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EVALUATION OF SARCOPENIA, MALNUTRITION AND NUTRITIONAL STATUS OF PATIENTS WITH AND WITHOUT CANCER TREATMENT BY AGE

Yıl 2022, , 6 - 13, 10.02.2022
https://doi.org/10.26650/JARHS2022-1035701

Öz

Objective: The aim of this study is to evaluate patients who are just starting or have started chemotherapy and also who are geriatric and nongeriatric, of sarcopenia and nutritional status. Materials and Methods: In this study, adult cancer patients who will receive chemotherapy for the first time were evaluated in terms of sarcopenia and nutritional status with patients between the 3rd month and 1st year of chemotherapy treatment. Patients were compared according to whether they were geriatric or not, and sarcopenic patients were also evaluated by classifying them according to cancer sides. The patients’ hand grip strength, bioelectrical impedance, appendicular skeletal muscle index (corrected for height), walking speed were measured and evaluated for sarcopenia. In addition, malnutrition risks, three-day food consumption records and laboratory parameters were examined. Results: A total of 123 adult patients were evaluated and 58 (47.2%) of the patients in the study were geriatric (65 years ≥). The risk of malnutrition was high in 39% of the patients and was found to be significantly higher in the geriatric group (46.6%) than in the non-geriatric group (32.3%) (p=0.029). The risk of malnutrition was found to be associated with the diagnosis groups of cancer. Compared to breast cancer, the risk of malnutrition was 18.2 times (p=0.002) higher in hepatobiliary cancers (including pancreas) and 7.6 times (p=0.018) in other cancers (head and neck, sarcoma, brain, stomach, peritoneum). Conclusion: Especially in geriatric patients, it is important to recognize and evaluate malnutrition caused by cancer at the beginning of treatment.

