Assessment of nutritional status of gynecological cancer cases in India and comparison of subjective and objective nutrition assessment parameters

Ushashree Das; Shilpa Patel; Kalpana Dave; Ronak Bhansali

doi:10.4103/2278-330X.126518

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FEMALE REPRODUCTIVE TRACT TUMORS : Original Article

03 (

); 038-042

doi:

10.4103/2278-330X.126518

Assessment of nutritional status of gynecological cancer cases in India and comparison of subjective and objective nutrition assessment parameters

Ushashree Das^1,, Shilpa Patel¹, Kalpana Dave¹, Ronak Bhansali¹

1 Department of Gynaecologic Oncology, Gujarat Cancer Research Institute, Ahmadabad, Gujarat

*Corresponding author: Dr. Ushashree Das. ushashreedas@gmail.com

Published: 2020-12-31

MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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Abstract

Aim: To assess the nutritional status of gynecological cancer patients using scored Patient Generated Subjective Global Assessment (PG-SGA) then compare it with the body mass index (BMI), hemoglobin, serum albumin, and approximate percentage weight lost in last 1 month so as to find any one parameter that can be used in place of the comprehensive assessment tool. Materials and Methods: Sixty gynecological cancer patients were assessed for their nutritional status using BMI, serum albumin, hemoglobin, percentage weight lost in last 1 month, and scored PG-SGA. Correlation, sensitivity, specificity, and predictive values of the former four parameters compared to scored PG-SGA were calculated. Results: 88.33% of cases were at risk of or had some degree of malnutrition according to scored PG-SGA. Serum albumin level ≤ 2 g/dl had highest specificity and positive predictive value at 1, whereas percentage weight lost in last month had better overall sensitivity, specificity, and positive and negative predictive values of 0.5833, 0.9444, 0.875, and 0.7727, respectively. The Pearson′s correlation coefficient between scored PG-SGA and percentage weight lost in last 1 month was 0.784, highest among all the parameters. Conclusion: 88.33% of gynecologic cancer cases had some degree of malnutrition or were at risk of malnutrition. Approximate percentage weight lost in last 1 month, that is, ≥ 5% may be used in place of the comprehensive scored PG-SGA to triage the patients in case the latter is not used for some reason. Severe hypoalbuminemia ≤ 2 g/dl is an indicator of severe malnutrition in gynecologic cancer cases.

