosis / Medicine / Medicine & Public Health / Middle Aged / Neoplasm Staging / Neoplasms - blood / Neoplasms - complications / Neoplasms - epidemiology / Neoplasms - pathology / Neoplasms - therapy / Neutrophils / Nursing / Nursing Research / Nutrition / Nutritional Status / Oncology / Oncology, Experimental / Original Article / Pain Medicine / Patient outcomes / Patients / Practitioner patient relationship / Product/Service Evaluations / Prognosis / Prospective Studies / Rehabilitation Medicine / Serum / Subjectivity / Survival Analysis / Treatment outcomes