Kaynakça

  • 1. Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H et al. ESPEN guidelines on nutrition in cancer patients. Clinical Nutrition 2017;36(1):11-48.
  • 2. Brandhorst S, Longo VD. Fasting and Caloric Restriction in Cancer Prevention and Treatment. Recent Results Cancer Res 2016;207:241-66.
  • 3. Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods.Int J Cancer 2019;144(8):1941-53.
  • 4. Benoist S, Brouquet A.Nutritional assessment and screening for malnutrition. J Visc Surg 2015;152(1):S3-7.
  • 5. Mislang AR, Di Donato S, Hubbard J, Krishna L, Mottino G et al. Nutritional management of older adults with gastrointestinal cancers: An International Society of Geriatric Oncology (SIOG) review paper. Journal of Geriatric Oncology 2018;9(4):382-92.
  • 6. Mantzorou M, Koutelidakis A, Theocharis S, Giaginis C. Clinical value of nutritional status in cancer: What is its impact and how it affects disease progression and prognosis? Nutrition in Cancer 2017;69(8):1151-76.
  • 7. Davies M. Nutritional screening and assessment in cancerassociated malnutrition. Eur J Oncol Nurs 2005;9(2):S64-73.
  • 8. Cederholm T, Jensen GL, Correia MITD, Gonzalez MC, Fukushima R et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clinical Nutrition 2019;38(1):1-9.
  • 9. Arends J ve diğerleri. ESPEN expert group recommendations for action against cancer-related malnutrition. Clinical Nutrition 2017;36(5):1187-96.
  • 10. Muscaritoli M, Anker SD, Argilés J, Aversa Z, Bauer JM et al. Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) “cachexia-anorexia in chronic wasting diseases” and “nutrition in geriatrics”. Clinical Nutrition 2010;29(2):154-9.
  • 11. Cereda E, Turri A, Klersy C, Cappello S, Ferrari A et al. Whey protein isolate supplementation improves body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy. Cancer Med 2019;8(16):6923-32.
  • 12. Mattox TW. Cancer Cachexia: Cause, Diagnosis, and Treatment. Nutr Clin Pract 2017;32(5):599-606.
  • 13. Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncology 2011;12(5):489-95.
  • 14. Tournadre A. Sarcopenia. Joint Bone Spine 2019;86(3):309-14.
  • 15. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019;48(1):16-31.
  • 16. Bahat G, Altinkaynak M, Karan MA. Handgrip strength cut-offs to define sarcopenia in Turkish population. Aging Clinical and Experimental Research 2021;33(1):207-8.
  • 17. Saka B, Kaya O, Ozturk GB, Erten N, Karan MA. Malnutrition in the elderly and its relationship with other geriatric syndromes. Clinical Nutrition 2010;29(6):745-8.
  • 18. Alan S et al. Patterns of Comorbidity in Older Adults with Heart Failure: The Cardiovascular Research Network PRESERVE Study. Journal of American Geriatrics Society 2013;61(1):26-33.
  • 19. Xiao J, Caan BJ, Cespedes Feliciano EM, Meyerhardt JA et al.Association of Low Muscle Mass and Low Muscle Radiodensity With Morbidity and Mortality for Colon Cancer Surgery. JAMA Surg 2020;155(10):942-9.
  • 20. Ubachs J, Ziemons J, Minis-Rutten IJG, Kruitwagen RFPM, Kleijnen J et al. Sarcopenia and ovarian cancer survival: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2019;10(6):1165- 74.
  • 21. Robinson SM, Reginster JY, Rizzoli R, Shaw SC, Kanis JA, Bautmans I et al. Does nutrition play a role in the prevention and management of sarcopenia? Clin Nutr 2018;37(4):1121-32.
  • 22. Bahat G, Kilic C , Altinkaynak M , Karan MA. Comparison of standard versus population-specific handgrip strength cut-off points in the detection of probable sarcopenia after launch of EWGSOP2. Aging Male 2020;23(5):1564-9.
  • 23. Kılınçarslan MG, Şahin EM, Sarıgül B, Kocaoğlu SB. Postmenopozal Türk Kadınlarında Vücut Kompozisyonu ve Fiziksel Aktivitenin Kemik Mineral Yoğunluğu ile İlişkisi. Turk J Osteoporos 2020;26:70-4.
  • 24. Bossi P, Delrio P, Mascheroni A, Zanetti M. The Spectrum of Malnutrition/Cachexia/Sarcopenia in Oncology According to Different Cancer Types and Settings: A Narrative Review. Nutrients 2021;13(6):1980.
  • 25. Oflazoglu U, Alacacioglu A, Varol U, Y Kucukzeybek Y, Salman T et al. Chemotherapy-induced sarcopenia in newly diagnosed cancer patients: Izmir Oncology Group (IZOG) study. Supportive Care in Cancer 2020;28(6):2899-910.
  • 26. Keller K. Sarcopenia. Wien Med Wochenschr 2019:169(7-8):157-72.
  • 27. Hébuterne X, Lemarié E, Michallet M, Montreuil CB, Schneider SM et al. Prevalence of malnutrition and current use of nutrition support in patients with cancer. Journal of Parentereral Enteral Nutrition 2014;38(2):196-204.
  • 28. Ryan AM, Power DG, Daly L, Cushen SJ, Bhuachalla EN et al. Cancerassociated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later. Proc Nutr Soc 2016;75(2):199-211.
  • 29. Williams GR, Chen Y, Kenzik KM, McDonald A, Shachar SS et al. Assessment of Sarcopenia Measures, Survival, and Disability in Older Adults Before and After Diagnosis With Cancer. The Journal of The American Medical Association 2020;3(5):e204783.
  • 30. Zhang Z, Pereira SL, Luo M, Matheson EM. Evaluation of Blood Biomarkers Associated with Risk of Malnutrition in Older Adults: A Systematic Review and Meta-Analysis. Nutrients 2017;9(8):829.
  • 31. Loftus TJ, Brown MP, Slish JH, Rosenthal MD. Serum Levels of Prealbumin and Albumin for Preoperative Risk Stratification. Nutrition in Clinical Practice 2019;34(3):340-8.
  • 32. Dellière S, Cynober L. Is transthyretin a good marker of nutritional status? Clinical Nutrition 2017;36(2):364-70.
  • 33. Sieber CC. Malnutrition and sarcopenia. Aging Clinical and Experimental Research. 2019;31(6):793-8.
  • 34. Rauh S, Antonuzzo A, Bossi P, Eckert R, Fallon M et al. Nutrition in patients with cancer: a new area for medical oncologists? A practising oncologist’s interdisciplinary position paper ESMO Open 2018;3(4):e000345.
  • 35. Hopancı DB, Çehreli R, Özveren A, Meseri R, Uslu R et al. Evaluation of sarcopenia, sarcopenic obesity, and phase angle in geriatric gastrointestinal cancer patients: before and after chemotherapy. Turkish Journal of Medical Science 2019;49(2):583-8.

