Prevalence of Upper Gastrointestinal Symptoms and Their Influence on Nutritional State and Performance Status in Patients With Different Primary Tumors Receiving Palliative Care
Restricted accessResearch articleFirst published online February, 2014
Prevalence of Upper Gastrointestinal Symptoms and Their Influence on Nutritional State and Performance Status in Patients With Different Primary Tumors Receiving Palliative Care
The aim of this study was to investigate the relationship between gastrointestinal symptoms, nutritional balance, and performance status in patients receiving palliative care for advanced cancers originating in different sites. We studied a total of 105 patients. Upper gastrointestinal symptoms, Eastern Cooperative Oncology Group Performance Status score (ECOG-PS), dietary intakes, anthropometric measures, and some serum proteins were determined. Unintentional weight loss, alterations in anthropometric measures, and highest number of symptoms were greater in patients with lung and stomach cancer. No differences were found in ECOG-PS according to cancer site. Patients with gastric or lung cancer have most evidence of protein-calorie malnutrition and a higher prevalence of upper gastrointestinal symptoms. The performance status is not affected by tumor site. Early nutritional support should be planned for all patients with cancer, especially for patients with gastric or lung cancer.
MercadanteSCasuccioAFulfaroF. The course of symptom frequency and intensity in advanced cancer patients followed at home. J Pain Symptom Manage. 2000;20(2):104–112.
2.
PotterJHamiFBryanTQuigleyC. Symptoms in 400 patients referred to palliative care services: prevalence and patterns. Palliat Med. 2003;17(4):310–314.
3.
KomurcuSNelsonKAWalshDDonnellySMHomsiJAbdullahO. Common symptoms in advanced cancer. Semin Oncol. 2000;27(1):24–33.
4.
SarhillNMahmoudFWalshD. Evaluation of nutritional status in advanced metastatic cancer. Support Care Cancer. 2003;11(10):652–659.
5.
BovioGBettaglioRBonettiGMiottiDVerniP. Evaluation of nutritional status and dietary intake in patients with advanced cancer on palliative care. Minerva Gastroenterol Dietol. 2008;54(3):243–250.
6.
KomurcuSNelsonKAWalshDFordRBRybickiLA. Gastrointestinal symptoms among inpatients with advanced cancer. Am J Hosp Palliat Care. 2002;19(5):351–355.
7.
WalshDDonnellySRybickiL. The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients. Support Care Cancer. 2000;8(3):175–179.
8.
CurtisEBKrechRWalshTD. Common symptoms in patients with advanced cancer. J Palliat Care. 1991;7(2):25–29.
9.
BovioGMontagnaGBarianiCBaiardiP. Upper gastrointestinal symptoms in patients with advanced cancer: relationship to nutritional and performance status. Support Care Cancer. 2009;17(10):1317–1324.
10.
BozzettiFMigliavaccaSScottiA. Impact of cancer, type, site, stage and treatment on the nutritional status of patients. Ann Surg. 1982;196(2):170–179.
11.
TongHIsenringEYatesP. The prevalence of nutrition impact symptoms and their relationship to quality of life and clinical outcomes in medical oncology patients. Support Care Cancer. 2009;17(1):83–90.
12.
TemelJSPirlWFLynchTJ. Comprehensive symptom management in patients with advanced-stage non-small-cell lung cancer. Clin Lung Cancer. 2006;7(4):241–249.
13.
LilenbaumR. Management of advanced non-small-cell lung cancer in patients with a performance status of 2. Clin Lung Cancer. 2004;5(4):209–213.
14.
KhalidUSpiroABaldwinC. Symptoms and weight loss in patients with gastrointestinal and lung cancer at presentation. Support Care Cancer. 2007;15(1):39–46.
15.
DeansDATanBHWigmoreSJ. The influence of systemic inflammation, dietary intake and stage of disease on rate of weight loss in patients with gastro-oesophageal cancer. Br J Cancer. 2009;100(1):63–69.
16.
CurlessRFrenchJMWilliamsGVJamesOF. Colorectal carcinoma: do elderly patients present differently?Age Ageing. 1994;23(2):102–107.
17.
ArndtVStegmaierCZieglerHBrennerH. A population-based study of the impact of specific symptoms on quality of life in women with breast cancer 1 year after diagnosis. Cancer. 2006;107(10):2496–2503.
