Journal
BMC CANCER
Volume 16, Issue -, Pages -Publisher
BIOMED CENTRAL LTD
DOI: 10.1186/s12885-016-2934-5
Keywords
Gastric cancer; Malnutrition; Chemotherapy; Adverse events; Hypoalbuminemia
Categories
Funding
- High Value-added Food Technology Development Program [312006-3]
- Ministry for Food, Agriculture, Forestry and Fisheries, Republic of Korea
- SRC program (Center for Food & Nutritional Genomics) of the National Research Foundation of Korea (NRF) - Ministry of Education, Science and Technology [2015R1A5A6001906]
- NRF grant - Korea government (MSIP) [2011-0030074]
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Background: Malnutrition in gastrectomized patients receiving chemotherapy is associated with the susceptibility to chemotherapy-related adverse events. This study evaluated pre-operative nutritional status-related indices associated with adverse events in post-operation gastric cancer patients receiving chemotherapy. Methods: Medical records of 234 gastrectomized patients under adjuvant tegafur/gimeracil/oteracil chemotherapy with extended lymph node dissection were analyzed. Nutritional status assessment included Patient-Generated Subjective Global Assessment (PG-SGA), body weight, body mass index, serum albumin concentration, and Nutrition Risk Index (NRI). Chemotherapy-originated adverse events were determined using Common Terminology Criteria for Adverse Events. Results: PG-SGA indicated 59% of the patients were malnourished, and 27.8% of the patients revealed serious malnutrition with PG-SGA score of = 9. Fifteen % of patients lost = 10% of the initial body weight, 14.5% of the patients had hypoalbuminemia (< 3.5 g/dL), and 66.2% had NRI score less than 97.5 indicating moderate to severe malnutrition. Hematological adverse events were present in 94% (= grade 1) and 16.2% (= grade 3). Non-hematological adverse events occurred in 95.7% (= grade1) and 16.7% (= grade 3) of the patients. PG-SGA and NRI score was not associated with treatment-induced adverse events. Multivariate analyses indicated that female, low body mass index, and hypoalbuminemia were independent risk factors for grade 3/4 hematological adverse events. Age was an independent risk factor for grade 3/4 non-hematological adverse events. Neutropenia was the most frequently occurring adverse event, and associated risk factors were female, total gastrectomy, and hypoalbuminemia. Conclusions: Hypoalbuminemia, not PG-SGA or NRI may predict chemotherapy-induced adverse events in gastrectomized cancer patients.
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