scholarly journals Altered Preoperative Nutritional Status in Colorectal Cancer: A Not So Infrequent Issue

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Javier Páramo-Zunzunegui ◽  
Araceli Ramos-Carrasco ◽  
Marcos Alonso-García ◽  
Rosa Cuberes-Montserrat ◽  
Gil Rodríguez-Caravaca ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Weight Loss ◽  
Observational Study ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Prospective Observational Study ◽  
Colorectal Neoplasia ◽  
Nutritional Risk ◽  
A Value ◽  
Asymptomatic Patients

Introduction. Malnutrition and weight loss in cancer patients is a common problem that affects the prognosis of the disease. In the case of CRC, malnutrition rates range between 30 and 60%. Objectives. Description of the preoperative nutritional status of patients diagnosed with colorectal neoplasia who will undergo surgery. Materials and Methods. A prospective observational study is performed. Results. Of 234 patients studied, we observed that 139 (59%) had some degree of nutritional risk. Of all of them, 44.9% (N = 47) had 1-2 points according to MUST and 25% (N = 27) had more than 2 points. No differences were found when studying nutritional risk according to the location of the neoplasm. It was observed that 2.15% of the patients were underweight, 51% overweight, and 23% obese. 19.4% of patients lost less than 5 kg in the 3–6 months prior to diagnosis, 20.7% lost between 5 and 10 kg, and 2.1% lost more than 10 kg. In asymptomatic patients, the weight loss was lower than in symptomatic patients, loss <5 kg, 8.2% vs. 22.8%, and loss 5–10 kg, 16.2% vs. 29.3%, with a value of p = 0.016 . 5% (N = 7) of the patients had hypoalbuminemia record. 16.5% (N = 23) had some degree of prealbumin deficiency and 20.9% (N = 29) of hypoproteinemia. Symptomatic patients had more frequent analytical alterations, 1-2 altered parameters in 48.8% (N = 20) of asymptomatic vs. 61.2% (N = 22) in the symptomatic, p = 0.049 .

scholarly journals P-P51 Assessing the severity of pre and post-operative malnutrition in cancer patients undergoing pancreaticoduodenectomy: A review of a virtual dietetic prehabilitation service

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Leah Cox
Keyword(s):  
Pancreatic Cancer ◽  
Weight Loss ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Nutritional Assessment ◽  
Nutritional Risk ◽  
Perioperative Outcomes ◽  
Risk Patients ◽  
Median Weight Loss ◽  
Dietetic Intervention

Abstract Background The prevalence of malnutrition amongst pancreatic cancer patients is widely reported. This is due to reduced nutritional intake, increased energy expenditure and increased nutrient losses secondary to malabsorption. A Whipple's procedure or pancreaticoduodenectomy is the only potentially curable intervention for pancreatic cancer patients. Malnutrition is associated with increased peri and post-operative complications including delayed wound healing, longer hospital admission and higher mortality rate. Dietetic prehabilitation is a proactive intervention to assess patients’ nutritional status in preparation for elective surgery and, through early dietetic intervention, has the potential to improve perioperative outcomes. This pilot study reviewed the severity of nutritional risk in both the pre and post-operative stages to understand the need for dietetic prehabilitation in this patient group. Methods All patients referred were nutritionally assessed as part of a dietetic cancer prehabilitation pathway, which includes pre-surgical nutritional assessment within one week of referral and early post discharge nutritional assessment. Nutritional assessment was carried out using the PG-SGA short form and patients were triaged as requiring either a universal, targeted or specialist dietetic intervention dependent on severity of nutritional risk. Patients who scored &lt;4 were triaged as universal, and were low nutritional risk. Patients who scored 5-9 were triaged as targeted and were medium nutritional risk, and patients who scored &gt;9 were triaged as specialist, and were high nutritional risk. Results 35 patients were referred for dietetic prehabilitation assessment. 71% of patients were triaged as requiring either a targeted or specialist prehabilitiation intervention. BMI ranged from 15.7kg/m² to 35.9kg/m² and median weight loss was 10.0%. 23 patients received early post surgical nutritional assessment, within 12 days of discharge from hospital. All 23 patients required targeted or specialist dietetic intervention. 22 patients reported post-operative weight loss, with a median weight loss of 7.5%. There was no correlation between pre-surgical and post-surgical nutritional risk. Conclusions Patients undergoing pancreaticoduodenectomy are at high nutritional risk in both the pre and post-operative periods. Patients without evidence of malnutrition in the pre-operative stage remain at high risk of malnutrition and the associated complications in the post operative stage. A prehabilitation programme can identify patients at nutritional risk and institute interventions to optimise perioperative nutritional status.  Findings from this review will form the basis of a study examining the effects of a prehabilitation programme on outcomes following pancreaticoduodenectomy.

scholarly journals Nutritional Profile of Patients with Colorretal Cancer Candidates for Big Surgery (P05-035-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ana Paula Rocha Trotte ◽  
Rosana Oliveira Macedo ◽  
Thaiza Fragoso Nunes ◽  
Danielly Rodrigues Wassita da Rocha ◽  
Maria Eliza De Gouvêa Marti Ferrão
Keyword(s):  
Colorectal Cancer ◽  
Weight Loss ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Nutritional Risk ◽  
Cross Sectional ◽  
Nutritional Profile ◽  
Funding Sources ◽  
Nrs 2002