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References

Antoun S, Baracos V. Malnutrition in cancer patient: When to have a specialized consultation? Bull Cancer 2009;96:615-23.
Kaikani W, Bachmann P. Consequences of a comorbidity often neglected in oncology: Malnutrition. Bull Cancer 2009;96:659-64.
Huhmann MB, August DA. Review of American society for parenteral and enteral nutrition (ASPEN) clinical guidelines for nutrition support in cancer patients: Nutrition screening and assessment. Nutr Clin Pract 2008;23:182-8.
Adams KM, Kohlmeier M, Powell M, Zeisel SH. Nutrition in medicine: Nutrition education for medical students and residents. Nutr Clin Pract 2010;25:471-80.
Spiro A, Baldwin C, Patterson A, Thomas J, Andreyev HJ. The views and practice of oncologists towards nutritional support in patients receiving chemotherapy. Br J Cancer 2006;95:431-4.
DeCicco PV, Wunderlich SM, Emmolo JS. Determination of malnourishment in the head and neck cancer patient: Assessment tools and nutrition education of radiation oncologists. Support Care Cancer 2011;19:123-30.
Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 2002;56:779-85.
Ottery FD. Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition 1996;12:S15-9.
WHO, Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity, 2001. Available from: http://www.WHO/NMH/NHD/MNM/11.1. [Last accessed on 2013 Aug 30].
Sama SK, Bhargava S, Nath NG, Talwar JR, Nayak NC, Tandon BN, et al. Noncirrhotic portal fibrosis. Am J Med 1971;51:160-9.
Lai CC, You JF, Yeh CY, Chen JS, Tang R, Wang JY, et al. Low preoperative serum albumin in colon cancer: A risk factor for poor outcome. Int J Colorectal Dis 2011;26:473-81.
Beghetto MG, Luft VC, Mello ED, Polanczyk CA. Accuracy of nutritional assessment tools for predicting adverse hospital outcomes. Nutr Hosp 2009;24:56-62.
Ali SM, Lindstrom M. Socioeconomic, psychosocial, behavioural, and psychological determinants of BMI among young women: Differing patterns for underweight and overweight/obesity. Eur J Public Health 2006;16:325-31.
Gomez Candela C, Olivar Roldán J, García M, Marín M, Madero R, Pérez-Portabella C, et al. Assessment of a malnutrition screening tool in cancer patients. Nutr Hosp 2010;25:400-5.
Laky B, Janda M, Bauer J, Vavra C, Cleghorn G, Obermair A. Malnutrition among gynaecological cancer patients. Eur J Clin Nutr 2007;61:642-6.
Bozzetti F, Mariani L, Lo Vullo S. SCRINIO Working Group. Amerio ML, Biffi R, Caccialanza G, et al. The nutritional risk in oncology: A study of 1,453 cancer outpatients. Support Care Cancer 2012;20:1919-28.
Vandewoude MF. Nutritional assessment in oncogeriatrics. Tijdschr Gerontol Geriatr 2010;41:214-20.
Laky B, Janda M, Kondalsamy-Chennakesavan S, Cleghorn G, Obermair A. Pretreatment malnutrition and quality of life-association with prolonged length of hospital stay among patients with gynecological cancer: A cohort study. BMC Cancer 2010;10:232.
Zorlini R, Akemi Abe Cairo A, Salete Costa Gurgel M. Nutritional status of patients with gynecologic and breast cancer. Nutr Hosp 2008;23:577-83.
Laky B, Janda M, Cleghorn G, Obermair A. Comparison of different nutritional assessments and body-composition measurements in detecting malnutrition among gynecologic cancer patients. Am J Clin Nutr 2008;87:1678-85.
Orrevall Y, Tishelman C, Permert J, Cederholm T. Nutritional support and risk status among cancer patients in palliative home care services. Support Care Cancer 2009;17:153-61.
Pereira Borges N, D′Alegria Silva B, Cohen C, Portari Filho PE, Medeiros FJ. Comparison of the nutritional diagnosis, obtained through different methods and indicators, in patients with cancer. Nutr Hosp 2009;24:51-5.
Barbosa-Silva MC. Subjective and objective nutritional assessment methods: What do they really assess? Curr Opin Clin Nutr Metab Care 2008;11:248-54.
Penel N, Vanseymortier M, Bonneterre ME, Clisant S, Dansin E, Vendel Y, et al. Prognostic factors among cancer patients with good performance status screened for phase I trials. Invest New Drugs 2008;26:53-8.
Asp ML, Tian M, Kliewer KL, Belury MA. Rosiglitazone delayed weight loss and anorexia while attenuating adipose depletion in mice with cancer cachexia. Cancer Biol Ther 2011;12:957-65.
Utech AE, Tadros EM, Hayes TG, Garcia JM. Predicting survival in cancer patients: The role of cachexia and hormonal, nutritional and inflammatory markers. J Cachexia Sarcopenia Muscle 2012;3:245-51.
Boleo-Tome C, Monteiro-Grillo I, Camilo M, Ravasco P. Validation of the Malnutrition Universal Screening Tool (MUST) in cancer. Br J Nutr 2012;108:343-8.
Kwang AY, Kandiah M. Objective and subjective nutritional assessment of patients with cancer in palliative care. Am J Hosp Palliat Care 2010;27:117-26.

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[1] Antoun S, Baracos V. Malnutrition in cancer patient: When to have a specialized consultation? Bull Cancer 2009;96:615-23.

[2] Kaikani W, Bachmann P. Consequences of a comorbidity often neglected in oncology: Malnutrition. Bull Cancer 2009;96:659-64.

[3] Huhmann MB, August DA. Review of American society for parenteral and enteral nutrition (ASPEN) clinical guidelines for nutrition support in cancer patients: Nutrition screening and assessment. Nutr Clin Pract 2008;23:182-8.

[4] Adams KM, Kohlmeier M, Powell M, Zeisel SH. Nutrition in medicine: Nutrition education for medical students and residents. Nutr Clin Pract 2010;25:471-80.

[5] Spiro A, Baldwin C, Patterson A, Thomas J, Andreyev HJ. The views and practice of oncologists towards nutritional support in patients receiving chemotherapy. Br J Cancer 2006;95:431-4.

[6] DeCicco PV, Wunderlich SM, Emmolo JS. Determination of malnourishment in the head and neck cancer patient: Assessment tools and nutrition education of radiation oncologists. Support Care Cancer 2011;19:123-30.

[7] Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 2002;56:779-85.