18.
PaulSBGulatiMSSreenivasV. Evaluating patients with cirrhosis for hepatocellular carcinoma: value of clinical symptomatology, imaging and alpha-fetoprotein. Oncology. 2007;72 (suppl 1):117–123.
19.
ChangVTHwangSSFeuermanMKasimisBSThalerHT. The memorial symptom assessment scale short form (MSAS-SF). Cancer. 2000;89(5):1162–1171.
20.
OkenMMCreechRHTormeyDC. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5(6):649–655.
21.
CarnevaleEMarlettaL. Tabelle Di Composizione Degli Alimenti. Edra Medical, New Media, Roma; 2000.
22.
ChumleaWCRocheAFSteinbaughML. Estimating stature from knee height for persons 60 to 90 years of age. J Am Geriatr Soc. 1985;33(2):116–120.
23.
BlackburnGLBistrianBRMainiBSSchlammHTSmithMF. Nutritional and metabolic assessment of the hospitalized patient. JPEN J Parenter Enteral Nutr. 1977;1(1):11–22.
24.
KruizengaHMWierdsmaNJvan BokhorstMA. Screening of nutritional status in The Netherlands. Clin Nutr. 2003;22(2):147–152.
25.
StrattonRJGreenCJEliaM. Disease-Related Malnutrition: An Evidence Based Approach To Treatment. CABI, Wallingford; 2003.
26.
McWhirterJPPenningtonCR. Incidence and recognition of malnutrition in hospital. BMJ. 1994;308(6934):945–948.
27.
LenkKSchulerGAdamsV. Skeletal muscle wasting in cachexia and sarcopenia: molecular pathophysiology and impact of exercise training. J Cachexia Sarcopenia Muscle. 2010;1(1):9–21.
28.
HeymsfieldSBMcManusCStevensVSmithJ. Muscle mass: reliable indicator of protein-energy malnutrition severity and outcome. Am J Clin Nutr. 1982;35(suppl 5):1192–1199.
29.
FrisanchoAR. Anthropometric Standards For The Assessment Of Growth And Nutritional Status. Ann Arbor: The University of Michigan Press; 1990.
30.
HarrisJSBenedictFG.A Biometric Study Of Basal Metabolism In Man. Washington DC: Carnegie Institute, publicationn. 279; 1919.
31.
CharneyP. Nutrition assessment in the 1990s, where are we now?Nutr Clin Pract. 1995;10(4):131–139.
32.
HeymsfieldSBTigheAWangZ-M. Nutritional assessment by anthropometric and biochemical methods. In: ShilsMEOlsonJAShikeM Eds. Modern Nutrition In Health And Disease. Philadelphia: Lea &Febiger Publishers; 1994:812–841.
33.
ParkinDMBrayFFerlayJPisaniP. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108.
34.
FerlayJAutierPBoniolMHeanueMColombetMBoyleP. Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol. 2007;18(3):581–592.
35.
DonnellySWalshD. The symptoms of advanced cancer. Semin Oncol. 1995;22(suppl 3):67–72.
36.
World Health Organisation. Obesity: Preventing And Managing The Global Epidemic. Report of a WHO consultation. WHO technical report series 894. Geneva: World Health Organisation; 2000.
37.
FearonKStrasserFAnkerSD. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12(5):489–495.
38.
LandisSHMurrayTBoldenSWingoPA. Cancer statistics, 1998. CA Cancer J Clin. 1998;48(1):6–29.
39.
JemalASiegelRXuJWardE. Cancer statistics, 2010. CA Cancer J Clin. 2010;60(5):277–300.
40.
GrindelCGWhitmerKBarsevickA. Quality of life and nutritional support in patients with cancer. Cancer Pract. 1996;4(2):81–87.
41.
Marín CaroMMLavianoA, Pichard C Nutritional intervention and quality of life in adult oncology patients. Clin Nutr. 2007;26(3):289–301.
42.
AugustDAHuhmannMB; American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors. A.S.P.E.N. clinical guidelines: nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. JPEN J Parenter Enteral Nutr. 2009;33(5):472–500.
43.
LisCGGuptaDLammersfeldCAMarkmanMVashiPG.Role of nutritional status in predicting quality of life outcomes in cancer--a systematic review of the epidemiological literature. Nutr J. 2012;11:27.