KANSER TANILI HASTALARIN KEMOTERAPİ ÖNCESİ VE SONRASI YAŞA GÖRE SARKOPENİ VE BESLENME DURUMUNUN DEĞERLENDİRİLMESİ

Yıl 2022, , 6 - 13, 10.02.2022
https://doi.org/10.26650/JARHS2022-1035701

Öz

Amaç: Kemoterapiye yeni başlayacak veya başlamış olan, geriatrik olan ve olmayan hastalarda sarkopeninin ve beslenme durumunun değerlendirilmesidir. Gereç ve Yöntem: Bu çalışmada, ilk kez kemoterapi alacak yetişkin kanser hastalar, kemoterapi tedavisinin 3.ayı ile 1.yılı arasında olan hastalarla sarkopeni yönünden ve beslenme durumları açısından değerlendirilmiştir. Hastaların geriatrik olup olmamasına göre karşılaştırılmış ve ayrıca sarkopenik olan hastalar kanser türlerine göre sınıflandırılarak da değerlendirilmiştir. Hastaların el kavrama kuvvetleri, biyoelektrik impedans ile apendiküler iskelet kas indeksi (boya göre düzeltilmiş), yürüme hızları ölçülmüş ve sarkopenik düzeyleri, malnütrisyon riskleri, üç günlük besin tüketim kayıtları ve laboratuvar parametreleri incelenmiştir. Bulgular: Toplamda 123 yetişkin hasta değerlendirilmiştir. Çalışmadaki hastaların 58’i (%47,2’si) geriatriktir (65 yaş ≥) ve %39’unun malnütrisyon riski yüksektir. Geriatrik olan grupta (%46,6) olmayanlara göre (%32,3) anlamlı derecede malnütrisyon riski yüksek bulunmuştur (p=0,029). Malnütrisyon riski kanserin tanı gruplarıyla da ilişkili bulunmuştur. Meme kanserine göre, malnütrisyon riskinin hepatobiliyer kanserlerde (pankreas dahil) 18,2 kat (p=0,002) ve diğer kanserlerde (baş-boyun, sarkom, beyin, mide, periton) 7,6 kat (p=0,018) daha yüksek olduğu görülmüştür. Sonuç: Özellikle geriatrik hastalarda, kanserin neden olduğu malnütrisyonun, tedavinin başlangıcında farkedilmesi ve değerledirilmesi önemlidir.

