Prognostic Signifi cance Of Body Composition Analysis Measurements In Patients With Locally Advanced Or Metastatic Cancers

Year 2015, Volume: 1 Issue: 2, - , 20.06.2015

Cemil Bilir Huseyin Engin Selcuk Ergen Yasemin Bakkal Temi Hasan Morcalı

https://doi.org/10.1093/annonc/

Abstract

Objectives: There are many parameters in the body composition analyses and Bio-impedance analysis (BIA) measurements such as total weight, body fat (BF%), fat-free mass (FFM), muscle mass, metabolic age, basal metabolic rate, resistance and phase angle. But we do not well known which of the parameter is the most important or which one of them are associated with overall survival (OS). Material and Method: In total, 173 patients have included in the study. Results: The mean age 54 years in man and 51 years in woman. Patients with cancer had lower hemoglobin and albumin levels compared to the healthy controls. The median OS was 17 months of the cancer group and women were alive longer than men (22 vs 13 months, p<0.001). Multivariate analysis revealed that, BF% (HR, 0.8, 95% CI, 0.75-0.87, r=35.8, P<0.001), total body water (TBW%) (HR, 0.89, 95% CI, 0.82-0.97, r=7.8, P=0.035), BMI (HR, 0.83, 95% CI, 0.740.93, r=13.9, P=0.003) were found to be statically signiŞ cantly associated with OS.Conclusion: Present study showed that, increased BMI, fat mass and total body water at the time of diagnosis of cancer, are good prognostic factors in patients with metastatic disease. Gender did not have any impact on relation of BIA parameters with survival

Keywords

Bio-impedance analysis, metastasis, cancer, survival

Prognostic Signifi cance Of Body Composition Analysis Measurements In Patients With Locally Advanced Or Metastatic Cancers

Abstract

Amaç: Biyoimpedans analizinde (BIA) ölçülen bir çok parametre mevcuttur;total vücut ağırlığı (TVA),vücut yağı (%VY), Yağsız vücut kütlesi (%YVK), Kas kütlesi, metabolizma yaşı, bazal metabolzma hızı, rezistans ve faz açısı gibi. Ama bu parametrelerden hangisinin daha önemli olduğu ve yaşam süresi ile ilişkili olduğu tam olarak bilinmemektedir. Gereç ve Yöntem: Toplamda 173 hasta çalışmaya dahil edildi.Bulgular: Ortanca yaş erkeklerde 54, kadınlarda 51’ di. Kanser hastalarında kontrol grubuna göre daha düşük hemoglobulin ve albumin düzeyleri mevcuttu. Ortanca sağ kalım süresi kanser grubunda 17 aydı ve kadınların yaşam süresi erkeklere göre anlamlı olarak daha uzun bulundu (22 aya karşın 13 ay, P<0.001). Multivaryant analize göre %VY (HR, 0.8, 95% CI, 0.75-0.87, r=35.8, P<0.001), total vücut suyu (%TVS) (HR, 0.89, 95% CI, 0.82-0.97, r=7.8, P=0.035) ve vücut kütle indeksi (VKI) (HR, 0.83, 95% CI, 0.74-0.93, r=13.9, P=0.003) genel sağkalımla anlamlı olarak ilişkili saptandı.Sonuç: Güncel çalışma gösterdiki artmış VKI, yağ kütlesi ve total vücut suyu kanser tanısı konulduğu anda metastatik hastalar için iyi prognostik bir bulgudur. Cinsiyetin BIA parametreleri ve sağkalıma ek bir katkısının olmadığı gösterildi

Keywords

Biyoo-impedans analizi, metastaz, kanser, survival

References

• MacDonald N, Easson AM, Mazurak VC, Dunn GP, Baracos VE. Understanding and managing cancer cachexia. J Am Coll Surg. 2003; 197: 143-61.
• Dewys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR, Cohen MH, Douglass HO Jr, Engstrom PF, Ezdinli EZ, Horton J, Johnson GJ, Moertel CG, Oken MM, Perlia C, Rosenbaum C, Silverstein MN, Skeel RT, Sponzo RW, Tormey DC. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med.1980; 69: 491-7.
• Clinical practice guidelines for nutrition in chronic renal failure. K/DOQI, National Kidney Foundation. Am J Kidney Dis. 2000; 35: 1-140.
• Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA & Jeejeebhoy KN. What is subjective global assessment of nutritional status? J. Parenter Enteral Nutr. 1987; 11:8– 13.
• Ottery FD. Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. Sem Oncol. 1994; 21:770 – 8.
• Halpern-Silveira D, Susin LR, Borges LR, Paiva SI, Assunção MC, Gonzalez MC. Body weight and fat-free mass changes in a cohort of patients receiving chemotherapy. Support Care Cancer. 2010; 18:617-5.
• Mourtzakis M, Prado CM, Lieffers JR, Reiman T, McCargar LJ, Baracos VE. A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. Appl Physiol Nutr Metab. 2008 ;33:997-1006.
• Dumler F, Kilates C. Use of bioelectrical impedance techniques for monitoring nutritional status in patients on maintenance dialysis patients. J Ren Nutr. 2000; 10: 116-4.
• Miyatake N, Nonaka K, Fujii M. A new air displacement plethysmograph for the determination of Japanese body composition. Diabetes Obes Metab. 1999; 1: 347–1.
• Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Manuel Gómez J, Lilienthal Heitmann B, Kent-Smith L, Melchior JC, Pirlich M, Scharfetter H, Schols A, Pichard C. ESPEN. Bioelectrical impedance analysis-part II: utilization in clinical practice. Clin Nutr. 2004; 23: 1430-53.
• Chertow GM, Lowrie EG, Wilmore DW, Gonzalez J, Lew NL, Ling J, Leboff MS, Gottlieb MN, Huang W, Zebrowski B, College J, Lazarus JM. Nutritional assessment with bioelectrical impedance analysis in maintenance hemodialysis patients. J Am Soc Nephrol. 1995; 6:75–1.
• Paiva SI, Borges LR, Halpern-Silveira D, Assunção MC, Barros AJ, Gonzalez MC. Standardized phase angle from bioelectrical impedance analysis as prognostic factor for survival in patients with cancer. Support Care Cancer. 2010; 19:187-2.
• Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Manuel Gómez J, Lilienthal Heitmann B, Kent-Smith L, Melchior JC, Pirlich M, Scharfetter H, M W J Schols A, Pichard C. ESPEN: Bioelectrical impedance analysis part I: review of principles and methods. Clin Nutr. 2004; 23: 1226–43.
• Treviño-Aguirre E1, López-Teros T, Gutiérrez-Robledo L, Vandewoude M, Pérez-Zepeda M. Availability and use of dual energy X-ray absorptiometry (DXA) and bio-impedance analysis (BIA) for the evaluation of sarcopenia by Belgian and Latin American geriatricians. J Cachexia Sarcopenia Muscle. 2014; 5:79-1.
• Das SK. Body composition measurement in severe obesity. Curr Opin Clin Nutr Metab Care. 2005; 8: 602-6.
• Inui A. Cancer anorexia–cachexia syndrome: current issues in research and management. CA J Clin. 2002; 52: 72–91.
• Segura A, Pardo J, Jara C, Zugazabeitia L, Carulla J, de Las Peñas R, García- Cabrera E, Luz Azuara M, Casadó J, Gómez-Candela C. An epidemiological evaluation of the prevalence of malnutrition in Spanish patients with locally advanced or metastatic cancer. Clin Nutr. 2005; 24:801–4.