Assessing the nutritional status of elderly Chinese lung cancer patients using the Mini-Nutritional Assessment (MNA®) tool

Abstract Introduction A retrospective clinical study was performed to identify the characteristics of patients with lung cancer treated with integrative cancer treatment in addition to conventional medicine. Materials and Methods We reviewed medical records for lung cancer patients who visited a single integrative setting in Rome, Italy. A total of 57 patients were included, and the majority had advanced-stage cancer. All of them underwent integrative therapy with nutrition and phytotherapy indications. The diet was designed to reduce most of possible factors promoting cancer proliferation, inflammation, and obesity. Foods with anti-inflammatory, prebiotic, antioxidant, and anticancer properties had been chosen. Herbal supplements with known effects on lung cancer were prescribed. In particular, astragal, apigenine, fucosterol, polydatin, epigallocatechin gallate, cannabis, curcumin, and inositol were used. Furthermore, medical mushrooms and other substances were used to improve the immune system and to reduce chemotherapy side effects. Five key parameters have been evaluated for 2 years starting at the first surgery: nutritional status, immune status, discontinuation of therapy, quality of life, and prognosis of the disease. Results A relevant improvement in parameters relative to nutritional status, immune status, and quality of life has been observed after integrative therapy compared with the same parameters at the first medical visit before starting such approach. Conclusion The results suggest that integrative therapy may have benefits in patients with lung cancer. Even though there are limitations, the study suggests that integrative therapy could improve nutritional status and quality of life, with possible positive effect on overall survival.

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Nutritional status of pre-operative early stage lung cancer patients and dietary intake assessment post-operatively

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2017.07.057 ◽

2017 ◽

Vol 22 ◽

pp. 138

Author(s):

E. O’Sullivan ◽

A. McAdam ◽

M. O'Sullivan ◽

R. Ryan ◽

V. Young

Keyword(s):

Lung Cancer ◽

Nutritional Status ◽

Dietary Intake ◽

Cancer Patients ◽

Early Stage ◽

Early Stage Lung Cancer ◽

Lung Cancer Patients ◽

Intake Assessment ◽

Dietary Intake Assessment ◽

Stage Lung Cancer

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Relationship between Nutritional Status and Clinical Outcome in Patients Treated for Lung Cancer

Nutrients ◽

10.3390/nu13103332 ◽

2021 ◽

Vol 13 (10) ◽

pp. 3332

Author(s):

Jacek Polański ◽

Mariusz Chabowski ◽

Natalia Świątoniowska-Lonc ◽

Krzysztof Dudek ◽

Beata Jankowska-Polańska ◽

...

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Overall Survival ◽

Clinical Outcome ◽

Nutritional Status ◽

Cancer Patients ◽

Meta Analysis ◽

Lung Cancer Patients ◽

Time To Tumor Progression

Background. Between 34.5% and 69% of the patients with lung cancer are at risk of malnutrition. Quality of life (QoL) and physical status assessment provides valuable prognostic data on lung cancer patients. Malnutrition is a prognostic parameter for clinical outcome. Therefore, the identification of significant factors affecting the clinical outcome and QoL is important. The purpose of this study was to evaluate the relationship between nutritional status and outcome, i.e., overall survival, time to tumor progression, and QoL, in lung cancer patients. Materials and methods. We performed a systematic search of the Pubmed/MEDLINE databases per the Cochrane guidelines to conduct a meta-analysis consistent with the PRISMA statement, using the following keywords: “lung cancer,” “malnutrition,” “nutrition,” “quality of life,” “well-being,” “health-related quality of life,” and “outcome.” Out of the 96 papers identified, 12 were included in our meta-analysis. Results. Our meta-analysis shows that patients with a good nutritional status have a better QoL than malnourished patients in the following functioning domains: physical (g = 1.22, 95% CI = 1.19 to 1.46, p < 0.001), role (g = 1.45, 95% CI = 1.31 to 1.59, p < 0.001), emotional (g = 1.10, 95% CI = 0.97 to 1.24, p < 0.001), cognitive (g = 0.91, 95% CI = 0.76 to 1.06, p < 0.001), and social (g = 1.41, 95% CI = 1.27 to 1.56, p < 0.001). The risk of death was significantly higher in malnourished than in well-nourished patients (HR = 1.53, 95% CI = 1.25 to 1.86, p < 0.001). Nutritional status was significantly associated with survival, indicating that patients with a poorer nutritional status are at more risk of relapse. Conclusions. Nutritional status is a significant clinical and prognostic parameter in the assessment of lung cancer treatment. Malnutrition is associated with poorer outcome in terms of overall survival, time to tumor progression, and QoL in patients treated for lung cancer.

