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The diversity of nutritional status in cancer : new insights

dc.contributor.authorChaves, Mariana Ramos
dc.contributor.authorBoléo-Tomé, Carolina
dc.contributor.authorMonteiro-Grillo, Isabel
dc.contributor.authorCamilo, Maria
dc.contributor.authorRavasco, Paula
dc.date.accessioned2012-03-29T15:44:33Z
dc.date.available2012-03-29T15:44:33Z
dc.date.issued2010
dc.description©AlphaMed Presspor
dc.description.abstractObjective. Nutritional status in cancer has been mostly biased toward undernutrition, an issue now in dispute. We aimed to characterize nutrition status, to analyze associations between nutritional and clinical/cancer-related variables, and to quantify the relative weights of nutritional and cancer- elated features. Methods. The cross-sectional study included 450 nonselected cancer patients (ages 18 –95 years) at referral for radiotherapy. Nutritional status assessment included recent weight changes, body mass index (BMI) categorized by World Health Organization's age/sex criteria, and Patient-Generated Subjective Global Assessment (PG-SGA; validated/specific for oncology). Results. BMI identified 63% as >25 kg/m2 (43% overweight, 20% obese) and 4% as undernourished. PG-SGA identified 29% as undernourished and 71% as well nourished. Crossing both methods, among the 319 (71%) well- nourished patients according to PG-SGA, 75% were overweight/obese and only 25% were well nourished according to BMI. Concordance between BMI and PG-SGA was evaluated and consistency was confirmed. More aggressive/ advanced stage cancers were more prevalent in deficient and excessive nutritional status: in 83% (n = 235/ 282) of overweight/obese patients byBMIand in 85% (n = 111/131) of undernourished patients by PG-SGA. Results required adjustment for diagnoses: greater histological aggressiveness was found in overweight/obese prostate and breast cancer; undernutrition was associated with aggressive lung, colorectal, head-neck, stomach, and esophageal cancers (p < .005). Estimates of effect size revealed that overweight/obesity was associated with advanced stage (24%), aggressive breast (10%), and prostate (9%) cancers, whereas undernutrition was associated with more aggressive lung (6%), colorectal (6%), and head-neck (6%) cancers; in both instances, age and longer disease duration were of significance. Conclusion. Undernutrition and overweight/obesity have distinct implications and bear a negative prognosis in cancer. This study provides novel data on the prevalence of overweight/obesity and undernutrition in cancer patients and their potential role in cancer histological behavior.eng
dc.description.sponsorshipThis study was partially supported by a grant from the “Fundação para a Cieência e Tecnologia” (RUN 437).eng
dc.identifier.citationThe Oncologist 2010;15:523–530por
dc.identifier.issn1083-7159
dc.identifier.urihttp://hdl.handle.net/10451/5796
dc.identifier.urihttp://theoncologist.alphamedpress.org/content/15/5/523.full.pdf+html
dc.identifier.uridoi: 10.1634/theoncologist.2009-0283
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherAlphaMed Presspor
dc.subjectCancerpor
dc.subjectHistological aggressivenesseng
dc.subjectNutritional statuseng
dc.subjectBody mass indexeng
dc.subjectPatient-generated subjective global assessmenteng
dc.titleThe diversity of nutritional status in cancer : new insightseng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage530por
oaire.citation.startPage523por
oaire.citation.titleThe Oncologistpor
rcaap.rightsrestrictedAccesspor
rcaap.typearticlepor

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