Abstract Objectives To identify the nutritional profile of adult and elderly patients with colorectal cancer admitted to a Proctology ward for large elective surgeries. Methods A cross-sectional and retrospective study was performed with 31 patients of both genders, aged 39 to 77 years with colorectal cancer. The nutritional screening parameters used were the percentage of weight loss and Nutrition Risck Screening (NRS 2002). The data (percentage of weight loss and NRS 2002) were collected through a nutritional assessment form completed in the care routine, applied within 72 hours after the patient's hospitalization. Results The study included 13 adults (41.9%) and 18 elderly (58.1%). The evaluation of the percentage of weight loss showed that 7 patients (22.5%) had weight loss greater than 15% in a period of less than or equal to 6 months. In the nutritional risk assessment based on the NRS 2002, we observed that 9 patients (29%) scored 2, while 22 patients (71%) achieved a score equal to or greater than 3. Conclusions The nutritional profile of the evaluated patients showed a considerable prevalence of malnutrition, considering a weight loss of more than 15% in a period of 6 months, which is associated to a decrease in survival in patients with cancer, and is a very relevant data to help in the classification of nutritional status. The classification by the NRS 2002, showed a high prevalence of patients at nutritional or malnourished risk. Variation in the classification of nutritional status using several parameters reinforces the need for them to be used in a complementary way. Funding Sources Hospital Federal dos Servidores do Estado, Ministerio da Saude.

scholarly journals Nutritional status in elderly cancer patients: Prospective observational study

2017 ◽  
Vol 28 ◽  
pp. vi107
Author(s):  
C. Gagliardi ◽  
G. Auletta ◽  
G. Salanitro ◽  
A. Bolamperti ◽  
K. Battistella ◽  
...  
Keyword(s):  
Observational Study ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Prospective Observational Study ◽  
Elderly Cancer Patients

scholarly journals Malnutrition and cancer, diagnosis and treatment

2021 ◽  
Author(s):  
Angelika Beirer
Keyword(s):  
Weight Loss ◽  
Cancer Patients ◽  
Cancer Cachexia ◽  
Screening Tool ◽  
Psychological Treatment ◽  
Early Stage ◽  
Nutritional Therapy ◽  
German Society ◽  
Fat Free Mass ◽  
Nutritional Risk

Summary Background The prevalence of malnutrition in cancer patients ranges from about 20% to more than 70%. However, 10–20% of cancer patients’ deaths are related to malnutrition, not the malignancy itself. To reverse the pattern of weight loss, improve the patients’ quality of life, reduce the treatment toxicity, the psychological stress and the risk of mortality, the diagnosis of malnutrition should be made as early as possible to facilitate the best possible treatment. Methods A systematic literature search was conducted following guidelines of ESPEN (European Society for Clinical Nutrition), DGEM (German Society for Nutritional Medicine) and ASPEN (American Society for Parenteral and Enteral Nutrition). Results and conclusion To assess the risk of malnutrition, all cancer patients should be screened regularly with a valid screening tool (e.g., MUST [Malnutrition Universal Screening Tool], NRS [Nutritional Risk Screening] or PG-SGA [Scored Patient-Generated Subjective Global Assessment]). If risk of malnutrition is present, adequate nutritional therapy is recommended to stop involuntary weight loss. Patients should engage in exercise to maintain and improve muscle mass, strength and function. They should be offered regular dietetic counselling, and their muscle depletion should be monitored by determining fat-free mass. As cachectic patients in particular are at risk, the presence of cachexia should also be recognized at an early stage. Three consensus-based definitions are widely accepted: Fearon et al. and the EPCRC (European Palliative Care Research Collaborative) propose definitions specifically for cancer cachexia, while Evans et al. put forward a definition for cachexia associated with all types of underlying chronic diseases. However, if there is a cancer cachexia diagnosis, additional pharmacological and psychological treatment should be considered.

Importance of body composition in grading body mass index and weight loss-related nutritional risk in cancer patients

2020 ◽  
Vol 40 ◽  
pp. 550-551
Author(s):  
E. Cereda ◽  
F. Lobascio ◽  
S. Masi ◽  
S. Crotti ◽  
S. Cappello ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Body Composition ◽  
Cancer Patients ◽  
Body Mass ◽  
Nutritional Risk

scholarly journals Cyst(e)ine in nutrition formulation promotes colon cancer growth and chemoresistance by activating mTORC1 and scavenging ROS

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Jiao Wu ◽  
Sai-Ching Jim Yeung ◽  
Sicheng Liu ◽  
Aiham Qdaisat ◽  
Dewei Jiang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Weight Loss ◽  
Cancer Patients ◽  
Cancer Cell ◽  
Cancer Progression ◽  
Colorectal Cancer Patient ◽  
Nutrition Support ◽  
Immunodeficient Mice ◽  
The Impact

AbstractWeight loss and cachexia are common problems in colorectal cancer patients; thus, parenteral and enteral nutrition support play important roles in cancer care. However, the impact of nonessential amino acid components of nutritional intake on cancer progression has not been fully studied. In this study, we discovered that gastrointestinal cancer patients who received cysteine as part of the parenteral nutrition had shorter overall survival (P < 0.001) than those who did not. Cystine indeed robustly promotes colon cancer cell growth in vitro and in immunodeficient mice, predominately by inhibiting SESN2 transcription via the GCN2-ATF4 axis, resulting in mTORC1 activation. mTORC1 inhibitors Rapamycin and Everolimus block cystine-induced cancer cell proliferation. In addition, cystine confers resistance to oxaliplatin and irinotecan chemotherapy by quenching chemotherapy-induced reactive oxygen species via synthesizing glutathione. We demonstrated that dietary deprivation of cystine suppressed colon cancer xenograft growth without weight loss in mice and boosted the antitumor effect of oxaliplatin. These findings indicate that cyst(e)ine, as part of supplemental nutrition, plays an important role in colorectal cancer and manipulation of cyst(e)ine content in nutritional formulations may optimize colorectal cancer patient survival.

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