[8] Ottery FD. Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition 1996;12:S15-9.

[9] WHO, Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity, 2001. Available from: http://www.WHO/NMH/NHD/MNM/11.1. [Last accessed on 2013 Aug 30].

[10] Sama SK, Bhargava S, Nath NG, Talwar JR, Nayak NC, Tandon BN, et al. Noncirrhotic portal fibrosis. Am J Med 1971;51:160-9.

[11] Lai CC, You JF, Yeh CY, Chen JS, Tang R, Wang JY, et al. Low preoperative serum albumin in colon cancer: A risk factor for poor outcome. Int J Colorectal Dis 2011;26:473-81.

[12] Beghetto MG, Luft VC, Mello ED, Polanczyk CA. Accuracy of nutritional assessment tools for predicting adverse hospital outcomes. Nutr Hosp 2009;24:56-62.

[13] Ali SM, Lindstrom M. Socioeconomic, psychosocial, behavioural, and psychological determinants of BMI among young women: Differing patterns for underweight and overweight/obesity. Eur J Public Health 2006;16:325-31.

[14] Gomez Candela C, Olivar Roldán J, García M, Marín M, Madero R, Pérez-Portabella C, et al. Assessment of a malnutrition screening tool in cancer patients. Nutr Hosp 2010;25:400-5.

[15] Laky B, Janda M, Bauer J, Vavra C, Cleghorn G, Obermair A. Malnutrition among gynaecological cancer patients. Eur J Clin Nutr 2007;61:642-6.

[16] Bozzetti F, Mariani L, Lo Vullo S. SCRINIO Working Group. Amerio ML, Biffi R, Caccialanza G, et al. The nutritional risk in oncology: A study of 1,453 cancer outpatients. Support Care Cancer 2012;20:1919-28.

[17] Vandewoude MF. Nutritional assessment in oncogeriatrics. Tijdschr Gerontol Geriatr 2010;41:214-20.

[18] Laky B, Janda M, Kondalsamy-Chennakesavan S, Cleghorn G, Obermair A. Pretreatment malnutrition and quality of life-association with prolonged length of hospital stay among patients with gynecological cancer: A cohort study. BMC Cancer 2010;10:232.

[19] Zorlini R, Akemi Abe Cairo A, Salete Costa Gurgel M. Nutritional status of patients with gynecologic and breast cancer. Nutr Hosp 2008;23:577-83.

[20] Laky B, Janda M, Cleghorn G, Obermair A. Comparison of different nutritional assessments and body-composition measurements in detecting malnutrition among gynecologic cancer patients. Am J Clin Nutr 2008;87:1678-85.

[21] Orrevall Y, Tishelman C, Permert J, Cederholm T. Nutritional support and risk status among cancer patients in palliative home care services. Support Care Cancer 2009;17:153-61.

[22] Pereira Borges N, D′Alegria Silva B, Cohen C, Portari Filho PE, Medeiros FJ. Comparison of the nutritional diagnosis, obtained through different methods and indicators, in patients with cancer. Nutr Hosp 2009;24:51-5.

[23] Barbosa-Silva MC. Subjective and objective nutritional assessment methods: What do they really assess? Curr Opin Clin Nutr Metab Care 2008;11:248-54.

[24] Penel N, Vanseymortier M, Bonneterre ME, Clisant S, Dansin E, Vendel Y, et al. Prognostic factors among cancer patients with good performance status screened for phase I trials. Invest New Drugs 2008;26:53-8.

[25] Asp ML, Tian M, Kliewer KL, Belury MA. Rosiglitazone delayed weight loss and anorexia while attenuating adipose depletion in mice with cancer cachexia. Cancer Biol Ther 2011;12:957-65.

[26] Utech AE, Tadros EM, Hayes TG, Garcia JM. Predicting survival in cancer patients: The role of cachexia and hormonal, nutritional and inflammatory markers. J Cachexia Sarcopenia Muscle 2012;3:245-51.

[27] Boleo-Tome C, Monteiro-Grillo I, Camilo M, Ravasco P. Validation of the Malnutrition Universal Screening Tool (MUST) in cancer. Br J Nutr 2012;108:343-8.

[28] Kwang AY, Kandiah M. Objective and subjective nutritional assessment of patients with cancer in palliative care. Am J Hosp Palliat Care 2010;27:117-26.

Assessment of nutritional status of gynecological cancer cases in India and comparison of subjective and objective nutrition assessment parameters

Abstract

Abstract

Keywords

References

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