Kaynakça

  • 1. Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H et al. ESPEN guidelines on nutrition in cancer patients. Clinical Nutrition 2017;36(1):11-48.
  • 2. Brandhorst S, Longo VD. Fasting and Caloric Restriction in Cancer Prevention and Treatment. Recent Results Cancer Res 2016;207:241-66.
  • 3. Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods.Int J Cancer 2019;144(8):1941-53.
  • 4. Benoist S, Brouquet A.Nutritional assessment and screening for malnutrition. J Visc Surg 2015;152(1):S3-7.
  • 5. Mislang AR, Di Donato S, Hubbard J, Krishna L, Mottino G et al. Nutritional management of older adults with gastrointestinal cancers: An International Society of Geriatric Oncology (SIOG) review paper. Journal of Geriatric Oncology 2018;9(4):382-92.
  • 6. Mantzorou M, Koutelidakis A, Theocharis S, Giaginis C. Clinical value of nutritional status in cancer: What is its impact and how it affects disease progression and prognosis? Nutrition in Cancer 2017;69(8):1151-76.
  • 7. Davies M. Nutritional screening and assessment in cancerassociated malnutrition. Eur J Oncol Nurs 2005;9(2):S64-73.
  • 8. Cederholm T, Jensen GL, Correia MITD, Gonzalez MC, Fukushima R et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clinical Nutrition 2019;38(1):1-9.
  • 9. Arends J ve diğerleri. ESPEN expert group recommendations for action against cancer-related malnutrition. Clinical Nutrition 2017;36(5):1187-96.
  • 10. Muscaritoli M, Anker SD, Argilés J, Aversa Z, Bauer JM et al. Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) “cachexia-anorexia in chronic wasting diseases” and “nutrition in geriatrics”. Clinical Nutrition 2010;29(2):154-9.
  • 11. Cereda E, Turri A, Klersy C, Cappello S, Ferrari A et al. Whey protein isolate supplementation improves body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy. Cancer Med 2019;8(16):6923-32.
  • 12. Mattox TW. Cancer Cachexia: Cause, Diagnosis, and Treatment. Nutr Clin Pract 2017;32(5):599-606.
  • 13. Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncology 2011;12(5):489-95.
  • 14. Tournadre A. Sarcopenia. Joint Bone Spine 2019;86(3):309-14.
  • 15. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019;48(1):16-31.
  • 16. Bahat G, Altinkaynak M, Karan MA. Handgrip strength cut-offs to define sarcopenia in Turkish population. Aging Clinical and Experimental Research 2021;33(1):207-8.
  • 17. Saka B, Kaya O, Ozturk GB, Erten N, Karan MA. Malnutrition in the elderly and its relationship with other geriatric syndromes. Clinical Nutrition 2010;29(6):745-8.
  • 18. Alan S et al. Patterns of Comorbidity in Older Adults with Heart Failure: The Cardiovascular Research Network PRESERVE Study. Journal of American Geriatrics Society 2013;61(1):26-33.
  • 19. Xiao J, Caan BJ, Cespedes Feliciano EM, Meyerhardt JA et al.Association of Low Muscle Mass and Low Muscle Radiodensity With Morbidity and Mortality for Colon Cancer Surgery. JAMA Surg 2020;155(10):942-9.
  • 20. Ubachs J, Ziemons J, Minis-Rutten IJG, Kruitwagen RFPM, Kleijnen J et al. Sarcopenia and ovarian cancer survival: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2019;10(6):1165- 74.
  • 21. Robinson SM, Reginster JY, Rizzoli R, Shaw SC, Kanis JA, Bautmans I et al. Does nutrition play a role in the prevention and management of sarcopenia? Clin Nutr 2018;37(4):1121-32.
