The Nutritional Status of Oncological Patient Prior to Antitumor Treatment: Single-Center Prospective Observational Study

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Abstract

Background: Malnutrition is a frequent medical problem of cancer patients (pts) that negatively impacts of results of antitumor treatment. Aim: To study the problem of malnutrition in cancer hospital. Materials and methods: The observational study included 80 pts (30 males, age 51.6±13.6 years) who underwent examination before antitumor treatment (medical/surgical). Body mass index (BMI), weight loss (WL) over last 6 months, decrease in appetite before admission, reasons for decrease in food intake, physical activity, nosology, cancer staging, the time to diagnosis, therapy status, total protein (TP), albumin, absolute lymphocyte count (ALC) were evaluated. The data were analyzed by SPSS13.0 software. The results were expressed as mean ±SD. Results: The BMI was 25.3±5.4 kg/m2, WL 9.0±0.1%. The most common pathology were esophageal/gastric cancer (31%), stage IV (77%). 25% had received treatment within the last 6–12 months, 60% of the pts had received chemotherapy, of whom 36% had received 1st-line chemotherapy. Only 13% had additionally used enteral nutrition. An unwanted reduction of appetite was observed in 75% of pts. Most of them (34%) could not explain the reason of WL, 31% reported nausea/vomiting, 19% referred to anorexia; 13% showed consequences of chemotherapy toxicity (dysgeusia, stomatitis), 3% could not eat properly due to the pain syndrome. Of 60 patients who lost weight unintentionally, 54 (67.5%) had an average WL 14.1±9.1%. WL up to 5% was in 5 pts (6.25%), up to 10% in 14 pts (17.5%) and in 35 pts (43.75%) — more than 10%. 46% retained their usual daily activity, 80% deemed it useful to include a nutritional program in the treatment. The concentration of TP was 63.5±8.1 g/l, albumin 34.9±7.4 g/l, ALC 1.6±0.6×109/l. Conclusions: Cancer patients have direct prerequisites for the development of cachexia, and, according to our study, 6.25% of patients were at the stage of precachexia, and 61.25% already had cachexia at the time of inclusion in the study. Although their compensatory capacity is quite high, the appointment of additional nutritional support is an integral component of the management of these patients. However, according to our data, only one tenth of patients used some kind of nutritional support. Nevertheless, in case of antitumor treatment, nutritional status evaluation must be mandatory in order to address the issue of nutritional support.

About the authors

Olga A. Obukhova

N.N. Blokhin National Medical Research Center of Oncology

Author for correspondence.
Email: obukhova0404@yandex.ru
ORCID iD: 0000-0003-0197-7721
SPIN-code: 6876-7701

MD, Cand. Sci. (Med.), Head of the Department of Medical Rehabilitation

Russian Federation, 24 Kashirskoe shosse, Moscow, 115487

Anton V. Snegovoy

N.N. Blokhin National Medical Research Center of Oncology

Email: drsneg@gmail.com
ORCID iD: 0000-0002-0170-5681
SPIN-code: 8398-2396

MD, Dr. Sci. (Med.), Head of the Oncological Day Hospital (Chemotherapy and Surgical Treatment)

Russian Federation, 24, Kashirskoe sh, Moscow, 115487

Ildar A. Kurmukov

A.S. Loginov Moscow Clinical Scientific Center; K 31 City

Email: kurmukovia@gmail.com
ORCID iD: 0000-0001-8463-2600
SPIN-code: 3692-5202
Scopus Author ID: 56195263800

MD, Cand. Sci. (Med), Senior Researcher of Department of Anesthesiology and Reanimatology

Russian Federation, 86, Enthusiasts highway, Moscow, 111123; 22, st. Academician Pavlova, Moscow, 12331

Elena A. Kolomiets

National Medical Research Center of Cardiology

Email: dr.kolomiets@mail.ru
SPIN-code: 2948-3385

MD, Head of the department of organization of quality control of medical care and examination of temporary disability

Russian Federation, 15a, st. 3rd Cherepkovskaya, Moscow, 121552

Marina G. Toms

N.N. Blokhin National Medical Research Center of Oncology

Email: biochimia@yandex.ru
ORCID iD: 0000-0001-9388-0956
Scopus Author ID: 6602142635

Cand. Sci. (Biol.), Laboratory of Clinical Biochemistry, Senior Researcher

Russian Federation, 24, Kashirskoe sh, Moscow, 115487

Marina M. Khulamkhanova

N.N. Blokhin National Medical Research Center of Oncology

Email: marina_2705@list.ru
SPIN-code: 9837-9841

MD, Physiotherapist, Department of Medical Rehabilitation

Russian Federation, 24, Kashirskoe sh, Moscow, 115487

Ruben S. Yagubyan

The Russian National Research Medical University named after N.I. Pirogov

Email: ruben.yagubyan@fresenius-kabi.com
SPIN-code: 5617-6196

assistant, Department of Anesthesiology, Reanimatology and Intensive Care

Russian Federation, 1 Ostrovityanova st. Moscow, 117997

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Purpose of hospitalization.

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3. Fig. 2. Duration of the disease.

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4. Fig. 3. Tumor localization.

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5. Fig. 4. Nutrition program and nutritional support.

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6. Fig. 5. Change in body weight (%) in patients who unintentionally lost weight (n=60).

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7. Fig. 6. Precachexia and cachexia in patients who have lost weight unintentionally.

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8. Fig. 7. Attitude of patients to the inclusion of a balanced diet in the anticancer treatment plan.

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Copyright (c) 2020 Obukhova O.A., Snegovoy A.V., Kurmukov I.A., Kolomiets E.A., Toms M.G., Khulamkhanova M.M., Yagubyan R.S.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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