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The Nutritional Status Sensitivity of the Assessment of Nutritional Status Based on Mini Nutritional Assessment (MNA) Was Compared with Patient-Generated Subjective Global Assessment (PG-SGA) in Cancer Patients Undergoing Chemotherapy in RSUP Dr Wahidin Sudirohusoda Makassar

NurseLine Journal ◽

10.19184/nlj.v4i2.11234 ◽

2020 ◽

Vol 4 (2) ◽

pp. 76

Author(s):

Khoirul Anam ◽

Takdir Tahir ◽

Ilkafah Ilkafah

Keyword(s):

Body Mass Index ◽

Nutritional Status ◽

Cancer Patients ◽

Body Mass ◽

Global Assessment ◽

Nutritional Assessment ◽

Subcutaneous Fat ◽

Mini Nutritional Assessment ◽

Subjective Global Assessment ◽

Cross Sectional

Background: Chemotherapy is highly recommended for cancer treatment, however can cause some side effects such as nausea and vomiting. This will affect food intake and nutritional status in cancer patients who undergo chemotherapy. Aim: To describe nutritional status based on anthropometry Body Mass Index (BMI), hemoglobin (Hb), Patient-Generated Subjective Global Assessment (PG-SGA) and Mini Nutritional Assessment (MNA) in cancer patients undergoing chemotherapy in RSUP. Dr. Wahidin sudirohusodo Makassar. Methode: This experiment uses a quantitative non-experimental research method with cross sectional approach on 1010 patients, nonprobability sampling with purposive sampling technique on 70 respondents, data collection with interview and observation techniques. Results: Nutritional status based on Body Mass Index (BMI) shows that 39 people (55.7%) had normal BMI values. About 37 people (52.9%) had good / normal nutritional status based on Patient-Generated Subjective Global Assessment (PG-SGA) while Mini Nutritional Assessment (MNA) reveals 100% of respondents experienced nutritional status problems. Conclusion: Mini Nutritional Assessment (MNA) is the best tool to identify nutritional status of cancer patients that undergo chemotherapy since this instrument is very sensitive and practical. Patient-Generated Subjective Global Assessment (PG-SGA) is good to assess nutritional status in subject who have lost weight drastically and shows signs of subcutaneous fat loss and muscle mass loss. Keyword: Cancer, chemotherapy, body mass index (BMI), Patient-Generated Subjective Global Assessment (PG-SGA), Mini Nutritional Assessment (MNA).

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A retrospective review of nutritional status and immunotherapy in lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e14112 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e14112-e14112

Author(s):

Chung-Shien Lee ◽

Rebecca Sin ◽

Joanna Stein Fishbein ◽

Craig E. Devoe ◽

Xinhua Zhu ◽

...

Keyword(s):

Lung Cancer ◽

Nutritional Status ◽

Cancer Patients ◽

Retrospective Review ◽

Cox Regression ◽

Checkpoint Inhibitors ◽

Normal Weight ◽

Rank Test ◽

Cancer Center ◽

Lung Cancer Patients

e14112 Background: Immunotherapy has transformed cancer treatment, including lung cancer. Approximately 20-25% of patients respond, therefore making it pivotal in understanding what factors may effect outcomes. There have been previous reports of obesity associated with an increased efficacy of PD-1/PD-L1 blockade and cachectic patients not responding as well. In this study, we aim to assess the association of body mass index (BMI) with outcomes of lung cancer patients being treated with immunotherapy. Methods: An IRB approved retrospective review of lung cancer patients receiving immunotherapy between 2014 and 2017 at the Monter Cancer Center, Northwell Health was conducted. Patients were categorized in underweight (BMI < 18.5), normal weight (BMI of 18.5 to < 25), overweight (BMI 25 to 30) or obese (BMI > 30) arms. The groups were compared using the log-rank test. Kaplan-Meier was used for overall survival (OS) and progression free survival (PFS) and Cox regression models were used to adjust for potential confounders. Results: A total of 116 were included in the analysis, with a median age of 70 (95% CI, 62.5 to 75.5). Ten (8.6%) were underweight, 44 (37.9%) were normal weight, 32 (27.6%) were overweight, and 30 (25.9%) were obese. BMI classification were not found to be a significant predictor of survival, after adjusting for therapy duration (p = 0.44). PFS was 6.6, 6.0, and 6.9 months for patients in the underweight, normal weight, and overweight/obese groups, respectively. Of 116 subjects, 46 (40%) died within the follow up period: 3 (30%), 17 (39%), 11 (34%), and 15 (50%) respectively. Additional post hoc analysis showed that patients with low nutritional status as defined by either a BMI < 18.5 and/or baseline albumin < 3.5 mg/dL had a median PFS of 2.2 months compared to those who did not of 5.2 months (p < 0.00032). Conclusions: In this single institution retrospective review, BMI or albumin as solitary factors did not have a significant effect on outcomes receiving immunotherapy in lung cancer patients. However, a more comprehensive nutritional assessment using a composite endpoint of BMI and serum albumin predicted response to checkpoint inhibitors. Additional studies are needed to validate these findings.

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