  • 22. Bahat G, Kilic C , Altinkaynak M , Karan MA. Comparison of standard versus population-specific handgrip strength cut-off points in the detection of probable sarcopenia after launch of EWGSOP2. Aging Male 2020;23(5):1564-9.
  • 23. Kılınçarslan MG, Şahin EM, Sarıgül B, Kocaoğlu SB. Postmenopozal Türk Kadınlarında Vücut Kompozisyonu ve Fiziksel Aktivitenin Kemik Mineral Yoğunluğu ile İlişkisi. Turk J Osteoporos 2020;26:70-4.
  • 24. Bossi P, Delrio P, Mascheroni A, Zanetti M. The Spectrum of Malnutrition/Cachexia/Sarcopenia in Oncology According to Different Cancer Types and Settings: A Narrative Review. Nutrients 2021;13(6):1980.
  • 25. Oflazoglu U, Alacacioglu A, Varol U, Y Kucukzeybek Y, Salman T et al. Chemotherapy-induced sarcopenia in newly diagnosed cancer patients: Izmir Oncology Group (IZOG) study. Supportive Care in Cancer 2020;28(6):2899-910.
  • 26. Keller K. Sarcopenia. Wien Med Wochenschr 2019:169(7-8):157-72.
  • 27. Hébuterne X, Lemarié E, Michallet M, Montreuil CB, Schneider SM et al. Prevalence of malnutrition and current use of nutrition support in patients with cancer. Journal of Parentereral Enteral Nutrition 2014;38(2):196-204.
  • 28. Ryan AM, Power DG, Daly L, Cushen SJ, Bhuachalla EN et al. Cancerassociated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later. Proc Nutr Soc 2016;75(2):199-211.
  • 29. Williams GR, Chen Y, Kenzik KM, McDonald A, Shachar SS et al. Assessment of Sarcopenia Measures, Survival, and Disability in Older Adults Before and After Diagnosis With Cancer. The Journal of The American Medical Association 2020;3(5):e204783.
  • 30. Zhang Z, Pereira SL, Luo M, Matheson EM. Evaluation of Blood Biomarkers Associated with Risk of Malnutrition in Older Adults: A Systematic Review and Meta-Analysis. Nutrients 2017;9(8):829.
  • 31. Loftus TJ, Brown MP, Slish JH, Rosenthal MD. Serum Levels of Prealbumin and Albumin for Preoperative Risk Stratification. Nutrition in Clinical Practice 2019;34(3):340-8.
  • 32. Dellière S, Cynober L. Is transthyretin a good marker of nutritional status? Clinical Nutrition 2017;36(2):364-70.
  • 33. Sieber CC. Malnutrition and sarcopenia. Aging Clinical and Experimental Research. 2019;31(6):793-8.
  • 34. Rauh S, Antonuzzo A, Bossi P, Eckert R, Fallon M et al. Nutrition in patients with cancer: a new area for medical oncologists? A practising oncologist’s interdisciplinary position paper ESMO Open 2018;3(4):e000345.
  • 35. Hopancı DB, Çehreli R, Özveren A, Meseri R, Uslu R et al. Evaluation of sarcopenia, sarcopenic obesity, and phase angle in geriatric gastrointestinal cancer patients: before and after chemotherapy. Turkish Journal of Medical Science 2019;49(2):583-8.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makaleleri
Yazarlar

Tuğçe Aytulu 0000-0002-2552-2847

Fatih Selçukbiricik Bu kişi benim 0000-0002-1273-1674

Fulya Çalıkoğlu 0000-0002-0964-5142

Meltem Yılmaz Çan Bu kişi benim 0000-0003-4918-0316

Gözde Ergene Bu kişi benim 0000-0002-8276-0948

Halim İşsever 0000-0002-5435-706X

İlhan Satman Bu kişi benim 0000-0001-8613-1797

Yayımlanma Tarihi 10 Şubat 2022
Gönderilme Tarihi 14 Aralık 2021
Yayımlandığı Sayı Yıl 2022

Kaynak Göster

MLA Aytulu, Tuğçe vd. “KANSER TANILI HASTALARIN KEMOTERAPİ ÖNCESİ VE SONRASI YAŞA GÖRE SARKOPENİ VE BESLENME DURUMUNUN DEĞERLENDİRİLMESİ”. Sağlık Bilimlerinde İleri Araştırmalar Dergisi, c. 5, sy. 1, 2022, ss. 6-13, doi:10.26650/JARHS2022-1035701.